Subscribe
Pulmonary Hypertension
Is pulmonary hypertension serious?
Whether pulmonary arterial hypertension (PAH) is serious depends on the cause and the severity of the PAH. It is generally categorized into mild, moderate, and severe. If the PAH is caused by diseases such as pulmonary embolism and is severe, this condition is very serious and may lead to sudden death. If it is chronic pulmonary arterial hypertension with also a severe degree and lasts for a long time, it can lead to right heart failure, and subsequently right heart failure may cause left heart failure, which is also a very serious issue. If the pulmonary hypertension is a reversible, mild condition, such as due to embolism in the pulmonary artery branches which resolves after the embolism is cleared, then the PAH can easily recover, and in this case, it is not serious. However, if it is caused by chronic lung diseases such as chronic obstructive pulmonary disease or pulmonary interstitial fibrosis leading to chronic pulmonary hypertension, it is quite serious because it is a progressively worsening disease. The pulmonary artery pressure will not decrease, and over time it will gradually worsen, eventually leading to heart failure.
Pulmonary Arterial Hypertension Mild, Moderate, Severe Classification
Pulmonary artery pressure refers to the average pressure in the pulmonary artery when the body is at rest. Generally, the normal average pulmonary artery pressure is less than 25mmHg. Pulmonary hypertension is considered when the pulmonary artery pressure exceeds 25mmHg. The grading is generally divided into three levels based on the data: the first level is mild pulmonary hypertension with pulmonary artery pressure between 26-35mmHg; moderate with pressure between 36-45mmHg; and severe with pressure greater than 45mmHg. If classified by the functional impact of pulmonary hypertension, grade I pulmonary hypertension is characterized by patients who are not limited in daily activities, and do not experience symptoms such as shortness of breath, difficulty breathing, or chest tightness after physical activity. Grade II pulmonary hypertension patients are limited by mild activities, do not feel discomfort at rest, but experience symptoms like difficulty breathing, fatigue, chest tightness, and chest pain during everyday activities. Grade III pulmonary hypertension patients have significantly limited activity; they feel no discomfort at rest, but experience symptoms like difficulty breathing, fatigue, and chest pain after only mild activity, less than everyday activities. Grade IV pulmonary hypertension is severe, with patients experiencing symptoms such as difficulty breathing and feeling tightness in their chest even at rest without any activity.
Does pulmonary hypertension require oxygen therapy?
Whether pulmonary arterial hypertension requires oxygen therapy primarily depends on the patient's blood oxygen saturation level at rest. Generally, it is recommended to measure the oxygen saturation for patients with pulmonary arterial hypertension. Due to intrapulmonary shunting and shunting between the left and right heart during pulmonary arterial hypertension, arterial and venous blood mix directly, resulting in very low blood oxygen saturation in patients. Generally speaking, if the measured blood oxygen saturation at rest is below 90%, such patients often need oxygen therapy. Even if it does not drop below 90%, patients with moderate to severe pulmonary arterial hypertension also require oxygen therapy. Oxygen therapy can improve hypoxia, significantly dilating the pulmonary vessels and thus alleviating symptoms of high pulmonary artery pressure. It is very valuable for improving patient prognosis and survival time.
How dangerous is pulmonary hypertension?
Pulmonary hypertension is itself a very complex disease, with many causative factors in clinical practice. In the early stages, patients may only exhibit symptoms such as shortness of breath after activity, difficulty breathing, and overall fatigue. However, as the condition gradually worsens, patients may experience chest tightness, rapid breathing, and even chest pain, fainting, or dizziness. If the patient also has right heart dysfunction, they may experience symptoms like swelling of the lower limbs, as well as diarrhea and abdominal distension. Therefore, if pulmonary hypertension patients are definitively diagnosed and do not receive timely appropriate treatment, the accompanying clinical symptoms may rapidly worsen. The patient's life may be at risk due to severe symptoms such as hypoxia or fainting.
Symptoms of pulmonary hypertension include:
The clinical symptoms of pulmonary hypertension primarily include: 1. Shortness of breath, which is the most common symptom of pulmonary hypertension. Many patients experience shortness of breath as their initial symptom, which is often related to physical activity. As the condition progresses, the shortness of breath tends to worsen. 2. Some patients may also experience chest pain, dizziness, or fainting. 3. Some patients may cough up blood, usually only a small amount, but occasionally there can be a significant amount. 4. Patients with pulmonary hypertension caused by chronic obstructive pulmonary disease may experience repeated symptoms of coughing and coughing up phlegm. 5. Patients with pulmonary hypertension often experience fatigue and weakness.
