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L’edema polmonare si verifica quando gli alveoli si riempiono di liquido in eccesso filtrato al di fuori dei vasi sanguigni dei polmoni . Come accennato in precedenza, l’edema polmonare puo essere suddiviso in cause cardiogene e non-cardiogene.
Le cause cardiogene di edema polmonare sono spesso date dall’alta pressione nei vasi sanguigni del polmone a causa della compromessa funzione del cuore. Sindrome da distress respiratorio acuto (ARDS), una condizione potenzialmente grave causata da infezioni gravi, traumi , lesioni polmonari, l’inalazione di tossine, infezioni polmonari, , o radiazioni. Trauma cranico,  emorragia cerebrale, attacchi epilettici molto gravi o interventi chirurgici al cervello, a volte possono risultare in un accumulo di liquido nei polmoni, provocando edema polmonare neurogeno. L’aspirina in sovradosaggio o un uso cronico ad alte dosi di aspirina puo causare una intossicazione, che specialmente negli anziani,  puo causare edema polmonare. Altre cause piu rare di  edema non cardiogeno  possono comprendere l’embolia polmonare ,  danno polmonare acuto da trasfusione (TRALI), alcune infezioni virali o eclampsia nelle donne in gravidanza . I fattori di rischio per l’edema polmonare sono essenzialmente le cause alla base della condizione.
L’ossigeno nel sangue nei pazienti affetti da edema e basso ( ipossia ) e puo essere rilevato facilmente con un saturimentro. La maggior parte dei casi di edema polmonare sono trattati da  Medici (internisti), specialisti del cuore (cardiologi), o medici del polmone (pneumologi). Una tipica radiografia del torace con edema polmonare puo mostrare un aspetto piu bianco su entrambi i campi polmonari .
Per identificare la causa dell’edema polmonare, una valutazione approfondita del quadro clinico del paziente e essenziale.
Il trattamento dell’edema polmonare dipende in gran parte dalla sua causa e dalla gravita. La maggior parte dei casi di edema polmonare cardiaco vengono trattati con diuretici insieme ad altri farmaci per l’insufficienza cardiaca.
La supplementazione di ossigeno e a volte necessaria se il livello di ossigeno misurato nel sangue e troppo basso. La maggior parte delle complicanze di edema polmonare possono derivare da complicazioni associate con la causa sottostante. L’edema polmonare spesso non e prevenibile, ma questi consigli possono contribuire a ridurre il rischio che si sviluppi. In molti casi, si puo abbassare la pressione sanguigna o mantenerla  sana con un regolare esercizio fisico, una dieta ricca di frutta fresca, verdura e basso contenuto di grassi e prodotti lattiero-caseari, ed ovviamente  limitando  sale e alcol. Consumare una dieta sana per il cuore.  Il pesce e un alimento fondamentale per una dieta sana, questo perche contiene acidi grassi omega-3, che contribuiscono a migliorare i livelli di colesterolo nel sangue e prevenire coaguli di sangue. Se si viaggia o sale ad alta quota ( scalate, escursioni etc), e bene ambientarsi lentamente. Speso viene consigliato il farmaco acetazolamide (Diamox) per aiutare a prevenire l’edema polmonare da alta quota. Utilizziamo i cookie per essere sicuri che tu possa avere la migliore esperienza sul nostro sito. It refers to a fluid accumulation between the tissue layers lining the chest cavity and the lungs.
The human body produces small amounts of pleural fluid in order to lubricate the surfaces of the pleura, the thin layer of tissue surrounding the lungs and lining the chest cavity.
The cause of the condition differs according to the type of Pleural effusion that one suffers from.
It results from leakage of fluid into the pleural space, caused by a low protein count in bloodstream or increased pressure within the blood vessels. The diagnosis of the condition usually begins with a physical examination and physicians using a stethoscope to listen to the lungs of sufferers. The differential diagnosis of Pleural effusion involves telling the symptoms of its types apart from those of other similar conditions. The plan and approach for treatment depends on the underlying causative factor for the condition.
