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Shortness of breath is one of the most common symptoms of pulmonary arterial hypertension (PAH). If you have shortness of breath, you may feel like you’re not getting enough air or that you can’t catch your breath.
Feeling breathless can deeply affect your quality of life and your ability to take care of yourself. “The shortness of breath and fatigue are disabling,” shared a member of myPHteam who was diagnosed with pulmonary hypertension.
In this article, we’ll discuss how shortness of breath develops when you have PAH and how treatments can help.
Learning why shortness of breath happens with PAH can help you understand how treatments may help.
PAH is a type of pulmonary hypertension that affects the pulmonary arteries (arteries in the lungs). Pulmonary arteries are the blood vessels that carry oxygen-poor blood from your heart to your lungs. In PAH, the pulmonary arteries become too thick and narrow. This makes it harder for blood to flow between the heart and the lungs. As a result, pressure builds up in the lungs.
High blood pressure in the lungs makes the right side of the heart work harder to pump blood through the narrowed arteries. Over time, this extra work can lead to heart failure.
When the pulmonary arteries get too thick and narrow, it becomes harder for blood to reach your lungs and pick up oxygen. This means your body gets less oxygen-rich blood.
Other symptoms of PAH may include:
It’s normal to become short of breath when you’re exercising or at high altitudes, but if you have PAH, you may get breathlessness even during normal daily activities. In the early stages of PAH, you may notice only mild shortness of breath when exercising or climbing stairs.
One myPHteam member said, “I’m running so short of breath after riding the stationary bike for 30 minutes.”
As PAH gets worse, you may start feeling short of breath during activities that didn’t cause this symptom before. “I have severe PAH. Just walking across a room gets me out of breath,” one member said. Another replied, “Shortness of breath on exertion is very common every day.”
You may feel other symptoms along with shortness of breath. One myPHteam member said, “I’m having a really rough day. I have extreme dizziness, chest pressure, joint pain, and shortness of breath. I’m also lightheaded. Here we go again.”
If you or someone you love has PAH, it’s important to learn how to treat shortness of breath so you can discuss the different options with your doctor.
PAH treatments usually work by opening up the pulmonary arteries. This helps lower the blood pressure in your lungs and takes some strain off your heart.
Treatments for PAH can help slow disease progression and improve shortness of breath and other symptoms. You and your healthcare provider will develop a treatment plan based on how bad your symptoms are, other medical conditions you may have, and more.
Oral treatments come as pills you swallow. Oral treatments help treat PAH by widening the blood vessels in the lungs or preventing them from getting narrower.
Endothelin receptor antagonists are a class of medications that prevent blood vessels from narrowing. They work by blocking endothelin, a substance that makes blood vessels constrict.
Endothelin receptor antagonists can help people feel less short of breath during physical activity.
Phosphodiesterase 5 (PDE5) inhibitors help your lungs make more vasodilators (substances that help open up blood vessels). These medications can help widen your pulmonary arteries and allow more oxygen-poor blood to flow to your lungs and out to the rest of your body.
PDE5 inhibitors have been shown to improve the ability to exercise.
Other oral treatments for PAH work by relaxing the blood vessels in your lungs so that your heart can pump blood to your lungs more easily. These medications can help slow disease progression and improve your ability to exercise.
Inhaled treatments are medications you breathe in using a special device that delivers the medicine straight to your lungs.
Inhaled treatments for PAH are lab-made versions of prostacyclins — substances your body makes to help open blood vessels. Inhaled medications help widen your pulmonary arteries and reduce the strain on your heart.
Using an inhaled treatment may help you be more physically active.
Intravenous (IV) and subcutaneous treatments are injected into your body. IV treatments go into a vein, while subcutaneous treatments go just under your skin. These medications may help you exercise more easily and reduce symptoms like shortness of breath and fatigue (extreme tiredness that doesn’t improve with rest).
Finding the right treatment can take time, so try to be patient with the process. Your healthcare provider may recommend pulmonary tests for shortness of breath to check how well your lungs are working and determine which medications or therapies might help. Lung function tests are usually simple and safe.
Supportive treatments can help relieve your symptoms, but they don’t treat the underlying cause of PAH.
Medications called calcium channel blockers can help lower the blood pressure in both your lungs and the rest of your body. However, they only work for a small group of people with PAH.
Other supportive medications may also be used. For example, blood thinners can help prevent blood clots, and diuretics (water pills) can reduce swelling. These treatments may help treat or prevent problems from PAH, but they don’t usually improve shortness of breath.
If your blood oxygen levels are low, your healthcare provider may prescribe oxygen therapy.
This supportive therapy may be helpful for some people with PAH. Supplemental oxygen can help you feel less breathless, be more active, and continue your daily activities.
Pulmonary rehabilitation is a program that teaches you how to exercise with less shortness of breath. These classes often include education about PAH, supervised exercise, breathing techniques, nutrition tips, and emotional support. Ask your healthcare provider if pulmonary rehabilitation could help improve your shortness of breath from PAH.
Lifestyle changes may help improve shortness of breath from PAH. These include:
One myPHteam member recommends staying indoors in hot, humid weather. They shared, “I’m a little short of breath today. The temperature is 98 degrees and very humid. Days like this are better spent at home.”
Talk to your healthcare provider about other lifestyle changes that may help with your shortness of breath.
On myPHteam, the social network for people with pulmonary hypertension and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with pulmonary hypertension.
What PAH treatment options have you tried? Which treatments have improved your shortness of breath? Share your experience in the comments below, or start a conversation by posting on your Activities page.
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