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Dizziness and fainting are common symptoms of pulmonary arterial hypertension (PAH). Dizziness might be described as a woozy, weak, or unsteady feeling. Sometimes, it’s a warning sign of fainting (or passing out) — a temporary loss of consciousness.
Many members of myPHteam have discussed these symptoms. One member shared, “I experience dizziness and lightheadedness, but I guess it comes with the disease.”
Dizziness can affect your quality of life. “Personally, dizziness and brain fog bother me more than breathing,” one member commented.
If you have PAH and also have dizziness and fainting, this article can help you understand what might be causing these symptoms and how some treatments may help.
Can pulmonary hypertension cause dizziness? Yes — dizziness and fainting can be symptoms of PAH or side effects of certain medications. Here’s how PAH and dizziness may be connected.
PAH can cause heart and lung problems that make it harder for oxygen-rich blood to move through your body. If parts of your body, especially your brain, don’t get enough oxygen, you may feel dizzy.
PAH is a form of pulmonary hypertension (PH) that happens when the arteries that carry blood from your heart to your lungs (called pulmonary arteries) get thick and narrow. This makes it harder for blood to flow and raises the pressure in your lungs.
The right side of your heart pumps blood to the lungs. Over time, the extra work of pushing blood through narrowed arteries can weaken the right side of the heart and lead to medical conditions like heart failure.
High blood pressure in your lungs and strain on the right side of your heart make it harder for blood to reach your lungs — and the rest of your body. If your brain doesn’t get enough oxygen, you may feel dizzy or lightheaded or may even faint.
Other common symptoms of PAH include:
Medications can help slow the progression of PAH, but some of these medicines can make you feel dizzy or faint if they lower your systemic blood pressure (the pressure of blood flowing through the rest of your body, outside the lungs) too quickly. These medications include:
Some myPHteam members have reported dizziness as a side effect. “Does anyone else have a problem with dizziness with their PH medication?” one member asked.
Macitentan/Tadalafil (Opsynvi) is a combination medication used to treat PAH. It may cause sudden loss of hearing, ringing in the ears, and dizziness. If this happens, contact your healthcare provider right away.
Sildenafil (Revatio) treats PAH by dilating (widening) the blood vessels in your lungs. However, this drug may also lower systemic blood pressure and lead to dizziness. Call your doctor right away if you start to have dizziness, hearing loss, or ringing in your ears while taking sildenafil. These could be signs of a serious health problem.
Sotatercept (Winrevair) is a medication that treats PAH and helps prevent the disease from getting worse. Dizziness is listed as a possible side effect of this medication.
Warfarin is sometimes prescribed to help prevent blood clots in people with PAH. If you suddenly become dizzy or feel faint while taking this medication, get medical help right away.
Dizziness can be a side effect of medications unrelated to PAH, such as antidepressants, anti-seizure drugs, and sedatives. If you’re experiencing dizziness, talk to your healthcare provider to find out if it could be related to a medication you take for PAH or another condition. They may suggest adjusting the medication or dose to help reduce this side effect.
The goal of PAH treatment is to slow the progression of your disease and reduce symptoms, including dizziness and fainting.
PAH treatments work in different ways to help open up the blood vessels in your lungs. This lowers pressure in the lungs and makes it easier for your heart to work. Your heart can do a better job of moving oxygen into your blood and sending it throughout your body, including to your brain.
“I have been on my PAH medications for a year, and it helps me so much. I can clean my home and walk without feeling dizzy. I feel great since I have been on the medication,” shared a myPHteam member.
PAH symptoms, like feeling dizzy or fainting, usually happen because the right side of the heart isn’t working well and not enough oxygen is moving from the lungs into the blood. PAH treatments that support heart and lung function can help reduce these symptoms. Common medications include prostaglandins, endothelin receptor antagonists, phosphodiesterase type 5 (PDE5) inhibitors, and others.
Prostaglandins are lab-made medications that mimic natural substances in your body and help open narrow blood vessels in the lungs. Prostaglandins can be taken orally (by mouth), injected into a vein or under the skin, or inhaled.
Endothelin receptor antagonists prevent blood vessels from narrowing. You take these medicines by mouth.
PDE5 inhibitors work by helping your body make more substances to relax and open the blood vessels in your lungs. You also take these medicines by mouth.
Newer PAH medications may relax the muscles in blood vessel walls or help stop the walls from thickening and narrowing — both of which can reduce symptoms like dizziness.
Other medications, such as vasodilators, calcium channel blockers, diuretics, and blood thinners, may also be prescribed to manage PAH symptoms.
As discussed earlier, you may feel dizzy or faint if your heart can’t pump enough oxygen-rich blood to your brain. Oxygen therapy can help boost oxygen levels in your blood to make sure your brain and other organs get the oxygen they need to function well.
Lifestyle changes may also help you manage PAH symptoms such as dizziness and fainting. For example, regular physical activity is important, and pulmonary rehabilitation programs can teach you how to exercise safely with less shortness of breath and dizziness. Talk to your healthcare provider about the best exercise plan for you.
Eating a heart-healthy diet that’s low in salt and unhealthy fats is also key. If you have heart problems, your doctor may also ask you to keep track of how much liquid you drink each day.
It’s important to talk with your healthcare provider about PAH symptoms such as dizziness and fainting. Your doctor may change your treatment plan based on your symptoms or side effects from medication.
You can also try to avoid activities that may trigger dizziness or fainting, such as:
With the right treatment plan and lifestyle approaches to manage your PAH symptoms, you may be able to minimize dizziness and fainting and improve your quality of life.
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? Have any treatments improved symptoms like dizziness and fainting? Share your experience in the comments below, or start a conversation by posting on your Activities page.
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It would be helpful to name the meds for PAH when describing their actions as it is impossible to remember.
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