[PP.06.18] PROPERTIES OF CLINICAL SYMPTOMS AND PHYSICAL EXAMINATION IN PATIENTS WITH DIFFERENT FORMS OF PULMONARY ARTERIAL HYPERTENSION

2016 ◽  
Vol 34 ◽  
pp. e152
Author(s):  
Z. Valieva ◽  
S. Glukhova ◽  
T. Martynyuk ◽  
I. Chazova
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Physical Examination ◽  
Arterial Hypertension ◽  
Clinical Symptoms ◽  
Pulmonary Arterial

scholarly journals The development of a screening questionnaire to improve the early detection of pulmonary arterial hypertension

2014 ◽  
Vol 11 (4) ◽  
pp. 62-67
Author(s):  
Z S Valieva ◽  
E G Valeeva ◽  
S I Glukhova ◽  
T V Martynyuk ◽  
I E Chazova
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Arterial Hypertension ◽  
Early Detection ◽  
Physical Examination ◽  
Arterial Hypertension ◽  
Heart Sound ◽  
Clinical Symptoms ◽  
Control Group ◽  
Pulmonary Arterial ◽  
Second Heart Sound

Objective: development of a questionnaire for the early detection of pulmonary arterial hypertension (PAH), and its further introduction for a broad routine medical practice.Were identified clinical symptoms, allowing differentiate various forms of the disease (IPAH and PAH-CHD), because these forms of PAH most frequent in cardiology practice.Material and methods. The questionnaire includes 6 sections: clinical symptoms, physical examination, anamnestic information, diseases associated with pulmonary hypertension; signs of PAH according to electrocardiography, chest radiography, echocardiography. All sections of the questionnaire filled by physician. Was held a retrospective analysis of the clinical symptoms, physical examination, anamnestic information, methods of instrumental examination of 70 patients with IPAH in comparison with 29 patients with PAH-CHD and the control group - 48 patients with arterial hypertension (AH).Results. The leading complaints in patients with PAH are dyspnea (99%), palpitations (58%), fatigue (59%), syncope (21%), dry cough (28%), peripheral edema (38%). The physical signs of PAH include an accentuated pulmonary component of second heart sound (93%), cyanosis (40%). Most often, the development of pulmonary hypertension precipitated by stress, pregnancy, acute respiratory infections.Conclusion. According to the results we concluded that the developed questionnaire may be offered for wide use in routine clinical practice and recommended not only for screening patients with IPAH, but also with PAH-CHD.

scholarly journals The validation of the questionnaire for the early detection of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension

2016 ◽  
Vol 13 (1) ◽  
pp. 34-38
Author(s):  
Z S Valieva ◽  
S I Glukhova ◽  
T V Martyniuk ◽  
I E Chazova
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Arterial Hypertension ◽  
Early Detection ◽  
Physical Examination ◽  
Arterial Hypertension ◽  
Clinical Symptoms ◽  
Heart Defects ◽  
Lower Limbs ◽  
Control Group ◽  
Pulmonary Arterial

The objective: to identify pathognomonic symptoms and signs of different groups of pulmonary hypertension (PH), analyze the possibility of early diagnosis of patients with PH and the validity of the questionnaire.Material and methods. The questionnaire consists of 6 sections: clinical symptoms, physical examination, anamnestic information; diseases associated with PH; signs of pulmonary arterial hypertension (PAH) according to electrocardiography, chest radiography, echocardiography. All sections of the questionnaire were filled by physician. Was held an analysis of clinical symptoms, medical history, physical examination, methods of instrumental examination of 81 patients with idiopathic PH in comparison with 29 patients with PAH due to congenital heart defects - PAH-CHD, 36 patients chronic thromboembolic PH - CTEPH and the control group - 48 patients with essential hypertension. In addition, the validity of the questionnaire was evaluated: structural, the criterion and discriminant validity.Results. The leading complaint in IPAH patients was syncope; in patients with PAH-CHD the most often detected signs were cyanosis and accentuated pulmonary component of 2d heart sound; in patients with CTEPH - cough, they had a history of venous thrombosis of the lower limbs and the debut of the disease has been associated with pregnancy.Conclusion. Development and validation of a screening questionnaire allows to improve approaches to early detection of various forms of PH, allows identify specific symptoms that more typical of definite forms of PH.

