Pulmonary Hypertension (PH) Symptoms

Reviewed by: HU Medical Review Board | Last reviewed: February 2024

Pulmonary hypertension (PH) is a serious heart condition that causes high blood pressure in the blood vessels of the lungs (pulmonary arteries). As PH progresses, it can lead to various symptoms and complications, especially when left untreated.1,2

There are 5 types of pulmonary hypertension:1

  • Pulmonary arterial hypertension (PAH)
  • PH due to left-sided heart disease
  • PH due to lung disease and/or low oxygen levels (hypoxia)
  • PH due to pulmonary artery obstructions
  • PH for unknown reasons

What are the symptoms of pulmonary hypertension?

While symptoms can vary between people, there are common symptoms linked to PH. They include:2-4

  • Shortness of breath
  • Fatigue
  • Mild chest pain
  • Dry cough
  • Dizziness or fainting
  • Swelling in the ankles, legs, or stomach
  • Weakness
  • Wheezing

As the disease progresses, symptoms become more noticeable and more severe.2-4

What are the stages of pulmonary hypertension?

PH is classified into 4 stages that range from mild to severe. Assigning a stage helps healthcare experts determine the right treatment plan. Because symptoms change as the stages progress, understanding PH stages is crucial to getting the right treatment.3,4

Stage 1: Mild PH

At this stage, people may not have any noticeable symptoms. The condition may be detected only through medical tests. For those at higher risk of developing PH, such as people with a family history of PH, it is important to get regular health screenings.3,4

Stage 2: Moderate PH

As PH progresses, symptoms may become more noticeable. You may notice shortness of breath when you are physically active. Fatigue and mild chest pain can also occur when active. Symptoms go away when you are at rest.3,4

It can be easy to ignore or dismiss these early signs. But do not ignore them. Tell your doctor about your symptoms. Early detection can greatly improve treatment outcomes.3,4

Stage 3: Severe PH

At this stage, symptoms are much more apparent. Symptoms during this stage include shortness of breath, fatigue that does not go away, and being unable to tolerate any physical activity.3,4

Stage 4: Very severe

In the most advanced stage of PH, people experience symptoms even while at rest. Symptoms become more frequent and more severe, greatly impacting quality of life. It is very hard to do everyday tasks. Medical attention is needed as soon as possible.3,4

How are pulmonary hypertension symptoms treated?

Treating PH involves a comprehensive approach to reduce symptoms and improve overall quality of life. Treatment depends on the cause and subtype of PH. There is no cure for PH, but there are treatment options. Treatment options may include:1,4

  • Medicines to help relax blood vessels and improve blood flow
  • Oxygen therapy to deliver more oxygen to the lungs and improve oxygen levels in the blood
  • Lifestyle changes, such as diet and exercise, to help improve the health of the heart
  • Medical procedures to remove blood clots in the lungs
  • Surgery to repair heart valves

What are the complications of pulmonary hypertension?

PH can result in complications that can be life-threatening if they are not addressed. These complications can include:4

  • Anemia – This condition, marked by a low level of red blood cells or hemoglobin, can worsen fatigue and can make the heart have to work harder.
  • Arrhythmias – The abnormal pressure in the pulmonary arteries can contribute to irregular heart rhythms. Arrhythmias may disrupt the normal electrical signals of the heart and lead to palpitations, dizziness, or fainting.
  • Blood clots – People with PH are at an increased risk of developing blood clots. The reduced blood flow through the pulmonary arteries can cause blood to pool, leading to clot formation. If these clots travel to other parts of the body, they can cause serious complications like stroke.
  • Right-sided heart failure – PH puts extra strain on the right side of the heart, as it has to work harder to pump blood through the pulmonary arteries. Over time, this increased workload can lead to right-sided heart failure, in which the heart is less effective in pumping blood.

When to seek medical help

Because symptoms are mild at first, PH often goes undiagnosed until the later stages. But early detection can make a huge difference in treatment outcomes and overall prognosis of the condition. If you suspect PH or have any risk factors, talk to your doctor about your concerns. For example:1-4

  • Persistent symptoms – If you have symptoms such as shortness of breath, chest discomfort, or fatigue that do not go away, talk to your doctor.
  • Worsening symptoms – If symptoms get worse over time or become more severe, get medical help immediately.
  • Trouble performing daily activities – If PH limits your ability to do everyday tasks and activities, like getting up out of your chair, it is time to see your doctor.

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