Pulmonary arterial hypertension standards

Written by Tang Li
Cardiology
Updated on September 28, 2024
00:00
00:00

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.

Other Voices

doctor image
home-news-image
Written by Tang Li
Cardiology
1min 31sec home-news-image

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.

doctor image
home-news-image
Written by Li Hai Wen
Cardiology
41sec home-news-image

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.

doctor image
home-news-image
Written by Tang Li
Cardiology
1min 21sec home-news-image

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.

doctor image
home-news-image
Written by Tang Li
Cardiology
1min 34sec home-news-image

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.

doctor image
home-news-image
Written by Tang Li
Cardiology
55sec home-news-image

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.