In individuals suffering from infections or cancer, a chest tube is kept for several days to drain the fluid and treat the effusion. In some cases, physicians may consider leaving small tubes in place within the pleural cavity for a long time. In case of extremely large types of Pleural effusions, where physicians suspect an infection as the underlying cause, a surgical technique known as Thoracotomy may be carried out.
This is a mimimally-invasive operation that involves making 1 to 3 tiny incisions in the chest.
The treatment approach for this condition aims at alleviating associated symptoms such as breathlessness and occasionally, curing the underlying cause for the disease.
The severity of this condition actually depends on the main underlying cause of the effusion. The following pictures show how the pleural fluid accumulates inside the body of individuals affected by this condition. If you, or any of your family members, are suffering from symptoms similar to that of Pleural effusion, do not delay treatment. Pulmonary emphysema : permanent increase in the volume of terminal airways affecting mainly alveoli occurring and, most often following a chronic bronchitis with bronchial asthma.
The result is a gradual reduction of airspace available for gas exchange with the appearance of dyspnea and respiratory distress.
Pulmonary emphysema is most often secondary to chronic inflammation of the lungs and bronchi, especially in obstructive pulmonary disease (COPD) or of bronchial asthma. In very rare cases, inhibitor deficiency of alpha-1 proteinase may be responsible for the occurrence of pulmonary emphysema in subjects under 40 years. Physical Examination: pectus excavatum, bluish lips and fingers and turgidity of the veins of the neck. Regular exercise after medical examination and medical recommendation improves the oxygen utilization of the patient. Rehabilitation, which can be performed at home or in hospital, uses endurance exercises, muscle exercises, to the education of breathing, physical therapy (massage promoting expectoration) in occupational therapy, to information and patient education, dietary advice to and psychosocial support.
In severe cases, the patient is no longer able to manage activities of daily living and should be institutionalized. Due to the alteration of lung tissue, the right heart is overloaded, which can conduct to the onset of heart failure. Copyright © 2012 Rayur, All trademarks are the property of the respective trademark owners. As tourism in Tibet enters the peak season, more and more visitors are longing to travel to the mysterious highland.
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Pulmonary hypertension (PH) is a life-threatening condition characterized by elevated pulmonary arterial pressure.
Pulmonary hypertension (PH) is characterized by elevated pulmonary arterial pressure and secondary right ventricular (RV) failure. This review focuses on the main therapeutic options to date available for PH of the adult and on emerging and potential therapies under development. The management of patients with PH has advanced rapidly over the last decade and the introduction of specific treatments especially for PAH has lead to an improved outcome for patients with this disease. Treatment begins with a baseline assessment of disease severity which is essential because the response to therapy will be measured as changes from baseline. It is warranted in patients with groups 2 and 3 who have PH secondary to left heart disease and lung diseases, respectively, and in patients with group 5 who have PH secondary to hematologic, systemic or metabolic disorders. Supportive therapy which should be considered in all patients with PH includes oxygen supplementation, diuretics, anticoagulation and exercise. Oxygen supplementation is of fundamental importance in all patients with arterial hypoxemia.
Diuretics are used to treat fluid retention due to PH and to reduce hepatic congestion and peripheral edema. Patients with PH are at increased risk for intrapulmonary thrombosis and thromboembolism, due to sluggish pulmonary blood flow, dilated right heart chambers, venous stasis, and a sedentary lifestyle.
The anticoagulant of choice is warfarin, with a therapeutic goal of an International Normalized Ratio (INR) of approximately two. The rationale to use vasodilatators such as CCBs is that vasoconstriction and smooth muscle cell hypertrophy contribute to the pathogenesis of PH. Treprostinil is a epoprostenol analog with a longer half-life (58–80 min) which can be given intravenously or subcutaneously although subcutaneous administration, that is accomplished by a microinfusion pump and a small subcutaneous catheter, frequently induces local side effects such as severe pain.
