Pulmonary Hypertension


Pulmonary hypertension is seen in what disease?
Pulmonary arterial hypertension can be seen in various diseases. The first major category is arterial pulmonary hypertension. Patients may have idiopathic arterial pulmonary hypertension, familial pulmonary hypertension, and arterial pulmonary hypertension caused by related diseases. Such as collagen vascular disease, portal hypertension, HIV infection, drug or toxin-induced thyroid dysfunction, myeloproliferative disorders, splenectomy, and hemoglobinopathies can also lead to arterial pulmonary hypertension. Venous pulmonary hypertension is mostly associated with left heart system diseases, such as left atrial and left ventricular heart diseases, left heart valvular diseases. Conditions like chronic obstructive pulmonary disease, interstitial lung disease, and sleep apnea related to hypotension also lead to pulmonary hypertension. Another category is chronic thrombotic or thromboembolic pulmonary hypertension. For instance, proximal or distal pulmonary artery thromboembolism, parts such as tumors, parasites, and foreign objects can also cause pulmonary embolism, thereby causing thromboembolic pulmonary hypertension.


Late-stage symptoms of pulmonary arterial hypertension
The prognosis of pulmonary hypertension depends on the function of the right heart. The main symptoms in the final stage of pulmonary hypertension are those of right heart failure. At this time, the patient mainly shows symptoms such as swelling of the lower limbs, oliguria, and abdominal distension. The difficulty in breathing may be slightly less severe than in the early stages. These symptoms are mainly caused by venous congestion in the systemic circulation, which prevents blood from returning from the lower limbs, leading to edema or ascites in the lower parts of the body.


Mild pulmonary hypertension
Pulmonary hypertension is a relatively common disease in daily life. Many patients, when they go to the hospital for examination, often see reports from cardiac ultrasound indicating mild pulmonary hypertension, moderate pulmonary hypertension, or non-severe pulmonary hypertension. So, what are the criteria for mild pulmonary hypertension? Generally, pulmonary artery pressure is measured using right heart catheterization or cardiac ultrasound. If the pressure is between 30 to 50 mmHg, this is often considered mild pulmonary hypertension. Generally, the prognosis for mild pulmonary hypertension is quite good, typically not producing noticeable symptoms or affecting health.


What to do with mild pulmonary hypertension?
Pulmonary artery hypertension is a relatively common disease in daily life. Based on the different pulmonary artery pressures, it can be divided into mild, moderate, and severe pulmonary artery hypertension. When the right heart catheter measures pulmonary artery pressure between 30 to 50 mmHg, this situation often belongs to mild pulmonary artery hypertension. So, what should one do if diagnosed with mild pulmonary artery hypertension? Generally, mild pulmonary artery hypertension is not serious and usually does not cause noticeable symptoms, so no special treatment is needed. However, having mild pulmonary artery hypertension does not mean it can be taken lightly. It is important to undergo regular examinations under the guidance of a doctor, identify the cause of the increased pulmonary artery pressure, and treat the symptoms timely.


Pulmonary hypertension is treated by which department?
Pulmonary arterial hypertension is a common clinical condition with complex causes, and depending on the cause, patients may visit different departments. The common causes of pulmonary arterial hypertension include the following. The first type is venous pulmonary hypertension, which is caused by diseases of the left heart system. Patients with this condition need to visit the department of cardiology, mainly to control heart failure. The second type is chronic thromboembolic pulmonary hypertension. The main reasons include thromboembolism in the proximal or distal pulmonary arteries, or due to tumors, parasites, foreign bodies, etc., leading to pulmonary embolism. Diseases of this type require visits to the respiratory department. Additionally, chronic pulmonary heart disease, such as heart failure caused by chronic obstructive pulmonary disease, interstitial lung disease, sleep breathing disorders, and hypoventilation lesions, also lead to pulmonary arterial hypertension and should be treated in the respiratory department. Furthermore, some rheumatic immune diseases and congenital heart diseases can also cause pulmonary arterial hypertension. As pulmonary arterial hypertension has gradually received more attention, some hospitals have established specialized outpatient clinics for pulmonary arterial hypertension.


