Millions of people around the world suffer from diseases of the cardiovascular system, which have firmly taken the lead among ailments leading to death. These include pulmonary hypertension (LH). What is pulmonary hypertension of the 1st degree, what are the symptoms of the disease, how to minimize the negative impact on the body, what methods of diagnosis and treatment are used by modern medicine? Answers to these questions will help to make a real picture of an insidious and intractable disease, improve the quality of life of the patient.
What it is?
Pulmonary hypertension is a type of hypertension, a characteristic feature of which is increased pressure in the arteries of the lungs. The result of the pathology is a narrowing of the lumen in the vessel of the lung due to the abnormal structure of the arteries of the respiratory system. It is characteristic more for women of the middle age group. In men, such a pathology is diagnosed three times less often.
The disease manifests itself almost asymptomatically in the initial stages of the course. A person may not even be aware of its presence until the disease manifests itself with symptoms such as hypertensive crisis, pulmonary edema, hemoptysis. That is, when the degree of development of the disease is high, the patient seeks medical help, which greatly complicates the treatment.
With pulmonary hypertension of the 1st degree, there is no shortness of breath and pain in the chest, unpleasant sensations with normal walking are absent, and there are none with other, moderately active actions of the body. Excessive fatigue and weakness are not observed.
Hypertension is classified according to several parameters:
At the stage of diagnosis, the main factor indicating the presence of this pathology is increased pulmonary pressure with a calm and active state of the body. It is measured in millimeters of mercury. The parameters are set by ICD-10 (International Classification of Diseases), should be no more than 25 (at rest) and 35 (with certain physical exertion). The ICD 10 code for pulmonary hypertension (127.0) is set only for primary diseases.
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Primary pulmonary hypertension
The primary and secondary type of disease can be determined only by exclusion. Secondary pulmonary hypertension appears as a result of acquired diseases, that is, it is the result of the negative impact of other diseases on the circulatory system.
The causes of hypertension:
- Chronic inflammatory processes such as tuberculosis, cirrhosis, pneumosclerosis
- Neoplasms in the heart muscle or respiratory tract
- Thrombus formation
- Pathologies in the structure of the spine or chest
- Congenital heart disease
The list of causes of idiopathic pulmonary hypertension includes:
- Autoimmune pathologies
- The development of atherosclerosis in the arterial branches
- Increased tone of the sympathetic nerve
- Congenital defects of the capillaries of the lungs in the fetus
- Pulmonary Vasculitis
- Oral contraceptives
- Herpes virus type No. 8
Most often, specialists find it difficult to determine the mechanism of development of primary pulmonary hypertension. Recall that ICD 10 of primary pulmonary hypertension assigns a code of 127.0.
Among the symptoms of the primary type of hypertension should be noted:
- Dyspnea of a different nature – from minimal to significant, appearing under heavy loads or at rest. As a rule, there are no asthma attacks.
- Fainting and dizziness, lasting up to 5 minutes. Appear with significant physical exertion.
- Pain of a different nature in the chest area. Duration from several minutes to several hours. Usually, taking drugs that positively affect vasodilation does not relieve pain.
- Dry cough, which can appear both during exercise and at rest.
- Disruption of the heart muscle.
- Sputum with blood during expectoration (single or prolonged).
Degrees of development and form of flow
According to the severity of the course, several degrees of development are distinguished. At each stage, the disease manifests itself brighter, restricting the patient to certain actions.
The first degree (average systolic pressure in the range of 25-45 mm RT. Art.) – subtle symptoms while maintaining physical activity. Lack of dizziness and shortness of breath with a traditional lifestyle.
The second degree (average systolic pressure 45-75 mm Hg. Art.) – there is respiratory failure with a steadily elevated blood pressure. Diagnosed with chest pain and dizziness, the first signs of cardiac ventricular hypertrophy.
