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Each month, SRF Chief Medical Officer Dr. Gregory Gordon responds to questions from the scleroderma community.
Question: Why does scleroderma cause pulmonary arterial hypertension (PAH)?
Answer: Scleroderma injures the small arteries throughout the body by damaging the lining of these vessels. Over time, the vessel walls thicken and scar, and the passages get narrower. When this damage occurs in the fingers and toes, it causes Raynaud’s Phenomenon, where fingers turn white or blue in the cold. When it occurs in the lungs, it causes pulmonary arterial hypertension (PAH).
As the small arteries in the lungs narrow, the right side of the heart has to pump harder to push blood through them. At first there may be no symptoms. But over time, as PAH progresses, it can cause shortness of breath with activity, tiredness or swelling in the ankles.
These are signs that the heart muscle is struggling to pump enough blood through the narrowed arteries. In addition, scleroderma itself can directly harm the heart muscle, which makes it harder for the heart to keep up with the extra workload.
Read his full response to this question, along with his response to a question about preventing PAH in scleroderma, on our blog.
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