Sitaxentan is a selective orally active endothelin-A receptor antagonist which has been assessed in two randomized controlled trials on PAH patients with WHO functional class II and III (Barst et al., 2004, 2006b).
The pulmonary vasculature contains substantial amounts of phosphodiesterase type-5, an enzyme that specifically contributes to cyclic guanosine monophosphate (cGMP) breakdown, thus decreasing smooth muscle cell capacity for vasodilatation. Tadalafil is a once-daily dispensed phosphodiesterase type-5 inhibitor currently approved for the treatment of erectile dysfunction which appears to improve outcomes in patients with group 1 PH.
It has been proposed that combining pharmacologic agents with different mechanisms of action may produce an additive effect or may induce the same effect at lower doses of each agent.
The addition of inhaled treprostinil may improve the exercise capacity and quality of life of patients with persistent symptoms despite bosentan or sildenafil therapy. A prospective cohort study followed 25 patients with group 1 PH who were initially treated with bosentan monotherapy, but developed clinical deterioration and had sildenafil added (Mathai et al., 2007).
Enter your email address to subscribe to this blog and receive notifications of new posts by email. Questo si verifica in genere quando il fluido dai vasi sanguigni  filtra al di fuori del vaso  nei tessuti circostanti, causando gonfiore. La zona immediatamente al di fuori dei piccoli vasi sanguigni nei polmoni e occupata da sacche molto piccole chiamate alveoli . Questo puo causare problemi con lo scambio di gas (ossigeno e anidride carbonica), con conseguente difficolta di respirazione e  scarsa ossigenazione del sangue. Puo essere collegato allo scompenso cardiaco, detto edema polmonare cardiogeno o riconducibile ad altre cause.

L’insufficienza cardiaca congestizia ,un attacco di cuore o anomalie delle valvole cardiache  possono portare ad un accumulo di sangue che va oltre la solita quantita  nei vasi sanguigni dei polmoni.
Nelle persone con avanzata malattia renale , la dialisi puo essere necessaria per rimuovere il  liquido in eccesso.
Cio puo verificarsi nei casi in cui avvenga il collasso del polmone ( pneumotorace ) o vi sia una grande quantita di fluido intorno al polmone, ( versamento pleurico ) che viene rimosso con conseguente rapida espansione del polmone.
Non vi e alcun specifico fattore di rischio per l’edema polmonare diversi fattori di rischio pero esistono per le condizioni causali.
Questo puo essere di esordio graduale, se il processo si sviluppa lentamente, oppure puo avere un esordio improvviso, nel caso di edema polmonare acuto. Inoltre, dopo l’esame dei polmoni con uno stetoscopio, il medico puo ascoltare i rumori polmonari anomali, come rantoli e crepitii. Molte cause di edema polmonare richiedono l’ospedalizzazione, soprattutto se sono episodi  acuti. Casi piu gravi di edema polmonare possono mostrare opacizzazione significativa (sbiancamento) sopra i polmoni con visualizzazione minima dei campi polmonari normali.
Una attenta anamnesi ed un esame obiettivo spesso forniscono informazioni preziose circa la causa. Nella maggior parte dei casi, un trattamento appropriato puo essere realizzato  prendendo farmaci per via orale.
Ad esempio, infezioni gravi ( sepsi ) devono essere trattate con antibiotici e altre misure di supporto, o l’insufficienza renale deve essere adeguatamente valutata e gestita. La pressione alta (ipertensione) puo portare a patologie gravi come ictus, malattie cardiovascolari e insufficienza renale. Il colesterolo e uno dei diversi tipi di grassi essenziali fondamentali per  una buona salute.
Il fumo aumenta il rischio di un attacco di cuore e aumenta anche il rischio di cancro ai polmoni ed enfisema.
