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 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.

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Written by Tang Li
Cardiology
1min 57sec home-news-image

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.

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Written by Wang Chun Mei
Pulmonology
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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.

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Written by Tang Li
Cardiology
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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.

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Written by Tang Li
Cardiology
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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.