Where can moxibustion be applied for pulmonary hypertension?
If the patient has pulmonary arterial hypertension, it is advisable for the patient to actively monitor their blood pressure changes sometimes. This type of pulmonary arterial hypertension may sometimes require drug treatment. The disease primarily manifests as the patient experiencing coughing, phlegm production, palpitations after activity, shortness of breath, and occasionally accompanied by difficulty breathing, especially worsening at night. Sometimes there may also be swelling in the lower extremities. Regarding Traditional Chinese Medicine, herbal medicine, and acupuncture, these treatments can relieve symptoms. However, pulmonary arterial hypertension can sometimes further develop into cor pulmonale, which is irreversible. In such cases, it is recommended to be hospitalized for infusion therapy.


Is moderate pulmonary hypertension serious?
Pulmonary hypertension is a common clinical condition with complex etiology, which can be caused by various cardiac, pulmonary, or pulmonary vascular diseases. The current diagnostic criteria for pulmonary hypertension are an average pulmonary arterial pressure greater than 25 mmHg at sea level in a resting state, or greater than 30 mmHg during exercise, as measured via right heart catheterization. The severity of pulmonary hypertension can be categorized based on resting average pulmonary arterial pressure levels into mild (26 to 35 mmHg), moderate (36 to 45 mmHg), and severe (greater than 45 mmHg). Echocardiography is the most important non-invasive screening method for pulmonary hypertension. Assessing the severity of moderate pulmonary hypertension not only involves the measurement of average pulmonary arterial pressure but also necessitates identifying its etiology. Since pulmonary hypertension is a disease with a complex etiology, it is crucial to first clarify the cause, and then further determine the patient's cardiopulmonary function status, whether it is in a compensatory or decompensatory stage. Additionally, it is important to determine if there are any related complications, such as pulmonary hypertension stemming from lung-induced conditions. When patients exhibit complications like pulmonary encephalopathy, acid-base imbalance, electrolyte disturbances, arrhythmias, or even shock and gastrointestinal bleeding, the severity of pulmonary hypertension can be extremely severe.


How is pulmonary hypertension measured?
There are usually two methods to measure pulmonary arterial hypertension. One is through echocardiography to estimate, by measuring the speed of tricuspid regurgitation and then calculating the systolic pressure of the pulmonary artery through a formula. This method may overestimate or underestimate, hence its accuracy is not reliable. The gold standard is measuring pulmonary artery pressure via right heart catheterization. The downside of this gold standard is that it is an invasive procedure, which needs to be performed in a catheterization room; compared to ultrasound, it is also more costly. These are the two methods, each with its pros and cons. We need to choose based on the patient's situation.


How is pulmonary hypertension treated?
The treatment of pulmonary hypertension mainly focuses on identifying the cause. For idiopathic pulmonary hypertension, treatment primarily targets vascular constriction, endothelial damage, thrombus formation, and heart failure. This is to restore the tension, resistance, and pressure of the pulmonary vessels, improve the patient's sexual function, increase cardiac output, and improve quality of life. The main treatments include: 1. Drug therapy, which includes calcium channel blockers, prostacyclin, nitric oxide, endothelin receptor antagonists, and related anticoagulants. Anticoagulants do not improve symptoms, but can slow down disease progression and improve prognosis in some aspects. However, in cases of right heart failure, hepatic congestion, and ascites, cardiotonic diuretics are used, such as digoxin and anti-calcium channel blockers, which can cause adverse reactions like decreased myocardial contractility. But these drugs should be administered under the guidance of a doctor. In advanced stages of pulmonary arterial hypertension, heart-lung transplantation may be considered.


Pulmonary hypertension belongs to which department?
Pulmonary hypertension is a relatively complex disease with many types, and the department to which a patient should go depends on the type. For example, patients with idiopathic pulmonary hypertension often need to visit the department of cardiology. Similarly, pulmonary hypertension associated with left heart disease also falls under the jurisdiction of cardiology. However, if the pulmonary hypertension is related to hypoxia, these patients typically belong to the department of respiratory medicine. Furthermore, there are cases of chronic thromboembolic pulmonary hypertension, where patients can be seen either in cardiology or respiratory medicine. Therefore, answering which department pulmonary hypertension belongs to is a complex issue that requires classification based on the cause of the disease.