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
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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 Zeng Wei Jie
Cardiology
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Symptoms of pulmonary hypertension

The symptoms of pulmonary arterial hypertension are varied. In the early stages when pulmonary cardiac function is compensatory, the symptoms mainly include cough, phlegm, shortness of breath, difficulty breathing, and fatigue. Later, when pulmonary cardiac function becomes decompensated, symptoms of respiratory failure and right heart failure may occur. In cases of right heart failure, symptoms mainly manifest as systemic circulatory congestion, including visceral nausea, vomiting, palpitations, and pronounced shortness of breath. In respiratory failure, particularly pulmonary hypertension caused by pulmonary heart disease, symptoms like drowsiness, confusion, and gaze fixation, which are typical of pulmonary encephalopathy, may occur. Therefore, the symptoms of pulmonary arterial hypertension are diverse.

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Written by Zeng Wei Jie
Cardiology
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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.

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Written by Li Hai Wen
Cardiology
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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.

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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.