Pulmonary Arterial Hypertension Mild, Moderate, Severe Classification

Written by Xie Zhi Hong
Cardiology
Updated on March 19, 2025
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Pulmonary artery pressure refers to the average pressure in the pulmonary artery when the body is at rest. Generally, the normal average pulmonary artery pressure is less than 25mmHg. Pulmonary hypertension is considered when the pulmonary artery pressure exceeds 25mmHg. The grading is generally divided into three levels based on the data: the first level is mild pulmonary hypertension with pulmonary artery pressure between 26-35mmHg; moderate with pressure between 36-45mmHg; and severe with pressure greater than 45mmHg. If classified by the functional impact of pulmonary hypertension, grade I pulmonary hypertension is characterized by patients who are not limited in daily activities, and do not experience symptoms such as shortness of breath, difficulty breathing, or chest tightness after physical activity. Grade II pulmonary hypertension patients are limited by mild activities, do not feel discomfort at rest, but experience symptoms like difficulty breathing, fatigue, chest tightness, and chest pain during everyday activities. Grade III pulmonary hypertension patients have significantly limited activity; they feel no discomfort at rest, but experience symptoms like difficulty breathing, fatigue, and chest pain after only mild activity, less than everyday activities. Grade IV pulmonary hypertension is severe, with patients experiencing symptoms such as difficulty breathing and feeling tightness in their chest even at rest without any activity.

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Written by Wang Chun Mei
Pulmonology
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Can people with pulmonary hypertension run?

In cases where pulmonary hypertension is not too severe, it is appropriate to do some light running, such as jogging. However, in severe episodes of pulmonary hypertension, vigorous activity is strictly prohibited, and some patients are even advised against getting out of bed. Therefore, for patients with pulmonary hypertension, the ability to run mainly depends on their individual condition. For example, in the early stages where the disease is not very severe, and some patients may only experience symptoms like shortness of breath and fatigue after activity without chest tightness, rapid breathing, or chest pain, these patients can opt for light jogging based on their own conditions.

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Written by Chen Tian Hua
Cardiology
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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.

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Written by Tang Li
Cardiology
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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.

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Written by Li Hai Wen
Cardiology
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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 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.