scholarly journals Management of pulmonary arterial hypertension in patients aged over 65 years

2019 ◽  
Vol 21 (Supplement_K) ◽  
pp. K29-K36 ◽  
Author(s):  
Olivier Sitbon ◽  
Luke Howard
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Older Patients ◽  
Clinical Symptoms ◽  
Survival Rates ◽  
Specific Treatment ◽  
Younger Patients ◽  
Expert Opinions ◽  
Literature Searches ◽  
Pulmonary Arterial

Abstract Historically, pulmonary arterial hypertension (PAH) has been considered a disease of young adults, but over the last three decades, the average age at diagnosis has increased, presenting clinicians with some unique challenges. Clinical symptoms of PAH, including shortness of breath and reduced functional capacity, are not specific for the disease and may be present in older patients because of their age or as a result of comorbid conditions. Eliminating other causes for these symptoms can delay PAH diagnosis and initiation of PAH-specific treatment compared with younger patients. Currently, there are no specific guidelines relating to PAH in older patients and existing guidelines for identifying patients at potential risk of PAH may not be appropriate for patients aged over 65 years. Even though older patients tend to be diagnosed with more advanced symptoms, and evidence suggests that they are less responsive to PAH-specific therapies, treatment is often less aggressive than in younger patients. Even after adjusting for age, survival rates remain disproportionately lower in the older vs. younger PAH populations. Specific guidelines for diagnosis and treatment of older patients with PAH are needed to improve care and outcomes in this growing population. This review aims to assess the challenges associated with diagnosing and managing PAH in older patients, based on literature searches, authors’ experiences, and expert opinions.

scholarly journals Assessing Response to Therapy in Idiopathic Pulmonary Arterial Hypertension: A Consensus Survey of Canadian Pulmonary Hypertension Physicians

2011 ◽  
Vol 18 (4) ◽  
pp. 230-234 ◽  
Author(s):  
Adrienne E Borrie ◽  
David N Ostrow ◽  
Robert D Levy ◽  
John R Swiston
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Arterial Hypertension ◽  
Physical Examination ◽  
Arterial Hypertension ◽  
Venous Pressure ◽  
Idiopathic Pulmonary Arterial Hypertension ◽  
Response To Therapy ◽  
Clinical Parameters ◽  
Standard Practice ◽  
Pulmonary Arterial

BACKGROUND: Many treatment options are now available for patients with idiopathic pulmonary arterial hypertension (IPAH). Data regarding the optimal combination of therapies are lacking, as is consensus on how to assess response to therapy and when to change therapeutic regimens.OBJECTIVES: To gather the opinions of Canadian pulmonary hypertension (PH) experts regarding standard practice in the care of IPAH patients after therapy is initiated.METHODS: Canadian PH physicians were surveyed using short questionnaires to assess their opinions and practices in the care of IPAH patients. A Delphi forecasting approach was used to gain consensus among Canadian physicians on the most important clinical parameters to consider when assessing patients after the initiation of therapy.RESULTS: Twenty-six of 37 Canadian PH experts who were invited to participate completed the study. All endorsed the use of combination therapy for IPAH patients despite the lack of universal provincial coverage for this approach. By consensus, WHO functional class, 6 min walk distance and hospitalization for right heart failure were the most important clinical parameters. The most highly rated physical examination parameters were jugular venous pressure, peripheral edema, the presence of ascites and body weight.CONCLUSIONS: The overall approach to care of IPAH patients is similar across PH centres in Canada. A limited number of clinical and physical examination parameters were considered to be most important to reassess patients after therapy is initiated. These parameters, along with definition of threshold values, will facilitate the development of standard practice guidelines for IPAH patients in Canada.

scholarly journals Bioactivities and mechanisms of natural medicines in the management of pulmonary arterial hypertension

