Pulmonary Arterial Hypertension Mild, Moderate, Severe Classification

Written by Xie Zhi Hong
Cardiology
Updated on March 19, 2025
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Pulmonary artery pressure refers to the average pressure in the pulmonary artery when the body is at rest. Generally, the normal average pulmonary artery pressure is less than 25mmHg. Pulmonary hypertension is considered when the pulmonary artery pressure exceeds 25mmHg. The grading is generally divided into three levels based on the data: the first level is mild pulmonary hypertension with pulmonary artery pressure between 26-35mmHg; moderate with pressure between 36-45mmHg; and severe with pressure greater than 45mmHg. If classified by the functional impact of pulmonary hypertension, grade I pulmonary hypertension is characterized by patients who are not limited in daily activities, and do not experience symptoms such as shortness of breath, difficulty breathing, or chest tightness after physical activity. Grade II pulmonary hypertension patients are limited by mild activities, do not feel discomfort at rest, but experience symptoms like difficulty breathing, fatigue, chest tightness, and chest pain during everyday activities. Grade III pulmonary hypertension patients have significantly limited activity; they feel no discomfort at rest, but experience symptoms like difficulty breathing, fatigue, and chest pain after only mild activity, less than everyday activities. Grade IV pulmonary hypertension is severe, with patients experiencing symptoms such as difficulty breathing and feeling tightness in their chest even at rest without any activity.

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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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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 Li Hai Wen
Cardiology
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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 Li Hai Wen
Cardiology
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What to do with mild pulmonary hypertension?

Pulmonary artery hypertension is a relatively common disease in daily life. Based on the different pulmonary artery pressures, it can be divided into mild, moderate, and severe pulmonary artery hypertension. When the right heart catheter measures pulmonary artery pressure between 30 to 50 mmHg, this situation often belongs to mild pulmonary artery hypertension. So, what should one do if diagnosed with mild pulmonary artery hypertension? Generally, mild pulmonary artery hypertension is not serious and usually does not cause noticeable symptoms, so no special treatment is needed. However, having mild pulmonary artery hypertension does not mean it can be taken lightly. It is important to undergo regular examinations under the guidance of a doctor, identify the cause of the increased pulmonary artery pressure, and treat the symptoms timely.

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Written by Zeng Wei Jie
Cardiology
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Pulmonary hypertension belongs to which department?

Pulmonary hypertension is a relatively complex disease with many types, and the department to which a patient should go depends on the type. For example, patients with idiopathic pulmonary hypertension often need to visit the department of cardiology. Similarly, pulmonary hypertension associated with left heart disease also falls under the jurisdiction of cardiology. However, if the pulmonary hypertension is related to hypoxia, these patients typically belong to the department of respiratory medicine. Furthermore, there are cases of chronic thromboembolic pulmonary hypertension, where patients can be seen either in cardiology or respiratory medicine. Therefore, answering which department pulmonary hypertension belongs to is a complex issue that requires classification based on the cause of the disease.