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Pulmonary hypertension : ウィキペディア英語版 | Pulmonary hypertension
Pulmonary hypertension (PH) is an increase of blood pressure in the pulmonary artery, pulmonary vein, or pulmonary capillaries, together known as the lung vasculature, leading to shortness of breath, dizziness, fainting, leg swelling and other symptoms. Pulmonary hypertension can be a severe disease with a markedly decreased exercise tolerance such as heart failure. It was first identified by Ernst von Romberg in 1891. According to the most recent classification, it can be one of six different types (see below). ==Signs and symptoms==
Because symptoms may develop very gradually, patients may delay seeing a physician for years. Common signs and symptoms include shortness of breath, fatigue, non-productive cough, angina pectoris, fainting or syncope, peripheral edema (swelling around the ankles and feet), and rarely coughing up blood. Pulmonary ''venous'' hypertension typically presents with shortness of breath while lying flat or sleeping (orthopnea or paroxysmal nocturnal dyspnea), while pulmonary ''arterial'' hypertension (PAH) typically does not. A detailed family history is established to determine whether the disease might be familial. A history of exposure to drugs such as cocaine, methamphetamine, ethanol leading to cirrhosis, and tobacco leading to emphysema is considered significant. A physical examination is performed to look for typical signs of pulmonary hypertension, including a split S2, and loud P2 (pulmonic valve closure sound) and (para)sternal heave indicating a hypertrophied right atrium. Signs of systemic congestion resulting from right-sided heart failure are jugular venous distension, pedal edema, ascites, hepatojugular reflux, clubbing, etc. Evidence of tricuspid insufficiency and pulmonic regurgitation is also sought and, if present, is consistent with the presence of pulmonary hypertension.
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