The third degree (average systolic pressure is from 76 to 110 mm Hg) is a stage of irreversible character with formed atherosclerosis of the vessels and complete hypertrophy of the ventricle of the heart. Hemoptysis and an obsessive, prolonged cough are added to previously identified manifestations. Small loads cause severe shortness of breath, significant swelling appears on the legs and in the area of the lymph nodes.
The fourth degree (average systolic pressure above 110 rt. Art.) – high pulmonary hypertension, in which a person loses his ability to work, cannot partially or fully service himself without outside help. Significant swelling of the lower extremities is observed, a number of concomitant diseases appear, for example, the liver increases in size, diffuse cyanosis. Pain in the chest area and severe shortness of breath are present at rest.
With the course, pulmonary hypertension is divided into acute and chronic. The provocateurs of the acute type are hypertensive crisis, myocardial infarction, pulmonary embolism, etc. Increased blood pressure in the left atrium, obstructive respiratory diseases, and other causes of narrowing of the pulmonary arteries are provocateurs of the development of a chronic type.
Pulmonary hypertension is diagnosed by a number of clinical and laboratory studies. When taking a patient with high pressure in the pulmonary artery, the doctor collects an anamnesis, conducts a survey.
To determine the exact diagnosis and preparation of a treatment program, the following procedures are necessary:
- A blood test of a general and biochemical nature.
- Test for walking for 6 minutes – to determine the behavior of the respiratory system during physical exertion.
- Chest X-ray.
- Ultrasound examination of the heart.
- Measurement of pressure in the pulmonary artery.
Depending on the condition of the patient, with such a disease, a number of additional hardware studies may be required. Their appointment is within the competence of the attending doctor.
In order to get an exhaustive answer to the question of how 1st-degree pulmonary hypertension manifests itself – what it is and how to cope with the disease, it is necessary to seriously listen to the doctor’s recommendations and follow them exactly.
Experts argue that only a responsible approach to diagnosis will allow you to draw up a real picture of the disease and begin effective treatment. Unfortunately, self-medication will not give any results, but can only do harm.
With such a pathology, traditional medicine methods do not work. They must be immediately abandoned so as not to aggravate the disease. According to statistics, hypertension in the early stages is very treatable by drugs.
The specialist draws up a treatment protocol, in accordance with which the patient is prescribed medications from the following groups:
- anticoagulants for blood thinning;
- inotropic drugs and cardiac glycosides to increase heart rate;
- endothelin receptor antagonists to block receptors for vasoconstrictor substances;
- calcium antagonists for blocking slow calcium channels in cells;
- prostaglandins for regulating vascular tone;
- nitrogen oxides for vasodilation;
In addition to medication, surgical treatment methods are used. This can be a transplant of a lung and heart, or only a respiratory organ. Atrial septostomy, which involves creating a hole in the atrial septum, is also used as a surgical treatment.
An important point in the treatment of the disease are such measures as:
Limit the use of salt and drinking flu >The 2016 International Classification of Disease System in the latest edition (10 mb) of primary pulmonary hypertension assigns the status of a disease in connection with which the patient may become disabled. To receive it, the patient must undergo a complete medical examination, confirming the presence of the disease, as well as its severity. There are disabilities of groups 1, 2 and 3.
The main criteria for disability:
- Disability group I – restriction of movement of the third degree, lost the ability to be served independently, without partial or full help, the progressive course of hypertension.
- Disability group II is assigned to patients who have limited disability and motor functions. The treatment does not practically give the desired effect, or the action is limited to a certain period. Such patients can work at home in the presence of special conditions, for example, to beadwork or knitting, to make souvenir products.
- Group III disability is given to patients with limited ability not only to work, but also to travel, self-care. They cannot work in professions related to heavy physical or mental stress, where there is a constant speech load during the working day. This degree of disability involves the transfer of the patient to light work, for example, clerical work, repair of radio equipment in appropriate production conditions.
The disability group is determined by a special commission (ITU). Depending on the severity of the disease, it needs regular confirmation.
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