Pulmonary Arterial Hypertension Signs And Symptoms

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PULMONARY ARTERIAL HYPERTENSION

Pulmonary arterial hypertension is a syndrome resulting from restricted flow through the pulmonary arterial circulation resulting in increased pulmonary vascular resistance and ultimately leading to right heart failure.
It is a part of the spectrum of pulmonary hypertension, which is hemodynamic and pathophysiological condition defined as an increase in mean pulmonary arterial pressure ≥25 mmHg at rest.
Typical symptoms include progressive dyspnea on exertion, palpitations, fatigue, weakness, angina, syncope and abdominal distention.

Signs and Symptoms

Introduction

A syndrome resulting from restricted flow through the pulmonary arterial circulation resulting in increased pulmonary vascular resistance & remodeling, & ultimately leading to right heart failure

Definition

Pulmonary arterial hypertension (PAH) is part of the spectrum of pulmonary hypertension (PH), which is a hemodynamic & pathophysiological condition defined as an increase in mean pulmonary arterial pressure (mPAP) ≥25 mmHg at rest

Signs and Symptoms

Typical Symptoms

Progressive dyspnea on exertion, palpitations
Fatigue, weakness, angina, syncope, abdominal distention
Less commonly: Hemoptysis, Raynaud’s phenomenon

Risk Factors

Risk Factors & Associated Conditions for Pulmonary Arterial Hypertension (PAH)
	Definite Causal Relationship	Likely Causal Relationship	Possible Causal Relationship	Unlikely Causal Relationship
Drugs & Toxins	Aminorex Fenfluramine Dexfenfluramine Toxic grapeseed oil Benfluorex Selective serotonin reuptake inhibitor	Amphetamines Dasatinib L-tryptophan Methamphetamine	Amphetamine-like drugs Cocaine Phenylpropanolamine Chemotherapeutic agents (Mytomycin C, Cyclophosphamide) Interferon α & β St. John's Wort	Oral contraceptives Estrogen therapy Cigarette smoking
Demographic Factors	Gender		Pregnancy Systemic hypertension	Obesity
Medical Conditions	HIV infection Severe symptomatic mitral or aortic valve disease	Portal hypertension or liver disease Collagen vascular diseases Congenital systemic-to- pumonary cardiac shunts	Thyroid disorders Hematological conditions (eg asplenia 2° to surgical splenectomy, sickle cell disease, β-thalassemia, chronic myeloproliferative disorders) Rare genetic or metabolic diseases (eg Type 1a glycogen storage disease, Gaucher's disease, hereditary hemorrhagic telangiectasia)

Managing COPD in primary care

22 May 2017

Chronic obstructive pulmonary disease (COPD) is currently the 10th commonest cause of death in Singapore, with a disease burden of 5.9 percent according to a 2015 population-based survey (EPIC-Asia survey) in Singapore. Pearl Toh spoke with Dr Augustine Tee, chief and senior consultant of the Department of Respiratory and Critical Care Medicine at Changi General Hospital (CGH) in Singapore, on how COPD is often underdetected in the primary care population as symptoms are not specific and diagnosis requires a combination of clinical risk factors, symptoms and spirometry testing.

Original New Drug Application Approvals by US FDA (1- 15 August 2017)

15 Aug 2017

New drug applications approved by US FDA as of 1 - 15 August 2017 which includes New Molecular Entities (NMEs) and new biologics. It does not include Tentative Approvals. Supplemental approvals may have occurred since the original approval date.