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Pain and Pulmonary Hypertension

Updated on October 18, 2021
Medically reviewed by
Steven C. Pugliese, M.D.
Article written by
Sarah Winfrey

Angina (chest pain) is one of the most common symptoms of pulmonary hypertension (PH), along with shortness of breath, heart palpitations, and edema (swelling). Although not everyone with PH experiences chest pain, many people do, and it can cause significant discomfort and distress.

If you are experiencing pain from pulmonary hypertension, it’s important to understand why that pain is occurring and what other people have done to alleviate it. If you experience chest pain with PH, talk to your doctor. Your health care provider is your best resource when it comes to relieving and managing your symptoms.

What Does Pain Associated With Pulmonary Hypertension Feel Like?

Many myPHteam members with pulmonary hypertension or pulmonary arterial hypertension (PAH) experience chest pain. As one explained, “I have chest pain, mostly on the left side, and shortness of breath even with slight movement. Sometimes, it goes away in a few minutes, but it usually stays for several hours. Sometimes, I wake up with it.”

Another wrote, “I ABSOLUTELY have chest pain. It just comes and goes. I can’t pinpoint a reason or specific movement that causes it.”

Others find that their chest pain is worse at certain times of the day or after certain activities. One member described how their pain changes: “I sometimes have bilateral pain underneath my breastplate that radiates to my back. The pain is really bad when I get out of bed in the morning or when I’m getting up from a seated position.”

Another member explained, “Most of us experience chest pain when lifting heavy objects or bending down, so we don’t do those things.”

Chest pain related to pulmonary hypertension can range from annoying or uncomfortable to severe and debilitating. One member wrote, “The chest pain and bad feeling in the chest are the most distracting.”

Another shared, “The chest pain is still there every day, especially with any kind of exercise or bending down. Some days, it’s unbearable and I go to the ER.”

As one member wrote, this pain can interfere with daily life and sleep: “Another night awake with chest pain.”

What Causes Pain in Pulmonary Hypertension?

Pulmonary hypertension occurs when there is high blood pressure in the blood vessels between the right side of the heart and the lungs. When this pressure is caused by narrow pulmonary arteries, it is called pulmonary arterial hypertension.

This high blood pressure (hypertension) means that the heart has to work harder than usual to get sufficient blood flow to the lungs (where the blood picks up oxygen to carry to the rest of the body). The narrowed blood vessels and excess strain on the heart can cause chest pain and may eventually lead to heart failure.

Several factors can cause pulmonary hypertension. Your doctor or cardiologist can help determine what is causing your pulmonary hypertension and work with you to help keep it under control and manage your symptoms such as chest pain.

Known causes of PH include:

  • Lung diseases, such as emphysema, pulmonary fibrosis, interstitial lung disease, or chronic obstructive pulmonary disease
  • Congenital heart disease
  • Connective tissue disease (such as lupus or scleroderma)
  • Sleep apnea
  • Liver problems (such as cirrhosis)
  • HIV infection
  • Metabolic disorders
  • Methamphetamine use
  • Sarcoidosis (a rare condition that causes granulomas — small patches of discolored, swollen tissue — to develop in the organs of the body)

Less frequently, people diagnosed with pulmonary hypertension may experience pain in the upper right-hand part of the abdomen. This kind of pain usually results from problems with the liver. Right-heart failure and reduced heart function caused by PH can damage the liver, leading to pain in the upper right abdomen. Liver disease is also a known cause of PH, so you may experience this abdominal pain before being diagnosed with PH.

Managing Pain With Pulmonary Hypertension

If you are experiencing chest pain, talk to your health care provider. They can work with you to find the right pain treatment plan.

The following are the most common ways of managing chest pain with pulmonary hypertension.

Treat Pulmonary Hypertension

Managing symptoms like pain often begins with treating the underlying medical condition. What treatments are appropriate for your pulmonary hypertension will depend on the condition’s unique cause. Work with your doctor to figure out which medication options might be best for you.

Some people use vasodilators (medications that dilate, or widen, the blood vessels). Others use anticoagulants (blood thinners), diuretics, or medications that reverse swelling in the arterial walls. It may take time, but you should be able to find an option that will work for you.

Other ways of managing PH include the following lifestyle factors.

Don’t Smoke

If you don’t smoke, don’t start. If you do smoke, make a plan to quit. Your doctor can help you quit effectively.

Avoid High Altitudes

Be cautious about high altitudes, which can lead to hypoxia (oxygen deficiency). Consider your PH before you make any travel plans, and bring supplemental oxygen if you think you might need it.

Avoid Activities That Lower Blood Pressure

Sitting in saunas or hot tubs and taking long, hot showers or baths can lower blood pressure to dangerous levels in people with PH.

Eat a Healthy Diet

People with PH need to eat a heart-healthy diet, including eating plenty of fresh fruits and vegetables, limiting portion sizes, and avoiding unhealthy fats. You can work with a nutritionist to determine the best diet for you.

Learn more diet and nutrition tips for PH.

Track Your Weight

Rapid weight gain may mean that your PH is becoming worse. Watch your weight carefully and mention any drastic changes to your doctor.

Try Pulmonary Rehabilitation

Pulmonary rehabilitation is a program in which professionals design exercises or other physical activities to help improve your breathing and overall quality of life. These programs are designed with the specifics of your PH (such as its cause) in mind. Pulmonary rehabilitation may also include an education component to help you modify your lifestyle in a way that will alleviate symptoms like pain.

Many of our members have participated in these programs and found them beneficial. One wrote, “I did pulmonary rehab, and it helped me tremendously. … This time last year, I was unable to go to the bathroom without sitting down twice before getting there because I couldn’t breathe. I can stand up for a shower now.”

Another explained, “I have pulmonary arterial hypertension, and I was going to pulmonary rehab, which worked for me like a charm.”

Take Deep Breaths

Making sure that your body is taking in enough oxygen can help alleviate chest pain, according to some members. As one shared, “Someone on this forum suggested taking slow deep breaths, and that seemed to help decrease the pain. Thanks for the suggestion.”

Find Your PH Team Today

By joining myPHteam, the social network for people with pulmonary hypertension, you can ask questions, share advice, and connect with more than 46,000 members who understand life with pulmonary hypertension.

Do you struggle with chest pain associated with pulmonary hypertension? Share your thoughts in the comments below or start a conversation 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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