Late-stage symptoms of pulmonary arterial hypertension

Written by Zeng Wei Jie

Cardiology

Updated on September 22, 2024

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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.

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Written by Tang Li

Cardiology

1min 57sec

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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 Tang Li

Cardiology

1min 34sec

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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 Xie Zhi Hong

Cardiology

1min 7sec

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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.

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Written by Tang Li

Cardiology

1min 31sec

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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.

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Written by Tang Li

Cardiology

1min 48sec

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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.