What is pulmonary hypertension? Do you understand it after this introduction?

When it comes to pulmonary arteries, few people really understand them. In fact, pulmonary hypertension is a type of cardiovascular disease characterized by a progressive increase in pulmonary vascular resistance and subsequent right ventricular hypertrophy and dilatation. It is divided into two types: idiopathic and secondary.

1. Overview

Pulmonary hypertension is a type of cardiovascular disease characterized by a progressive increase in pulmonary vascular resistance and subsequent right ventricular hypertrophy and dilatation. It has high morbidity, disability and mortality rates and can lead to refractory right heart failure. 75% of patients are between 20 and 40 years old, and 15% of patients are under 20 years old. Symptoms of pulmonary hypertension include shortness of breath, easy fatigue, fainting, chest pain, a dry cough, and swelling in the legs and ankles. In addition, cardiac auscultation may reveal hyperactivity of P2.

If not treated promptly, the patient's pulmonary hypertension will gradually worsen and even shorten his life. Most symptoms associated with pulmonary hypertension result from right heart failure. Before the 1990s, the medical community did lack treatment for this disease. However, some new drugs have been developed since then, and the average 5-year or 10-year survival rate of patients can be increased several times. In addition to drugs, new therapies such as gene therapy, living lung transplantation, and atrial septostomy are also emerging. Pulmonary hypertension is divided into two categories: idiopathic and secondary.

2. Clinical symptoms

Pulmonary arterial hypertension lacks specific clinical symptoms. Patients may have no symptoms in the early stages or only show clinical manifestations of the primary disease. As pulmonary artery pressure increases, some nonspecific symptoms appear, such as exertional dyspnea, fatigue, dizziness, chest pain, abdominal distension, and syncope. Due to the increase in pulmonary artery pressure, signs of right atrial and right ventricular hypertrophy may appear, such as hypertrophy of P2, holosystolic murmur caused by tricuspid regurgitation, diastolic murmur caused by pulmonary valve insufficiency, and right ventricular third heart sound. In right heart failure, distended jugular veins, hepatomegaly, and lower limb edema may be seen. Signs related to the cause of pulmonary hypertension may also be found, such as telangiectasia, digital ulcers, and sclerosis of the fingertips, which are common in patients with scleroderma; moist rales during the inspiratory phase indicate interstitial lung disease; and spider angiomas, palmar erythema, and testicular atrophy indicate liver disease. Finger clubbing, if detected in patients with idiopathic pulmonary hypertension, suggests congenital heart disease or peripheral vascular occlusive disease. The World Health Organization (WHO) divides pulmonary arterial hypertension into four levels according to the severity of its clinical manifestations.