Is moderate pulmonary hypertension serious?

Written by Tang Li
Cardiology
Updated on September 12, 2024
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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.

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Written by Chen Tian Hua
Cardiology
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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.

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Written by Yuan Qing
Pulmonology
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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.

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Written by Li Hai Wen
Cardiology
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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.

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Written by Tang Li
Cardiology
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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.

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Written by Zeng Wei Jie
Cardiology
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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.