How is pulmonary hypertension measured?

Written by Zeng Wei Jie
Cardiology
Updated on September 11, 2024
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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.

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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
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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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Written by Li Qiang
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Is pulmonary hypertension serious?

Whether pulmonary arterial hypertension (PAH) is serious depends on the cause and the severity of the PAH. It is generally categorized into mild, moderate, and severe. If the PAH is caused by diseases such as pulmonary embolism and is severe, this condition is very serious and may lead to sudden death. If it is chronic pulmonary arterial hypertension with also a severe degree and lasts for a long time, it can lead to right heart failure, and subsequently right heart failure may cause left heart failure, which is also a very serious issue. If the pulmonary hypertension is a reversible, mild condition, such as due to embolism in the pulmonary artery branches which resolves after the embolism is cleared, then the PAH can easily recover, and in this case, it is not serious. However, if it is caused by chronic lung diseases such as chronic obstructive pulmonary disease or pulmonary interstitial fibrosis leading to chronic pulmonary hypertension, it is quite serious because it is a progressively worsening disease. The pulmonary artery pressure will not decrease, and over time it will gradually worsen, eventually leading to heart failure.

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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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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.