Is pulmonary hypertension serious?

Written by Li Qiang
Intensive Care Unit
Updated on April 02, 2025
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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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Mild pulmonary hypertension

Pulmonary hypertension is a relatively common disease in daily life. Many patients, when they go to the hospital for examination, often see reports from cardiac ultrasound indicating mild pulmonary hypertension, moderate pulmonary hypertension, or non-severe pulmonary hypertension. So, what are the criteria for mild pulmonary hypertension? Generally, pulmonary artery pressure is measured using right heart catheterization or cardiac ultrasound. If the pressure is between 30 to 50 mmHg, this is often considered mild pulmonary hypertension. Generally, the prognosis for mild pulmonary hypertension is quite good, typically not producing noticeable symptoms or affecting health.

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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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Written by Zeng Wei Jie
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How to treat pulmonary hypertension?

Pulmonary arterial hypertension (PAH), depending on its various causes, has different treatments. The treatment commonly referred to as for pulmonary arterial hypertension specifically targets Group 1 PAH. This category of PAH has some targeted medications that are quite effective, such as prostacyclin medications, endothelin receptor antagonists, and phosphodiesterase type 5 inhibitors. These drugs target pulmonary artery pressure among other things. In addition to targeted treatments, anticoagulant therapy is usually necessary. When right heart failure occurs, diuretic therapy may be needed. In advanced stages, heart-lung or lung transplantation might be required.

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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.

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Written by Zeng Wei Jie
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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.