How is pulmonary hypertension treated?

Written by Tang Li
Cardiology
Updated on September 10, 2024
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The treatment of pulmonary hypertension mainly focuses on identifying the cause. For idiopathic pulmonary hypertension, treatment primarily targets vascular constriction, endothelial damage, thrombus formation, and heart failure. This is to restore the tension, resistance, and pressure of the pulmonary vessels, improve the patient's sexual function, increase cardiac output, and improve quality of life. The main treatments include: 1. Drug therapy, which includes calcium channel blockers, prostacyclin, nitric oxide, endothelin receptor antagonists, and related anticoagulants. Anticoagulants do not improve symptoms, but can slow down disease progression and improve prognosis in some aspects. However, in cases of right heart failure, hepatic congestion, and ascites, cardiotonic diuretics are used, such as digoxin and anti-calcium channel blockers, which can cause adverse reactions like decreased myocardial contractility. But these drugs should be administered under the guidance of a doctor. In advanced stages of pulmonary arterial hypertension, heart-lung transplantation may be considered.

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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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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.

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What happens to pulmonary hypertension if you stay up late?

Because if pulmonary hypertension is not treated consistently, it can further develop into pulmonary heart disease, which is very dangerous. Patients may also experience palpitations, chest tightness, and difficulty breathing, especially after respiratory activities, where palpitations and breathing difficulties worsen. Frequent staying up late can lead to abnormal arterial hypertension in patients and cause this high pressure to continue to rise. Sometimes the condition can worsen because once patients are diagnosed with pulmonary hypertension, it is important to rest, especially to avoid staying up late, as it can cause further worsening due to vascular constriction.

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Early symptoms of pulmonary arterial hypertension

It depends on what disease causes pulmonary hypertension. There are several common causes of pulmonary hypertension, one of which is a pathological change in the pulmonary artery itself. Early on, there may be signs of mild increases in pulmonary artery pressure, possibly accompanied by slight right heart dysfunction. At this stage, symptoms such as mild hypotension and hypoxia might occur, manifesting as dizziness and fatigue. If the pulmonary hypertension is due to a disease of the lungs themselves, such as changes in the lung interstitium, then early symptoms of hypoxia will be more apparent, with chest tightness, slight breathing difficulties, and feelings of suffocation. If pulmonary hypertension is caused by conditions such as pulmonary embolism—specifically, an embolism in a smaller branch—the increase in pulmonary artery pressure may not be significant and will also be mild. This may be accompanied by a slight drop in blood pressure and mild breathing difficulties; however, because it is mild pulmonary hypertension, these symptoms are not severe and might include slight respiratory difficulty, mild chest tightness, shortness of breath, and mild dizziness. Therefore, early symptoms of pulmonary hypertension are typically not pronounced and generally do not attract special attention from patients.

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The harms of pulmonary arterial hypertension during pregnancy

Pulmonary hypertension is categorized into mild, moderate, and severe stages. If it is mild pulmonary hypertension, pregnancy generally does not have a major impact. However, for those with moderate or especially severe pulmonary hypertension, pregnancy can be very dangerous for both the mother and the fetus. As the fetus grows, pulmonary hypertension can lead to ischemia and hypoxia, which can worsen over time. The mother is likely to develop symptoms of acute heart failure, severely endangering her life. Additionally, it can cause intrauterine hypoxia for the fetus, leading to miscarriage or stillbirth. Therefore, pregnancy is not recommended for patients with moderate, and particularly severe, pulmonary hypertension.