E’ particolarmente importante utilizzare meno sale (sodio) se si dispone di malattie cardiache o  pressione alta. Parlare con il medico e discutere circa i pro e contro della assunzone quotidiana di aspirina. Per ridurre il rischio di problemi di cuore, cercare di ridurre i livelli di stress, ovviamente quanto possibile.
Anche se le raccomandazioni variano, la maggior parte degli esperti consigliano di aumentate gradualmente  la quota,ovvero non piu di 300 o 600 metri  al giorno, una volta raggiunti circa  i 2.400 metri. However, the disorder is considered to affect as many as 1 million individuals per year in the United States.
In other words, they do not exhibit any abnormalities that are typically associated with this condition. The term “Pleural effusion” indicates an abnormal accumulation of this fluid in excessive amounts. In the majority of cases where an effusion is suspected in the pleural cavity, physicians may use maneuvers like percussion (tapping on the chest) or auscultation (listening with a stethoscope).
In case of congestive heart failure, patients may be prescribed medications such as (diuretics) water pills to cure heart failure. This operative procedure involves removal of fluid from the pleural cavity as well as ablation of any infected tissue. The process is quite effective in the management of pleural effusions that recur as a result of malignancy or are hard to drain. In this condition, an abnormal amount of fluid gets collected within the pleural lining due to a cancerous condition.
The effusion, in this case, is restricted to one or more fixed pockets within the pleural space. Some cases of the disorder result from common ailments like arthritis, bacterial infections, tuberculosis and pneumonia.
This can be prevented by the use of sclerosing agents which induce scarring, such as tetracycline or talc.
If effusion results from a viral infection, heart failure or pneumonia, it can be controlled. Preventing the underlying cause can help reduce the possibility of development of an effusion. Delay in diagnosis and medical treatment can give rise to a range of complications and jeopardize health. Inflammatory processes and increased airway resistance accompanied by hyperinflation of alveoli, which eventually break and merge with neighboring cells to form larger air spaces.
In the long term, the gradual increase in pressure in the pulmonary circulation leads to heart failure with corresponding clinical symptoms.
Less frequently, it is pulmonary emphysema associated with age, which manifests itself during the fifties. The goal of treatment is to slow the disease progression and improve quality of life for patients. It aims to improve the quality of life of patients and their exercise tolerance while reducing their consumption of drugs and the number and duration of hospitalizations. This means that you will not need to remember your user name and password in the future and you will be able to login with the account you choose to sync, with the click of a button. This page doesn't support Internet Explorer 6, 7 and 8.Please upgrade your browser or activate Google Chrome Frame to improve your experience.
It is clinically classified into five groups: patients in the first group are considered to have pulmonary arterial hypertension (PAH) whereas patients of the other groups have PH that is due to cardiopulmonary or other systemic diseases. Functional classification of pulmonary hypertension according to World Health Organization (WHO). Parameters with established importance for assessing disease severity, stability, and prognosis.
Mechanisms which trigger pulmonary arterial hypertension (PAH) as targets for pharmacological treatments.
In patients with group 4 who have PH due to thromboembolic occlusion of the proximal or distal pulmonary vasculature, anticoagulation is primary medical therapy, whereas surgical thromboendarterectomy is primary surgical therapy for selected patients with thromboembolic obstruction of the proximal pulmonary arteries. The indication to the oxygen therapy is generally set at a value of arterial pressure of oxygen (PaO2) less than 60 mmHg. Moreover, diuresis can prevent a distended right ventricle from impending left ventricular filling. These risk factors and the consideration that even a small thrombus can produce hemodynamic deterioration in a patient with a compromised pulmonary vascular bed that is unable to dilate or recruit unused vasculature, represent the rationale for oral anticoagulation in PH. A randomized controlled trial has demonstrated an improvement in exercise capacity in patients with PAH who took part in a training program (Mereles et al., 2006). Specific therapy is often needed for patients with group 1 PH, because there are not effective primary therapies for these patients.
