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Pulmonary Hypertension
How to diagnose pulmonary arterial hypertension?
To accurately diagnose pulmonary hypertension, the following aspects should be considered: symptoms, signs, laboratory, and other tests. Early-stage pulmonary hypertension usually doesn't exhibit clear symptoms, but discomfort occurs during intense activities. Common symptoms include difficulty breathing, chest pain, dizziness or fainting, and coughing up blood. Additionally, patients should undergo laboratory tests such as blood tests including liver function tests and HIV antibody testing, serological tests; an electrocardiogram to check for right ventricular enlargement or hypertrophy; chest X-ray; echocardiography and Doppler ultrasound; pulmonary function tests; blood gas analysis; radioactive isotope lung ventilation/perfusion scan; right heart catheterization; and lung biopsy.
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.
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.
Which department should pulmonary hypertension be registered under?
Pulmonary hypertension is becoming increasingly common in our daily lives. Pulmonary hypertension refers to a condition where the pressure in the pulmonary artery exceeds 30 mmHg. If you have pulmonary hypertension and need to see a doctor, you might wonder which department to visit in such a large hospital with many departments. As the name implies, pulmonary hypertension is primarily characterized by an increase in pressure in the pulmonary artery. Therefore, you can make an appointment with the Department of Cardiology. Additionally, the Department of Respiratory Medicine or the Department of Vascular Surgery are also suitable options for seeking treatment.
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.
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.
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.
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.
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.
Where can moxibustion be applied for pulmonary hypertension?
If the patient has pulmonary arterial hypertension, it is advisable for the patient to actively monitor their blood pressure changes sometimes. This type of pulmonary arterial hypertension may sometimes require drug treatment. The disease primarily manifests as the patient experiencing coughing, phlegm production, palpitations after activity, shortness of breath, and occasionally accompanied by difficulty breathing, especially worsening at night. Sometimes there may also be swelling in the lower extremities. Regarding Traditional Chinese Medicine, herbal medicine, and acupuncture, these treatments can relieve symptoms. However, pulmonary arterial hypertension can sometimes further develop into cor pulmonale, which is irreversible. In such cases, it is recommended to be hospitalized for infusion therapy.