Pulmonary hypertension is a condition in which there is a progressive increase in pulmonary vascular resistance that leads to right-sided insufficiency. The disease involves many diseases, complex pathogenesis, young onset population, limited treatment methods, so it is called "cancer of the cardiovascular system", and the 5-year survival rate without targeted drug therapy is only 20.8%. Therefore, although "niche", "lethality" is amazing. Recently, the reporter learned from the Department of Cardiology of Nanjing First Hospital that the department used pulmonary denerration (PADN technology) to successfully treat a young patient with severe pulmonary hypertension, and the patient has been discharged from the hospital.
Lupus erythematosus and Sjogren's syndrome cause pulmonary hypertension
Xiao Li, a 29-year-old woman, often has asthma symptoms, and can walk slowly in normal times, but the intensity of activity is slightly larger and even climbs to the second floor to have obvious asthma. Two months ago, the symptoms began to get worse and worse with chest pain and dizziness, and then Xiao Li felt that her face was swollen and went to the local hospital for treatment, and the doctor told her that she had severe pulmonary hypertension. Xiao Li's family was very anxious. This is a strange disease, there are very few people around who know it, it is also a relatively rare disease, and it is easy to confuse with other lung diseases.
Image source Visual China
After introduction, Xiao Li and his family came to the first batch of national standardized pulmonary vascular disease centers in China - the Department of Cardiology of Nanjing First Hospital. In the specialist clinic, Professor Chen Shaoliang observed that Xiao Li had cyanosis on his lips and edema of his lower limbs, and his condition was very serious and required hospitalization. The Department of Cardiology of Nanjing First Hospital convened a multidisciplinary joint consultation to diagnose Xiao Li's pulmonary hypertension caused by lupus erythematosus and Sjogren's syndrome. The pulmonary hypertension team of Nanjing First Hospital made a right heart catheter for Xiao Li, and proposed the most appropriate treatment plan for Xiao Li's pulmonary hypertension related to connective tissue disease, and Shen Minning, director of the Department of Immunology, also guided the diagnosis and treatment of patients throughout the process.
According to Zhang Hang, chief physician of the Department of Cardiology, Professor Chen Shaoliang used the original percutaneous pulmonary denerration (PADN) to perform surgical treatment for Xiao Li, and after a week of careful treatment, Xiao Li's symptoms have been significantly improved, and Xiao Li has been discharged from the hospital. Before being discharged from the hospital, Xiao Li's asthma symptoms were significantly improved, she said: "It feels good to be able to breathe normally"!
The picture shows Professor Chen Shaoliang's original cardiology pulmonary denerration surgery debuted in France. First from right: Prof. Shaoliang Chen, Middle: Dr. Christophe Pison, Director of the Department of Internal Medicine and Director of the Department of Pulmonary Hypertension at the University Medical Center of Grenoble, first from left: Dr. He
Occult disease, pulmonary hypertension is difficult to detect
Chief physician Zhang Hang told reporters that blood starts from the right heart, flows into the main pulmonary artery, lobe and section pulmonary artery, pulmonary arterioles, and eventually flows into the pulmonary capillary bed, thus flowing into the pulmonary venules and pulmonary veins with increased diameter, and finally returning to the left atrium. When pulmonary blood vessels continue to contract, remodel, or thrombosis, it leads to a progressive increase in pulmonary vascular resistance, which in turn causes right heart failure. The disease is insidious, but the rate of disability and mortality is high. Like Xiao Li, who was originally a flower-like age, he should have enjoyed youth and laughter, but he had no choice but to climb the 2nd floor and walk fast. In addition to patients like Xiao Li, nanjing First Hospital has recently received several young male patients, and the symptoms are more serious, and symptoms such as syncope have appeared. The disease is an insidious disease with a variety of symptoms that is not easily detectable. Some patients have been ill for 5-10 years, only feel chest tightness, asthma, and it is difficult to be found without careful examination, but when it is found, it is too late.
Zhang Hang introduced that patients with pulmonary hypertension face low survival rate, high burden, no specific treatment and other problems, pulmonary hypertension involves multi-system diseases, the current classification involves five major categories of pulmonary hypertension population, and the first major category of pulmonary hypertension patients connective tissue disease associated pulmonary hypertension (CTD-PAH) accounts for a large proportion of the national pulmonary hypertension patient population. Percutaneous pulmonary denerration (PADN) is a pulmonary hypertension interventional treatment technology independently developed by Professor Chen Shaoliang, which has obtained invention patents and methodological protection in nearly 50 countries around the world. It is a minimally invasive interventional treatment that uses radiofrequency ablation to block the sympathetic nerves of the pulmonary vascular lining and reduce pulmonary artery pressure, thereby treating pulmonary hypertension or delaying disease progression.
Expert reminder: Be wary of unexplained impatience
It is understood that the main symptoms of patients with pulmonary hypertension are unexplained shortness of breath, fatigue, and edema. Patients may initially think that symptoms are caused by poor constitution, colds, cardiac insufficiency, etc., but if echocardiography is done, it is easier to detect. Echocardiography is a widely used screening method for finding pulmonary hypertension. Early detection and treatment are critical for patients with pulmonary hypertension.
Zhang Hang introduced, pulmonary hypertension patients come to the hospital for treatment, there are 2 common situations, one is ultrasound early detection, found in time, the condition can find the cause, for the cause of active treatment; the other, from other areas to transfer, may be the living conditions themselves limit lead to delayed treatment, the condition is relatively serious, ultrasound examination found that the pulmonary artery pressure is high, and the right ventricle has been enlarged, the need to do right heart catheterization to confirm the diagnosis. Before the right heart catheterization, a series of noninvasive tests are also required, including lung function, arterial blood gases, liver function, rheumatism and other complete tests to rule out other diseases.
Correspondent Zhang Chen Shan Shensheng
Yangzi Evening News/Purple Cow News trainee reporter Lu Yanlin
Proofread by Faye Wong