Related Experiment Video
Updated: Jul 3, 2026
14:39
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
Pulmonary arterial hypertension masquerading as severe refractory asthma
L Achouh1, D Montani, G Garcia
1Université Paris-Sud 11, Centre National de Référence de L'Hypertension Artérielle Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital Antoine-Béclère, Clamart, France.
The European Respiratory Journal
|August 2, 2008
Summary
Severe pulmonary arterial hypertension can cause airway obstruction, mimicking asthma symptoms like chronic cough and wheezing. This rare presentation highlights the importance of considering pulmonary arterial hypertension in difficult-to-treat respiratory conditions.
Area of Science:
- Cardiology
- Pulmonology
- Respiratory Medicine
Background:
- Pulmonary arterial hypertension (PAH) diagnosis is typically followed by symptoms like dyspnea, not chronic cough or wheezing.
- Adult-onset severe refractory asthma is a common diagnosis for persistent respiratory symptoms.
Observation:
- Two non-smoking patients with confirmed severe PAH presented with chronic cough and wheezing.
- These symptoms led to a misdiagnosis of severe refractory asthma.
Findings:
- Both patients exhibited irreversible obstructive lung disease.
- Fibreoptic bronchoscopy and CT scans revealed extrinsic proximal airway obstruction caused by dilated pulmonary arteries compressing the mainstem bronchi.
Implications:
- Dilated central pulmonary arteries causing bronchial compression can masquerade as asthma in PAH patients.
- This emphasizes the need for thorough differential diagnosis in refractory asthma cases to include rare conditions like PAH.
Related Concept Videos
01:30Pulmonary Hypertension: Classification and Pathogenesis
Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
There are various classifications for PH, each relating to different underlying causes and also...
01:13Asthma III: Clinical Manifestations
Asthma presents with a characteristic pattern of episodic respiratory symptoms that reflect underlying airway inflammation, bronchoconstriction, and mucus hypersecretion. Although severity varies among individuals, certain clinical manifestations are considered hallmarks of the disorder and often guide diagnosis and assessment.Respiratory SymptomsA persistent cough is one of the most common early features of asthma. It is frequently dry and tends to worsen at night or in the early morning,...
01:20Asthma: Pathogenesis and Management
Asthma is a chronic pulmonary condition involving inflammation of the airways, hyper-reactivity, and reversible obstruction of the airways. This condition can significantly impact a person's quality of life, making breathing difficult and leading to distressing symptoms.
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:24Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features
Chronic bronchitis is a key phenotype of chronic obstructive pulmonary disease (COPD), characterized by airway-centered inflammation and mucus overproduction. It develops from long-term exposure to harmful particles or gases, most commonly cigarette smoke, which triggers a persistent inflammatory response.Cellular and Structural ChangesInflammation initially affects the large bronchi and later the smaller airways, with infiltration by immune cells, including neutrophils, macrophages, and...
01:26Asthma-II: Pathophysiology and Classification
Asthma is a prevalent chronic respiratory condition marked by inflammation and hyperresponsiveness of the airways. Its pathophysiology involves complex interactions among inflammatory pathways, immune responses, and neural mechanisms.
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:17Other Pulmonary Disorders
Respiratory disorders encompass a range of conditions with varying levels of severity. Asthma, marked by chronic airway inflammation and hypersensitivity, is one such condition. It can lead to airway obstruction due to factors like bronchial spasms, mucosal edema, increased mucus secretion, or epithelial damage. Asthma triggers are diverse, ranging from allergens to emotional upset, and treatment focuses on both immediate relief through bronchodilators and long-term inflammation suppression.