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Zhijie Yu ◽  
Jun Xiao ◽  
Xiao Chen ◽  
Yi Ruan ◽  
Yang Chen ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Animal Models ◽  
Arterial Hypertension ◽  
Clinical Symptoms ◽  
Treatment Strategies ◽  
Terminal Phase ◽  
Pharmacokinetic Studies ◽  
Natural Medicine ◽  
Pulmonary Arterial ◽  
Natural Medicines

AbstractPulmonary arterial hypertension (PAH) is a progressive and rare disease without obvious clinical symptoms that shares characteristics with pulmonary vascular remodeling. Right heart failure in the terminal phase of PAH seriously threatens the lives of patients. This review attempts to comprehensively outline the current state of knowledge on PAH its pathology, pathogenesis, natural medicines therapy, mechanisms and clinical studies to provide potential treatment strategies. Although PAH and pulmonary hypertension have similar pathological features, PAH exhibits significantly elevated pulmonary vascular resistance caused by vascular stenosis and occlusion. Currently, the pathogenesis of PAH is thought to involve multiple factors, primarily including genetic/epigenetic factors, vascular cellular dysregulation, metabolic dysfunction, even inflammation and immunization. Yet many issues regarding PAH need to be clarified, such as the “oestrogen paradox”. About 25 kinds monomers derived from natural medicine have been verified to protect against to PAH via modulating BMPR2/Smad, HIF-1α, PI3K/Akt/mTOR and eNOS/NO/cGMP signalling pathways. Yet limited and single PAH animal models may not corroborate the efficacy of natural medicines, and those natural compounds how to regulate crucial genes, proteins and even microRNA and lncRNA still need to put great attention. Additionally, pharmacokinetic studies and safety evaluation of natural medicines for the treatment of PAH should be undertaken in future studies. Meanwhile, methods for validating the efficacy of natural drugs in multiple PAH animal models and precise clinical design are also urgently needed to promote advances in PAH. Graphical Abstract

scholarly journals THE COMPLEXITY OF DIAGNOSING IDIOPATHIC PULMONARY ARTERIAL HYPERTENSION

2018 ◽  
Vol 63 (5) ◽  
pp. 167-171
Author(s):  
D. I. Sadykova ◽  
D. R. Sabirova ◽  
N. V. Kustova ◽  
N. N. Firsova ◽  
G. A. Khusnullina
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Clinical Symptoms ◽  
Pulmonary Arteries ◽  
Idiopathic Pulmonary Arterial Hypertension ◽  
Incurable Disease ◽  
Pulmonary Arterial ◽  
Unclear Etiology ◽  
High Degree ◽  
Diagnostic Criterion

Idiopathic pulmonary arterial hypertension is a progressive, incurable disease of unclear etiology; it is characterized by intensive remodeling of the pulmonary vascular bed with a predominant lesion of the distal pulmonary arteries and arterioles. A diagnostic criterion of the disease is an increase in the average pressure in the pulmonary artery more than 25 mm Hg. Arterial hypertension is difficult to diagnose, especially at the early stages due to non-specific clinical symptoms. The article describes the clinical case of diagnostics and treatment of a child with primary pulmonary hypertension of high degree.

scholarly journals Bosentan use in pulmonary arterial hypertension: Russian and foreign experience

2017 ◽  
Vol 89 (8) ◽  
pp. 95-103
Author(s):  
Z S Valieva ◽  
T V Martynyuk ◽  
I E Chazova
Keyword(s):  
Physical Activity ◽  
Clinical Practice ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Clinical Symptoms ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Serious Illness ◽  
Randomized Controlled ◽  
Pulmonary Arterial

The results of evaluating the efficacy and safety of bosentan in patients with pulmonary arterial hypertension (PAH), as shown by the data of foreign randomized controlled trials and the authors’ own experience, convincingly demonstrate that the introduction of the drug into clinical practice has led to a significant improvement of the possibilities of drug therapy in patients with this serious illness. Bosentan substantially improves physical activity in patients, reduces the severity of clinical symptoms, slows down the rates of disease progression, and prolongs survival in patients with different forms of PAH.

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