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Thursday, 28 November 2013

Pulmonary vascular disease – Pulmonary arterial hypertension – The Symptoms

Pulmonary vascular disease is defined as a condition of blood flow to the lung’s artery is blocked suddenly due to a blood clot somewhere in the body, including pulmonary embolism, chronic thromboembolic disease, pulmonary arterial hypertension, pulmonary veno-occlusive disease, pulmonary arteriovenous malformations, pulmonary edema, etc.
Pulmonary arterial hypertension
Pulmonary arterial hypertension is a subgroup of a specific subgroup of pulmonary hypertension (PH) defined as a condition of slowly progressive disorder as a result of abnormally high blood pressure in the blood vessel, including pulmonary artery, pulmonary vein, or pulmonary capillaries, that carries blood from the heart to the lungs due to narrowing in diameter of most of the very small arteries throughout the lungs of that increased resistance to blood flow, leading to right heart failure and death. Because the phrase pulmonary arterial hypertension is long and pulmonary hypertension is a bit shorter the phrase pulmonary hypertension is often used in place of pulmonary arterial hypertension(a).According to statistic, approximately over 1,000 new cases of pulmonary arterial hypertension are diagnosed each year, In the United States alone.
I. Symptoms
1. Depressive disorder
In the study to screen Consecutive outpatients with PAH of a A group of 100 patients (88% women, 50% with idiopathic PAH) (idiopathic; or associated with scleroderma, congenital heart disease, or anorexiant use) seen in two university PAH clinics, showed that 5% of subjects had symptoms suggestive of major depressive disorder; 40% had mild-to-moderate depressive symptoms; and 45% had no-to-minimal depressive symptoms(1).
2. Other symptoms
In the study to use cluster analysis to describe the symptom profile in PAH and differences in the health outcomes of health status, health-related quality of life (HRQoL) and psychological states in the cluster groups, by University of Pennsylvania, School of Nursing, found that of the 151 participants, the mean age was 53.5 ± 15.1 with the majority female (n = 128, 85%). Fifty-eight (41%) were disabled and 67 (44%) were Functional Class IV. The most prevalent symptoms were shortness of breath with exertion (n = 149, 99%) and fatigue (n = 144, 93%). Three clusters emerged: Cluster 1 diffuse symptoms (n = 93), Cluster 2 severe cardiopulmonary symptoms (n = 32) and Cluster 3 moderate cardiopulmonary symptoms (n = 26). Overall, on the SF-36 the participants had poor general health, reduced physical function, role physical, vitality, and a low composite score for physical health. On the POMS the sample had limited vigor and increased fatigue. Other study showed that
The most common symptom of PH is breathlessness on exertion. Syncope may be the presenting symptom especially in children. Other PH symptoms include: angina pectoris, palpitations, dry cough, exertional nausea and vomiting(3).
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Sources
(a) http://pulmonaryhypertensionrn.com/ph-vs-pah/
(1) http://www.ncbi.nlm.nih.gov/pubmed/20587763
(2) http://www.ncbi.nlm.nih.gov/pubmed/22357779
(3) http://www.ncbi.nlm.nih.gov/pubmed/23477017