Grading and treatment of pulmonary hypertension

Pulmonary hypertension can be divided into different levels. Patients with stage I pulmonary hypertension are not restricted in physical activity, and general activities will not cause shortness of breath, fatigue, chest pain, and headache. However, patients with stage II pulmonary hypertension are prone to symptoms of shortness of breath.

1. Grade I: Patients have pulmonary hypertension but are not restricted in physical activity

Normal physical activity does not cause dyspnea, fatigue, chest pain, or dizziness

2. Grade II: Patients have pulmonary hypertension and mild limitation of physical activity

Resting is not uncomfortable, but general physical activity may cause dyspnea, fatigue, chest pain, and dizziness

3. Grade IV: Patients have pulmonary hypertension and any activity can cause symptoms

Signs of right heart failure, including dyspnea and/or fatigue at rest, which may be evident with minimal physical activity

4. Treatment of pulmonary hypertension includes:

a. Appropriately adjust your daily physical activities. It is not clear whether physical activity can slow the development of pulmonary hypertension, but the intensity of physical activity should be appropriate for patients without experiencing symptoms (such as dyspnea, syncope, and chest pain), and activities should be avoided after meals and in high or low temperatures. Appropriate adjustments to daily activities can improve quality of life and reduce the occurrence of symptoms.

b. Avoid going to high altitude areas. Hypoxia can aggravate pulmonary vasoconstriction in patients with pulmonary hypertension. The altitude of 1500 to 2000 meters is a mild low-pressure hypoxic area. Therefore, patients should be advised to avoid such areas. The environment on commercial aircraft is similar to that at an altitude of 1,500 to 2,500 meters, and patients should be advised to use oxygen while on board.

c. Prevent infection. Patients with pulmonary hypertension are prone to lung infections and have poor tolerance. Pneumonia accounts for 7% of total causes of death, so early diagnosis and active treatment are necessary. Influenza and pneumococcal vaccines are recommended. Patients who receive continuous prostacyclin via an intravenous catheter should be alert to catheter infection if they develop persistent fever.