The harms of pulmonary arterial hypertension during pregnancy

Written by Li Hai Wen
Cardiology
Updated on September 04, 2024
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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.

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Written by Li Qiang
Intensive Care Unit
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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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Written by Tang Li
Cardiology
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Is moderate pulmonary hypertension serious?

Pulmonary hypertension is a common clinical condition with complex etiology, which can be caused by various cardiac, pulmonary, or pulmonary vascular diseases. The current diagnostic criteria for pulmonary hypertension are an average pulmonary arterial pressure greater than 25 mmHg at sea level in a resting state, or greater than 30 mmHg during exercise, as measured via right heart catheterization. The severity of pulmonary hypertension can be categorized based on resting average pulmonary arterial pressure levels into mild (26 to 35 mmHg), moderate (36 to 45 mmHg), and severe (greater than 45 mmHg). Echocardiography is the most important non-invasive screening method for pulmonary hypertension. Assessing the severity of moderate pulmonary hypertension not only involves the measurement of average pulmonary arterial pressure but also necessitates identifying its etiology. Since pulmonary hypertension is a disease with a complex etiology, it is crucial to first clarify the cause, and then further determine the patient's cardiopulmonary function status, whether it is in a compensatory or decompensatory stage. Additionally, it is important to determine if there are any related complications, such as pulmonary hypertension stemming from lung-induced conditions. When patients exhibit complications like pulmonary encephalopathy, acid-base imbalance, electrolyte disturbances, arrhythmias, or even shock and gastrointestinal bleeding, the severity of pulmonary hypertension can be extremely severe.

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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.

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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.

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Symptoms of pulmonary hypertension include:

The clinical symptoms of pulmonary hypertension primarily include: 1. Shortness of breath, which is the most common symptom of pulmonary hypertension. Many patients experience shortness of breath as their initial symptom, which is often related to physical activity. As the condition progresses, the shortness of breath tends to worsen. 2. Some patients may also experience chest pain, dizziness, or fainting. 3. Some patients may cough up blood, usually only a small amount, but occasionally there can be a significant amount. 4. Patients with pulmonary hypertension caused by chronic obstructive pulmonary disease may experience repeated symptoms of coughing and coughing up phlegm. 5. Patients with pulmonary hypertension often experience fatigue and weakness.