It is recommended that patients with group 1 PH also undergo a vasoreactivity test with intravenous adenosine, intravenous epoprostenol, or inhaled nitric oxide (NO, Barst et al., 2009).
However, it has been recognized that these drugs are of benefit only in a small number of patients with PAH who demonstrate a positive response to the vasoreactivity test.
Prostacyclin is produced by the endothelial cells, induces vasodilatation and is a powerful platelet aggregation inhibitor. The main limitation of its use is that it has a short half-life (3–5 min) and is stable for only 8 h. Inhaled iloprost has theoretical advantages in targeting the lung vasculature and not require intravenous administration. A randomized controlled trial showed that this compound improved the exercise capacity in patients with PAH.
High concentrations of endothelin-1 have been recorded in the lungs of patients with PAH (Channick et al., 2004). The studies demonstrated the efficacy of sitaxentan in improving exercise capacity and hemodynamics. Inhibition of the cGMP degrading enzyme results in vasodilatation through the increase of NO which is a potent vasodilatator. Early observational studies suggested that the combination was both safe and effective when bosentan was added to preexisting inhaled iloprost therapy (Hoeper et al., 2003).
A trial randomly assigned 267 patients with group 1 PH who were receiving epoprostenol to have sildenafil or placebo added for 16 weeks (Simonneau et al., 2008).
Clinical improvement occurred after the addition of sildenafil, as measured by symptoms, exercise capacity, and WHO functional class.
Cio puo accadere sia a causa della troppa pressione nei vasi sanguigni o quando non vi sono abbastanza proteine nel sangue per mantenere il fluido del plasma (la parte del sangue che non contiene cellule del sangue). Questo a sua volta puo causare che il liquido dai vasi sanguigni possa essere spinto fuori agli alveoli. Questo puo causare edema polmonare sul solo lato interessato  (edema polmonare unilaterale). In alcuni casi di edema cronico (a lungo termine), l’edema polmonare,  richiede controlli piu frequenti . Questo sbiancamento rappresenta il riempimento degli alveoli a causa di edema polmonare, ma puo dare informazioni minime circa la possibile causa sottostante. Questa scarsa ossigenazione (ipossia) puo potenzialmente condurre a un diminuito apporto di ossigeno agli organi , come ad esempio il cervello. La maggior parte degli adulti dovrebbero controllare la pressione sanguigna  almeno una volta ogni due anni. Ma livelli di colesterolo elevati possono causare depositi di grasso nelle arterie, aumentando il rischio di malattia vascolare.
Anche l’esposizione al fumo passivo e un fattore che contribuisce alla malattia coronarica.
Regolare esercizio aerobico per circa 30 minuti al giorno aiuta a controllare la pressione sanguigna ed i livelli di colesterolo. D’altra parte, anche la perdita di piccole quantita di peso puo abbassare la pressione sanguigna, il colesterolo e ridurre il rischio di diabete. During surgery, antibiotic or sterile talc may be inserted to prevent the recurrence of fluid accumulation in the pleural space.

Around 50-65% cases of this disorder results from cancerous conditions of the breast or the lungs. The pleural fluid may loculate between the visceral and parietal pleura (when there is partial fusion of the pleural layers) or within the fissures. Antibiotic medications are very useful in eliminating the causes of the effusion as well as the effusion itself in such cases.
The fluid accumulation can occur due to a chronic condition, such as congestive heart failure. The fluid build-up may put more pressure over the lungs and make comfortable respiration more and more difficult for sufferers. Operative techniques may be needed in cases where sclerosing agents fail to yield benefits.
During treatment, physicians should consider curing problems associated to the disorder as well as curing the underlying condition. Seeking medical attention on an immediate basis can ensure faster cure of the disease and a quicker recovery.
