Living with pulmonary hypertension (PH) sometimes means experiencing a wide range of symptoms. These may include shortness of breath, fatigue, dizziness, heart palpitations, fainting, and edema (swelling). For some people, chest pain may also accompany a PH diagnosis. This symptom can be troubling for those who suddenly feel it.

“My chest really hurts and it’s hard to breathe,” one myPHteam member wrote. Another said, “I had chest pain two days ago, but I’m feeling better now.”

There are many causes of chest pain — some are related to PH and some aren’t. Any chest pain, no matter what the type or cause, should be evaluated by your healthcare provider. Read on to explore five facts about chest pain and PH.

1. Angina Is Common Among People With PH

Angina is one type of chest pain that occurs in people with PH. In fact, it’s one of the most common symptoms of PH and is experienced by about 2,100 myPHteam members. Angina occurs when too little oxygen-rich blood flows to your heart. This can cause pain in your chest, which may feel like squeezing or pressure instead of pain.

Angina is a symptom, not a chest or lung disease. In other words, feeling this type of chest pain means you have something else (such as PH or other issues with the lungs or heart) going on. Finding an effective PH treatment may help reduce the severity of symptoms such as angina.

2. People With PH Experience Chest Pain Differently

When myPHteam members talk about their chest pain, they often describe it very differently. Some members find that chest pain comes and goes, while others feel that it never completely goes away.

Some say their chest pain tends to correlate with other PH symptoms, such as shortness of breath. Others associate chest pain with certain activities or situations. “Any exertion causes chest tightness and pain,” one member noted. Another said, “I noticed that when I eat large meals, the chest pain is more intense.” A third member said, “Most of us experience chest pain when lifting heavy objects or bending down, so we don’t do those things.”

Many find that chest pain is a good indicator that they need to take a break and allow their body to rest. As one member wrote, “I’m feeling really tired and run-down with mild chest pain, so I won’t be doing much today.”

3. Stress on Your Heart May Cause PH Chest Pain

People diagnosed with PH experience hypertension (high blood pressure) in the pulmonary arteries. These are the blood vessels that deliver blood to your lungs. In people with PH, the pulmonary arteries become blocked, narrowed, stiff, or thickened. This can slow the flow of blood through them.

The thickening or narrowing of the arteries makes it more difficult for the heart to pump oxygenated blood throughout the body. As a result, the right side of the heart can become overworked and, eventually, damaged. This may cause chest pain.

4. PH Treatments May Help Ease Chest Pain

A range of strategies can help alleviate chest pain associated with PH. You and your healthcare provider can work together to find the right treatment or combination of therapies to address your PH. If your PH is stable, you may find that you have fewer symptoms, such as chest pain.

Note that if you’re experiencing new chest pain or chest pain that doesn’t go away, you should contact your doctor right away.

Medications for PH

Medications commonly used to treat PH include vasodilators, blood thinners, and diuretics.

Vasodilators

Also called blood vessel dilators, vasodilators help open narrowed or blocked blood vessels, including the pulmonary arteries. Your heart will not have to work as hard to pump blood through the widened blood vessels, which may ease your chest pain. There are different types of vasodilators that your doctor may prescribe for PH, including:

• Endothelin receptor antagonists — These drugs block endothelin receptors, which are substances that can cause blood vessels to get narrower.
• Phosphodiesterase-5 inhibitors — Also called PDE5 inhibitors, these drugs can help prompt more blood to flow through your lungs.
• Prostacyclin analogs — These medications can help open up blood vessels so more blood can flow through them.
• Activin signaling inhibitors — These enhance healthier structure of blood vessels by balancing the growth of smooth muscle cells.
• Soluble guanylate cyclase (sGC) stimulators — These drugs prompt your pulmonary arteries to relax and reduce lung pressure.

Diuretics

Diuretics eliminate fluid buildup in the body, and less fluid means less work for your heart. While diuretics can help manage the symptoms of PH, they don’t directly treat the disease.

More types of medications can treat PH, depending on the type and severity of your condition. Talk to your doctor until you find the drug or combination of drugs that works best for you.

Surgery for PH

You and your cardiology or pulmonology teams might consider several surgical options, especially if medications aren’t working well for you. Surgical interventions may include:

• Balloon pulmonary angioplasty — This minimally invasive surgery can clear blockages and widen the pulmonary arteries.
• Atrial septostomy — This surgery allows the care team to alleviate pressure in the heart.
• Pulmonary endarterectomy — Also called PTE, this surgery removes blood clots from the lungs and pulmonary arteries.
• Lung transplantation — During a lung transplant, the surgeon replaces one or both of your lungs.

5. Lifestyle Adjustments May Help Reduce Chest Pain

Certain lifestyle changes can help you reduce strain on your heart and manage PH symptoms, such as chest pain. You can discuss self-care measures with your healthcare team.

Quitting Smoking

Cigarette smoking can increase your risk of chest pain. Quitting is one of the best moves you can make to alleviate chest pain and improve your overall health. People with PH should also avoid secondhand smoke. If you’re interested in quitting smoking, talk with your healthcare provider about smoking cessation support or products.

Achieving or Maintaining a Healthy Weight

Being overweight doesn’t directly cause PH. But extra weight may put more pressure on your heart and lungs. If you have PH, it can also make it more challenging to do your usual activities. Ask your pulmonologist (lung doctor) for health information about weight-loss programs that may be helpful for you if you’re living with PH and are interested in bringing your weight down.

Eating a Healthy Diet

Eating well is important if you’re living with PH. Avoid unhealthy fats and excess cholesterol. Your healthcare provider may ask you to remove as much salt from your diet as possible, too, as this can contribute to water retention. Ask for a referral to a registered dietitian if you’re interested in learning healthy eating strategies.

Getting Enough Rest

Rest and sleep will help your body function optimally and counteract some of the fatigue that can accompany PH.

Avoiding Factors That Worsen PH Symptoms

Being at high altitudes (8,000 feet or higher) and performing activities that cause you to strain (like lifting weights) can both worsen PH symptoms such as chest pain. Talk with your doctor if you’re concerned that a specific factor or activity in your daily life may be worsening this symptom.

Adjustments to Activities That Cause Chest Pain

Quite a few myPHteam members say certain activities can worsen chest pain. It’s best to avoid such activities, if possible. If bending over makes your chest hurt, you may want to talk with your doctor or an occupational therapist about tools to help you reach objects near the ground. That way, you won’t have to bend to pick up objects.

If exertion or physical activity causes your chest pain, it may be wise to be supervised by a physical therapist (PT). They’ll work with you to design an exercise regimen that your body can handle. This will help you get the physical activity you need without experiencing undue strain that worsens chest pain. Over time, you may find that your capacity for exercise and exertion improves. You may also experience less chest pain.

“I’m going to PT,” one myPHteam member said. “The physical therapist is monitoring me well and I’m resting in between activities.”

When Should You Go to the Hospital for PH Chest Pain?

Always call your pulmonologist about new or worsening chest pain. If it’s severe and sudden or accompanied by any of the symptoms below, call 911 or go straight to an emergency room:

• The pain moves to your neck, stomach, or back.
• You faint or lose consciousness.
• You have trouble breathing.
• One leg swells up.
• You’re experiencing stroke symptoms, such as vision changes or trouble talking.

Find Your Team

By joining myPHteam, the social network for people with pulmonary hypertension, you can ask questions and share advice with more than 56,000 members who understand life with PH.

Have you experienced chest pain with pulmonary hypertension? How do you manage it? Share your thoughts or tips in the comments below or by posting on your Activities page.