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Pulmonary hypertension (PH or PHTN) is a condition of increased blood pressure in the arteries of the lungs. [7] Symptoms include shortness of breath, fainting, tiredness, chest pain, swelling of the legs, and a fast heartbeat. [7] [1] The condition may make it difficult to exercise. [7] Onset is typically gradual. [8]
A pulmonary artery wedge pressure being less than 15 mmHg (also measured by right heart catheterization) excludes post-capillary bed (in the veins distal to the capillary bed) pulmonary hypertension. Pulmonary arterial hypertension is a subgroup of pulmonary hypertension and is categorized as World Health Organization as group 1. [3]
Moderate pulmonary hypertension, Normal systolic function, Poor diastolic function, typically Grade III - IV Diastolic heart failure. Those affected by RCM will experience decreased exercise tolerance, fatigue, jugular venous distention, peripheral edema, and ascites. [3] Arrhythmias and conduction blocks are common.
Common causes include pulmonary hypertension, which can be the primary defect leading to RAE, or pulmonary hypertension secondary to tricuspid stenosis; pulmonary stenosis or Tetralogy of Fallot i.e. congenital diseases; chronic lung disease, such as cor pulmonale.
Hypertension is a very common condition, affecting about half of all adults in the U.S. But it doesn’t always have symptoms, so about one in three people don’t know they have it.
Right heart strain can be caused by pulmonary hypertension, [3] pulmonary embolism (or PE, which itself can cause pulmonary hypertension [4]), RV infarction (a heart attack affecting the RV), chronic lung disease (such as pulmonary fibrosis), pulmonic stenosis, [5] bronchospasm, and pneumothorax. [6]
Increased pulmonary arterial and capillary pressures (pulmonary hypertension) secondary to hypoxic pulmonary vasoconstriction. [9] [11] Increased capillary pressure (hydrostatic pressure) with over-distention of the capillary beds and increased permeability of the vascular endothelium, also known as "stress failure."
Since the main causes of right ventricular hypertrophy is tricuspid regurgitation or pulmonary hypertension (discussed above), management involves treatment of these conditions. [3] Tricuspid regurgitation is typically treated conservatively by aiming to treat the underlying cause and following up the patient regularly. [12]
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