Pulmonary hypertension vomiting, what's the matter?
In the early stages, arterial hypertension may present no symptoms. However, when it reaches a certain severity, it can lead to difficulties in breathing, tightness in the chest, and may cause edema in the gastrointestinal tract, facial swelling, and fluid accumulation in the abdominal and thoracic cavities. When gastrointestinal edema becomes severe, patients may experience nausea, vomiting, and a significant loss of appetite. Thus, these are symptoms of pulmonary arterial hypertension. Some cases of vomiting occur because patients consume high-fat foods that are not absorbed in a timely manner, leading to gastrointestinal bloating which causes nausea and vomiting. Additionally, some cases involve patients who use diuretics to reduce swelling; they often experience vomiting due to electrolyte imbalances, such as low sodium and low potassium levels.
How to diagnose pulmonary arterial hypertension?
To accurately diagnose pulmonary hypertension, the following aspects should be considered: symptoms, signs, laboratory, and other tests. Early-stage pulmonary hypertension usually doesn't exhibit clear symptoms, but discomfort occurs during intense activities. Common symptoms include difficulty breathing, chest pain, dizziness or fainting, and coughing up blood. Additionally, patients should undergo laboratory tests such as blood tests including liver function tests and HIV antibody testing, serological tests; an electrocardiogram to check for right ventricular enlargement or hypertrophy; chest X-ray; echocardiography and Doppler ultrasound; pulmonary function tests; blood gas analysis; radioactive isotope lung ventilation/perfusion scan; right heart catheterization; and lung biopsy.
Pulmonary arterial hypertension standards
Pulmonary hypertension is a common clinical condition with very complex causes, which can be induced by a variety of heart, lung, and pulmonary vascular diseases. When pulmonary hypertension occurs, because the resistance in the pulmonary circulation increases, the burden on the right heart increases, eventually leading to right heart failure, thus causing a series of clinical manifestations. During the disease course, pulmonary hypertension commonly shows progressive development. Currently, the diagnostic criteria for pulmonary hypertension are an average pulmonary artery pressure greater than 25 mmHg measured by right heart catheterization at sea level in a resting state, or greater than 30 mmHg during exercise. Additionally, diagnosing arteriogenic pulmonary hypertension requires, beyond the aforementioned criteria, that the pulmonary capillary wedge pressure or left ventricular end-diastolic pressure be less than 15 mmHg. The severity of pulmonary hypertension can be classified into mild, moderate, and severe stages based on resting mean pulmonary artery pressure levels. Mild is defined as 26 to 35 mmHg, moderate as 36 to 45 mmHg, and severe as greater than 45 mmHg. Echocardiography is the most important non-invasive examination method for assessing pulmonary hypertension, and it is recommended that a pulmonary artery systolic pressure greater than 40 mmHg be considered indicative of pulmonary hypertension according to echocardiographic standards.
Symptoms of pulmonary hypertension
The symptoms of pulmonary arterial hypertension are varied. In the early stages when pulmonary cardiac function is compensatory, the symptoms mainly include cough, phlegm, shortness of breath, difficulty breathing, and fatigue. Later, when pulmonary cardiac function becomes decompensated, symptoms of respiratory failure and right heart failure may occur. In cases of right heart failure, symptoms mainly manifest as systemic circulatory congestion, including visceral nausea, vomiting, palpitations, and pronounced shortness of breath. In respiratory failure, particularly pulmonary hypertension caused by pulmonary heart disease, symptoms like drowsiness, confusion, and gaze fixation, which are typical of pulmonary encephalopathy, may occur. Therefore, the symptoms of pulmonary arterial hypertension are diverse.
Which department should pulmonary hypertension be registered under?
Pulmonary hypertension is becoming increasingly common in our daily lives. Pulmonary hypertension refers to a condition where the pressure in the pulmonary artery exceeds 30 mmHg. If you have pulmonary hypertension and need to see a doctor, you might wonder which department to visit in such a large hospital with many departments. As the name implies, pulmonary hypertension is primarily characterized by an increase in pressure in the pulmonary artery. Therefore, you can make an appointment with the Department of Cardiology. Additionally, the Department of Respiratory Medicine or the Department of Vascular Surgery are also suitable options for seeking treatment.