Experts advised that tourists to Tibet should have a scientific and better understanding of the disease. The management of patients with PH has advanced rapidly over the last decade and the introduction of specific treatments especially for PAH has lead to an improved outcome. However, some patients still have a very poor prognosis and a rapid deterioration of their condition. However, RHC is often deferred until specific therapy is indicated because it is an invasive procedure. Therefore it needs to be administered continuously by an infusion pump and a permanently implanted central venous catheter. Inhaled treprostinil has recently been approved for patients with group 1 PH who are WHO functional class III. The main disadvantages is the need for frequent administration (six to nine time per day) due to its short half-life. Two distinct receptors with different characteristics are present in the pulmonary vascular smooth muscle cells and, in part, in the endothelial cells: endothelin-A and endothelin-B receptors. Ambrisentan has been approved for the treatment of patients in WHO functional class II and III at a dose of 5 mg once daily which can be increased to 10 mg once daily. The treprostinil group had a larger improvement in their 6-min walking distance and quality of life, but there were no differences in the time to clinical worsening, dyspnea, or WHO functional class.
Sildenafil improved hemodynamic parameters, exercise capacity, quality of life, and time to clinical worsening, compared to placebo but there was no difference in dyspnea. Gli alveoli normalmente hanno una parete sottile che permette  questo scambio d’aria, e i fluidi sono in genere tenuti fuori degli alveoli a meno che queste mura non perdano la loro integrita. Piu alto si sale piu rapidamente si respira, e significa che si peronoe grandi quantita di acqua emanate dai polmoni.
Thoracotomy helps remove all fibrous tissue and evacuate the infection from the region known as the pleural space. These are easier cases of effusion and can be easier to diagnose and treat than other forms of the disorder.
However, it may also be associated with trauma, cancers, acute infection and respiratory disorders such as tuberculosis. However, despite the progress in the treatment, the functional limitation and the survival of these patients remain unsatisfactory and there is no cure for PAH.
PH can be found in multiple clinical conditions and for this reason it is clinically classified into five groups, as shown in Table 1 (Simonneau et al., 2009). For these reasons, early identification and treatment of PH are crucial because advanced disease may be less responsive to therapy.
Specific therapy is directed at the PH itself and includes treatment with vasodilatators such as calcium channel blockers (CCBs) and with vasodilatator and pathogenetic drugs such as prostanoids, endothelin receptor antagonists and phosphodiesterase type-5 inhibitors. Indeed, oxygen is the only treatment with proven mortality benefit in some patients with group 3 PH as shown by two large trials which studied patients with chronic obstructive pulmonary disease (COPD), the most common cause of group 3 PH (NOTT, 1980; MRC, 1981).
Although there are no randomized controlled trials of diuretics in PAH, clinical experience shows symptomatic benefits also in patients with group 1 PH when a decompensated right heart failure occurs.
In contrast, patients with a negative vasoreactivity test require therapy with a prostanoid, endothelin receptor antagonist, or phosphodiesterase type-5 inhibitor. Iloprost has been evaluated in a randomized controlled trial in which patients with group 1 and 4 PH who were in WHO functional class III and IV, inhaled iloprost (median 30 mcg daily) or placebo for 12 weeks (Olschewski et al., 2002). Despite potential differences in receptor activity, the efficacy in PAH of the dual endothelin-A and B receptor antagonist drugs and of selective endothelin receptor antagonist compounds appears to be comparable.
It appears to be effective in group 1 PH patients both in WHO functional class III or IV and in WHO functional class II. However, sitaxentan has been very recently withdrawn from the market worldwide after two cases of fatal liver injury and all ongoing clinical trials have also been discontinued.
