Pulmonary Hypertension: How to Determine Mild, Moderate, and Severe Cases

Pulmonary hypertension is a condition characterized by high blood pressure in the arteries of the lungs. Determining the severity—whether mild, moderate, or severe—is essential for proper diagnosis and treatment planning. Here's how each category is typically classified:

Understanding the Severity Levels of Pulmonary Hypertension

Mild Pulmonary Hypertension: This stage is diagnosed when the pulmonary artery pressure ranges between 30 mmHg and 50 mmHg. At this level, symptoms may be minimal or even absent, making it challenging to detect without proper medical evaluation.

Moderate Pulmonary Hypertension: This classification applies when the pressure in the pulmonary artery is between 50 mmHg and 80 mmHg. Patients may begin to experience noticeable symptoms such as shortness of breath, fatigue, or chest discomfort during physical activity.

Severe Pulmonary Hypertension: This occurs when the pulmonary artery pressure exceeds 80 mmHg. At this stage, symptoms are often pronounced and can significantly impact a person's quality of life, including severe shortness of breath, dizziness, and swelling in the lower extremities.

How Pulmonary Arterial Pressure Is Measured

Accurate measurement of pulmonary arterial pressure is crucial in diagnosing the severity of the condition. One of the most commonly used clinical tools is echocardiography (ultrasound of the heart), which estimates pulmonary artery pressure by measuring the tricuspid regurgitation velocity.

The formula used is: Tricuspid Regurgitation Velocity squared multiplied by 4, which gives an estimated value of the pulmonary artery pressure. However, this calculation may be adjusted based on the presence of right atrial enlargement.

Refining the Measurement with Right Atrial Pressure

To improve accuracy, right atrial pressure is also considered. Depending on the degree of right atrial dilation, additional values of 5 mmHg, 10 mmHg, or 15 mmHg are added to the calculated pressure. The final value represents a more precise estimation of the pulmonary artery pressure.

Why Pulmonary Pressure Matters

The level of pulmonary artery pressure directly correlates with the severity of the disease. Higher pressure readings generally indicate more advanced disease and a greater risk of complications such as right heart failure. Early and accurate diagnosis allows for timely medical intervention, which can help manage symptoms and improve long-term outcomes.