What are the symptoms of idiopathic pulmonary hypertension

Idiopathic pulmonary hypertension will have an impact on our health and life, because patients will show clinical symptoms such as difficulty breathing, chest pain or edema, and severe cases may even cause hemoptysis and death.

1. Difficulty breathing

It is an early and common symptom, characterized by exertional nature. Its occurrence is related to factors such as reduced cardiac output, imbalance in pulmonary ventilation/perfusion ratio, and decreased minute ventilation.

2. Chest pain

It may present as a typical angina attack, often occurring during exertion or emotional changes. Myocardial ischemia is caused by increased right heart afterload, thickening of right ventricular myocardial tissue, increased oxygen consumption, and reduced blood supply to the right coronary artery.

3. Fainting

It includes presyncope (vertigo) and syncope, which often occurs after activity but can also occur during rest, and is caused by a sudden decrease in oxygen supply to the brain tissue. The following situations may induce it: ① High pulmonary vascular resistance limits the increase in cardiac output during exercise; ② Sudden shunting of hypoxic venous blood to the systemic circulation system; ③ Sudden decrease in systemic circulation resistance; ④ Sudden spasm of pulmonary arterioles; ⑤ Sudden blockage of the pulmonary artery by a large embolus; ⑥ Sudden arrhythmia, especially bradycardia.

4. Fatigue

Tissue hypoxia caused by decreased cardiac output, reduced oxygen exchange and transport.

5. Hemoptysis

Unlike hemoptysis due to pulmonary venous hypertension, hemoptysis due to pulmonary arterial hypertension comes from the rupture of pulmonary precapillary microaneurysms. Even if the amount of hemoptysis is small, death may still occur due to severe hemoptysis.

Lower limb edema is common in this disease, suggesting right heart failure. Nausea and vomiting indicate worsening right heart failure. The incidence of Raynaud's phenomenon is about 10%, and if it occurs, it is a bad sign. If hoarseness occurs, it is caused by the dilation of the pulmonary artery compressing the left recurrent laryngeal nerve. It may disappear after the condition improves.