Ironing out pulmonary arterial hypertension复制标题

烫平肺动脉高压

The diagnosis is often delayed because the presenting features of PH are frequently attributed incorrectly to age, deconditioning, or a coexisting or alternate medical condition. As a result, PH is often not suspected until symptoms become severe or serious. It has been estimated that more than 20 percent of patients have symptoms of PH for longer than two years before it is recognized. Symptoms — Common symptoms include the following: Dyspnea and fatigue; Symptoms of right ventricular (RV) failure：Exertional chest pain，Exertional syncope，Weight gain from edema，Anorexia and/or abdominal pain and swelling. The diagnosis of PAH requires RHC to demonstrate an mPAP ≥20 mmHg at rest and a pulmonary vascular resistance (PVR) ≥3 Wood units. Several additional criteria to exclude the remaining categories of PH must also be met: Mean pulmonary capillary wedge pressure ≤15 mmHg (to exclude PH due to left heart disease [ie, group 2 PH])；CLDs and other causes of hypoxemia are mild or absent (to exclude PH owing to CLD or hypoxemia [ie, group 3 PH])；Venous thromboembolic disease and pulmonary artery obstructions are absent (to exclude group 4 PH)；Certain miscellaneous disorders are absent, including systemic disorders (eg, sarcoidosis, chronic renal insufficiency), hematologic disorders (eg, myeloproliferative diseases and chronic hemolytic anemias), and metabolic disorders (eg, glycogen storage disease). The purpose is to exclude PH with unclear multifactorial mechanisms (group 5 PH).

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