Pulmonary hypertension vomiting, what's the matter?

Written by Xie Zhi Hong
Cardiology
Updated on September 29, 2024
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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 Zeng Wei Jie
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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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Obvious symptoms of pulmonary hypertension

Pulmonary hypertension is a relatively common disease in everyday life. Based on the causes of pulmonary hypertension, it can be divided into two categories: primary and secondary pulmonary hypertension. Regardless of the type of pulmonary hypertension, patients often exhibit certain symptoms, such as chest tightness and shortness of breath, which are the most common symptoms. In severe cases, some patients may even experience syncope. When pulmonary hypertension affects the heart, causing right ventricular enlargement, patients often show signs of right heart failure, such as shortness of breath, difficulty breathing, lower limb edema, and gastrointestinal symptoms, such as nausea and abdominal distension.

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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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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.

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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.