Early symptoms of pulmonary hypertension

The early symptoms of pulmonary hypertension (PH) – of which November is the awareness month – may not become apparent until after months or years have passed. However, they worsen as the condition advances.

Pulmonary hypertension symptoms include:

·         Shortness of breath – first during exercise and later even at rest.

·         Fatigue.

·         Dizziness.

·         Fainting spells.

·         Pain or pressure in the chest.

·         Swollen ankles, legs, and abdomen.

·         Pain in the upper right abdomen.

·         Bluish lips and skin.

·         Racing heartbeat.

·         Palpitations.

·         Loss of appetite.

·         Lightheadedness.

When these symptoms occur without a clear cause, we are talking about idiopathic pulmonary hypertension. Secondary pulmonary hypertension, on the other hand, is caused by an underlying medical problem such as:

·         Blood clots.

·         Emphysema and other chronic obstructive pulmonary diseases (COPD).

·         Scleroderma, lupus, and other connective tissue disorders.

·         Sleep apnea.

·         Obesity.

·         Congenital heart defects.

·         Sickle cell anemia.

·         Cirrhosis.

·         AIDS.

·         Pulmonary fibrosis and other lung disease.

·         Left-sided heart failure.

·         Mitral valve disease.

Other risk factors include:

·         High altitude – either living at 8,000 feet and higher or climbing to such heights without acclimation.

·         Former users of appetite suppressant fen-phen and users of cocaine.

·         Elder adults are at an increased risk for secondary PH.

·         Young people are at a higher risk for idiopathic PH.

·         Men are more likely to develop PH than women.

·         Family history.

Failure to diagnose and treat the early symptoms of pulmonary hypertension can lead to such complications as:

·         Right-sided heart failure.

·         Arrhythmia.

·         Bleeding into the lungs.

·         Hemoptysis (coughing up blood).

Diagnosing pulmonary hypertension

Confirming diagnosis

·         Echocardiography.

·         Chest x-ray.

·         Electrocardiogram.

·         Right-heart catheterization.

Checking for underlying causes

·         Chest computed tomography.

·         Chest magnetic resonance imaging.

·         Lung function tests.

·         Polysomnogram.

·         Lung ventilation/perfusion scan.

·         Blood tests.

Establishing severity

·         Six-minute walk test.


Treatment for PH consists of medications or surgery.

Pulmonary hypertension treatment


·         Oxygen.

·         Blood thinners.

·         Diuretics.

·         Potassium.

·         Inotropic agents.

·         Vasodilators.

·         Phosphodiesterase-5 inhibitors.

·         Prostanoids.

·         Endothelin receptor antagonists.

·         Calcium channel blockers.


·         Pulmonary thromboendarterectomy.

·         Lung transplant.

·         Heart-lung transplant.

·         Atrial septostomy.


Living with the early symptoms of pulmonary hypertension is difficult but not impossible. Lifestyle changes can help lead a quality life, for instance:

·         Staying physically active.

·         Getting enough rest.

·         Quitting smoking.

·         Avoiding pregnancy.

·         Not using birth control pills.

·         Avoiding high altitudes.

·         Reducing stress.

·         Following a nutritious diet.

·         Keeping a healthy weight.

The amount and type of physical activity that a person with PH is capable of varies – for example, they should favor walking over weight lifting – and they may need to carry oxygen medical supplies during exercise. Patients should consult a physician before starting any exercise regime.

Related: Early symptoms of IPF