Late-stage symptoms of pulmonary arterial hypertension

Written by Zeng Wei Jie
Cardiology
Updated on September 22, 2024
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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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Written by Li Hai Wen
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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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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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Written by Di Zhi Yong
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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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Written by Tang Li
Cardiology
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Can pulmonary hypertension cause coughing?

Pulmonary arterial hypertension is a commonly seen clinical condition with complex causes, which may arise from various cardiac, pulmonary, and pulmonary vascular diseases. When pulmonary arterial hypertension occurs, due to increased resistance in the pulmonary circulation, the load on the right heart will increase, eventually leading to right heart failure, thus causing a series of clinical manifestations. In the early stages, pulmonary arterial hypertension may not present with obvious symptoms, and discomfort may be felt during intense exercise, with most patients showing shortness of breath after activity. During the compensatory period of pulmonary heart function, symptoms such as palpitations, shortness of breath, fatigue, and decreased endurance may occur during activities, and acute infections can also exacerbate these conditions, potentially causing mild chest pain or hemoptysis. Some patients may exhibit signs of heart dysfunction, like coughing and expectorating phlegm.

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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.