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Difficulty Breathing and Pulmonary Hypertension

Updated on September 27, 2021
Medically reviewed by
Steven C. Pugliese, M.D.
Article written by
Sarah Winfrey

What It Feels Like | Causes | Treatment | Get Support

Pulmonary hypertension (PH) is a condition in which the blood vessels between the heart and the lungs become narrow, causing high blood pressure in those arteries. Along with chest pain, heart palpitations, and fatigue, difficulty breathing is a common symptom of PH.

If you’re experiencing shortness of breath, here’s what to know about its role in PH, including why shortness of breath happens, and how to work with your health care provider to help manage breathing troubles.

What Does Difficulty Breathing With Pulmonary Hypertension Feel Like?

The shortness of breath associated with PH can be anywhere from moderate to severe. Some people experience trouble breathing only in certain situations, as one myPHteam member shared: “I get short of breath when bending over to pick something up.” Another said that they “have noticed that it is really hard to take a deep breath or walk very far outside in the cold air.”

Other people experience difficulty breathing more often. One member experiences “shortness of breath with slight movement. Sometimes, it goes away in a few minutes, but it usually stays for several hours. Sometimes, I even wake up with it.”

Breathing difficulties can affect different people in different ways, although they often interfere with completing tasks in daily life. A member put it this way: “I have breathing problems mainly upon exertion or when getting out of our vehicle or shopping.” Another member shared that they struggle with shortness of breath at home as well: “I get short of breath when I exert my energy to do chores or anything.”

Shortness of breath can even interfere with sleep. “I didn’t sleep last night, and then I tried to sleep today,” wrote one member. “Had problems breathing, but at least I got a couple hours.”

Breathing troubles can be scary, even if you know why it is happening. A member summed it up when they said, “Sometimes, it is terrifying because it feels like I am suffocating.”

What Causes Breathing Difficulties With Pulmonary Hypertension?

PH causes the arteries running between the heart and lungs (the pulmonary arteries) to narrow, making it much more difficult for blood to flow through them. This narrowing and resistance causes high blood pressure in the pulmonary arteries. High pulmonary artery pressure can raise the risk of blood clots (especially in the lungs, called a pulmonary embolism). It may eventually lead to heart disease and even heart failure as the heart muscles work harder to pump blood.

Breathing troubles in people with PH stem from issues with proper blood flow between the heart and lungs. Because of the high blood pressure, the right side of the heart struggles to pump blood to the lungs, which is where the blood picks up oxygen before being pumped to the rest of the body. When there’s not enough oxygen in the blood, a person will feel out of breath, even if their lungs are bringing in plenty of air.

In some people, the heart overworks itself and becomes damaged, causing further difficulty circulating oxygenated blood throughout the body — and leading to more shortness of breath.

At first, breathing difficulties may only be triggered by certain situations, like exertion, physical activity, or bending over. In more severe cases, shortness of breath can occur at rest.

Treating and Managing Breathing Problems With Pulmonary Hypertension

There are several ways to treat PH to help make the condition more manageable and to alleviate symptoms like difficulty breathing. Talk to your health care provider to learn more about what treatment options might work best for you.

Medication

Certain medications are used to help with PH, including:

  • Blood vessel dilators, which widen narrowed arteries
  • Diuretics, which help decrease the load on your heart
  • Medications that help the heart beat more strongly

A cardiologist can help you find the right combination of medications to manage your symptoms.

Oxygen

Many people diagnosed with PH find that using extra oxygen helps alleviate their shortness of breath. Some people use it all the time, while others only use it when they need it. One member who uses oxygen said, “When I’m walking with oxygen and it gets harder to breathe, I stop and rest for a minute to get my oxygen saturation rates up again. Then I am good to go another 25 to 35 feet before I have to stop again.”

Other breathing machines may help as well. For instance, many people with PH also deal with sleep apnea, a condition that causes interrupted breathing during sleep. If untreated, sleep apnea can worsen PH symptoms. Some people with PH may wear a continuous positive airway pressure (CPAP) machine while they sleep to help them breathe at night. As one member said, “I use a CPAP at night but no oxygen, as my rate only falls to about 80 upon exertion.”

Breathing Exercises for Pulmonary Rehabilitation

If you are eligible and your doctor thinks it would be helpful for you, pulmonary rehabilitation could give you the resources you need to manage your shortness of breath. One member explained, “When I went through pulmonary rehab, they taught us how to breathe several ways.” Another wrote, “When I have a problem breathing, I sit and do pulse breathing. I breathe in and breathe out until my oxygen level goes up to at least 90, and then I do my work again.”

Pulmonary rehab may also include physical activity. “I don’t exercise very fast because I get so out of breath, but the rehab has helped. Even a little bit makes a difference,” one member shared.

Lifestyle Changes

Many doctors recommend lifestyle changes to help manage PH and its symptoms. These lifestyle changes include:

  • Managing your diet and weight
  • Quitting smoking
  • Avoiding high altitudes
  • Getting enough sleep
  • Keeping your activity levels as high as your body will allow
  • Avoiding saunas, hot tubs, or hot showers
  • Seeing a doctor regularly
  • Asking for help when you need it
  • Getting all of the vaccines your health care provider recommends for you

Connect With Others Who Understand

It’s easy to feel stressed and alone when dealing with pulmonary hypertension, but it may be easier with the support of others who understand. On myPHteam, the social network for those who live with PH every day, more than 46,000 members come together to ask questions, give advice, and share their experiences of life with pulmonary hypertension.

Have you experienced difficulty breathing with PH? How have you managed it? Share your experience and tips in the comments below or by posting on myPHteam.

All updates must be accompanied by text or a picture.
Steven C. Pugliese, M.D. is affiliated with the Hospital of the University of Pennsylvania in Philadelphia, serving as the director of the pulmonary embolism response team, co-director of the comprehensive pulmonary embolism program, and an assistant professor of clinical medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here.

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