Blood is moved from the heart to the lungs to be replenished with oxygen, so this narrowing can push oxygen-starved blood back into your heart. The result is shortness of breath and breathing problems from a lack of oxygen and eventually heart problems from the strain this backup causes.
In this article, we discuss the symptoms and possible complications of pulmonary hypertension.
Frequent Symptoms
If you get winded climbing stairs or become short of breath while you go about your daily activities, it could be a sign of pulmonary hypertension. Shortness of breath with activity—also called dyspnea on exertion—is the primary symptom that leads people to visit their doctor and receive a diagnosis of pulmonary hypertension.
Your symptoms may gradually develop over time without you noticing until they become more severe. Some people overlook developing symptoms because many people have other chronic conditions that share similar symptoms to pulmonary hypertension.
The most common symptoms of pulmonary hypertension are:
Shortness of breath Chest pain Fainting Dizziness Fatigue Weakness
Other symptoms of pulmonary hypertension may develop as the condition gradually worsens over time.
Advanced symptoms of pulmonary hypertension can include:
Throbbing in your chest Racing heartbeat Palpitations Extreme shortness of breath, even while resting Swelling (edema) in your face, abdomen, legs, or ankles
Rare Symptoms
Pulmonary hypertension is not curable and gradually worsens. As this happens, you may develop more severe symptoms. These symptoms tend to be more individualized based on the severity and stage of the disease. These aren’t as much rare as they are less common.
Advanced signs and symptoms that may not be seen until later stages of the disease or alongside other complications include:
A cough that brings up blood (hemoptysis) An enlarged heart An enlarged liver Low blood pressure (hypotension) A hoarse voice Cyanosis, or a blue tone to your skin
Complications/Sub-Group Indications
Other chronic medical problems are often present in people with pulmonary hypertension, either as a consequence or as an underlying cause of this condition. Examples include:
Chronic liver disease or cirrhosis, where scar tissue replaces healthy liver tissue Scleroderma, which causes hardening of the skin and connective tissues Lupus, where your immune system attacks its own tissue Chronic obstructive pulmonary disease (COPD) (a group of lung diseases that block airflow and make it difficult to breathe) Pulmonary fibrosis (scarring of the lungs) Aortic valve disease (narrowing of the valve in the large blood vessel branching off the heart [aorta]) Left-sided heart failure Congenital heart disease (heart disease that presents at birth) Mitral valve disease, where the mitral valve (controls blood flow from the left atrium into the left ventricle) becomes damaged or diseased Blood-clotting disorders Obesity Sleep apnea, where breathing suddenly stops and starts while you are sleeping Lung tumors Thyroid disease Metabolic disorders, where abnormal chemical reactions in your body disrupt your metabolism Sickle cell disease HIV infection Parasitic infections
As pulmonary hypertension worsens, a number of complications can develop. One of the most common complications is heart failure. When the pulmonary artery, which moves blood from the heart to the lungs, narrows, blood backs up into the right ventricle. The right ventricle receives blood from all over the body. A backup here could lead to heart failure and other problems throughout the body
As this backup continues over time, the right atrium can become stretched and weak. It also has to work harder to pump blood through the narrowed vessel to the lungs. This develops into right-sided heart failure.
The left side of your heart may also try to compensate for the lack of oxygen-rich blood coming from the lungs, working harder to pump blood out to your body. This leads to left-sided heart failure. These conditions—separately or together—are called congestive heart failure.
Other complications that could develop with pulmonary hypertension include:
Vascular disease (problems in your blood vessels) Anemia Blood clots Abnormal heart rhythms (arrhythmia) Liver damage Pericardial effusion (collection of fluid around the heart)
In advanced stages, you could end up experiencing several complications or becoming so short of breath that you struggle to do even basic tasks. Cor pulmonale describes extreme pulmonary disease in both the heart and lungs.
When to See a Doctor/Go to the Hospital
If you get short of breath once in a while or have symptoms that come and go, you should schedule an appointment with your primary care provider. Dietary and lifestyle changes can help improve your general health and prevent cardiovascular problems like pulmonary hypertension.
If you are already being treated for pulmonary hypertension, you doctor will also teach you how to watch for progression of the disease. Call the doctor who is managing your condition if you have:
Weight gain of more than 5 pounds in a single weekIncreased swelling in your abdomen, arms, or legsWorsening shortness of breath, especially at restWorsening coughRestlessnessConfusionConstant dizzinessNauseaPoor appetite
Sometimes, having a chronic condition can make it difficult to tell when things are getting worse. Your doctor will tell you when to call and when to seek emergency care. If you become so short of breath that you are unable to speak in a full sentence or carry on with your normal daily activities, this is a red flag.
Other symptoms that could signal an emergency include:
New-onset, severe chest painA heart rate that’s above 150 beats per minuteSudden weakness or paralysisSudden, severe headachesLoss of consciousness
Summary
Pulmonary hypertension is a severe, chronic disease that typically occurs alongside similar chronic conditions like heart failure and COPD. Because these conditions share many symptoms, like shortness of breath, it can be difficult to diagnose pulmonary hypertension until it reaches advanced stages. Talk with your doctor about any new or worsening chronic symptoms you may have.
A Word From Verywell
Pulmonary hypertension usually develops as a result of other chronic health conditions like obesity, high blood pressure, and heart disease. Be sure to see your doctor for wellness visits to address these issues before they progress into more serious conditions. There are many causes for shortness of breath, and your doctor is the best person to pinpoint the cause.