As reported above, the main adverse effect of the endothelin receptor antagonists is hepatotoxicity, which appears to be more severe at higher doses. Following surgery, chest tubes need to be kept in place for about 2 weeks to continue drainage of fluid. Patients in the first group are considered to have pulmonary arterial hypertension (PAH), whereas patients in the remaining four groups are considered to have PH. These drugs act in several pathogenetic mechanisms of the PH and are specific for PAH although they might be used also in the other groups of PH.
In a systematic review of seven observational studies that evaluated the effect of warfarin in patients with group 1 PH, five studies found a mortality benefit (Johnson et al., 2006).
Combination specific therapy may be appropriate in refractory cases, although data are limited.
The primary endpoint (improvement in WHO functional class and in exercise capacity at the 6-min walking test) was greater in the iloprost group compared to the placebo group. The initial dose is 62.5 mg twice daily and uptitrated to 125 mg twice daily after 4 weeks.
According to one observational study ambrisentan may be a safe and effective alternative for patients who previously discontinued bosentan or sitaxsentan due to abnormal liver function test results (McGoon et al., 2009), suggesting the hepatotoxicity may differ among the endothelin receptor antagonists. The drug is approved for patients with WHO functional class II and III at a dose of 20 mg three times daily.
A schematic diagram of the main mechanisms which trigger PAH and represent targets for pharmacological treatments is shown in Figure 1. Oxygen is generally administered via nasal prongs or Venturi masks at a flow rate or concentration as to maintain saturation above 90%. The most commonly used loop diuretic is furosemide, usually at a starting dose of 20–40 mg daily. In patients with other groups of PH the potential benefits of anticoagulation should be weighed against the risk of bleeding. Sustained release preparations of both nifedipine and diltiazem are recommended because they minimize the adverse effects of therapy, especially systemic hypotension.
Side effects include both diarrhea, arthralgias, flushing, headache and effects related to the delivery system such as thrombosis, local site infection, sepsis. Overall, inhaled iloprost is well tolerated with flushing and cough being the most frequent side effects. Increases in hepatic aminotransferases occurred in about 10% of the patients but were found to be dose dependent and reversible after discontinuation of the drug.
Liver function tests should be closely monitored during therapy and endothelin receptor antagonists should be avoided in patients with moderate or severe hepatic dysfunction.
However the durability of effect up to 1 year has been demonstrated only with the dose of 80 mg three times daily. In such cases, lung transplantation or creation of a right to left shunt by atrial septostomy may be considered (Keogh et al., 2009).
The use of intravenous treprostinil is approved by the US Food and Drug Administration (FDA) in WHO functional class II, III, and IV PAH patients in whom subcutaneous infusion in not tolerated.
Inhaled iloprost is approved by the FDA for PAH patients in WHO functional class III and IV. It also includes a supportive therapy consisting in oxygen supplementation, diuretics, and anticoagulation which should be considered in all patients with PH. Patients who respond to CCB therapy should be reassessed after 3–6 months of treatment. Specific therapy is directed at the PH itself and includes treatment with vasodilatators such as calcium channel blockers and with vasodilatator and pathogenetic drugs such as prostanoids, endothelin receptor antagonists and phosphodiesterase type-5 inhibitors. Finally, atrial septostomy and lung transplantation are reserved for patients refractory to medical therapy. In China, as breakthroughs have been made in the causes and treatment of altitude sickness, the cure rate of the two most common acute altitude sickness -- high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE) -- have reached 99 percent. Therapy can be established on the basis of both the clinical classification and the functional class. It is also possible to adopt a goal-oriented therapy in which the timing of treatment escalation is determined by inadequate response to known prognostic indicators.
The symptoms include low-oxygen symptoms like ache, dizziness, palpitations, lack of strength, nausea and vomiting. The symptoms include headache, dizziness, nausea, vomiting, palpitations, shortness of breath, lack of strength and appetite, sleeping problems, peripheral edema and oliguria.
The symptoms can be reduced or gone after a person takes a rest or receives proper treatment.
After getting off the plane, they should try not to carry heavy things or run and avoid outdoor activities.

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