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Symptoms of Pulmonary Hypertension

Medically reviewed by Steven C. Pugliese, M.D.
Written by Kelly Crumrin
Updated on June 2, 2023

Symptoms of pulmonary hypertension (PH) vary for each individual and by how advanced the condition is. For some classes of PH, there may not be any symptoms. As damage progresses, symptoms can become debilitating and force those with PH to significantly limit their activities. Symptoms of PH are similar across different types of PH.

People with PH may not experience each of these symptoms — or any symptoms — but here are some of the most common.

Trouble Breathing

Many people with PH experience shortness of breath or trouble breathing. You may notice breathing difficulties only with exertion, or even at rest. You may feel light-headed or dizzy, like you are going to faint. You may even faint.

A dry or persistent cough may also be a symptom of PH, which also affects breathing. In advanced PH, coughing may bring up blood. Some people with PH may experience respiratory infections or vocal changes.

Pain

Chest pain (angina), pressure, and discomfort are common for people with PH. Pain can sometimes be felt in the upper-right abdomen. Some people with PH may also experience leg cramps.

Fatigue

Fatigue is a common and debilitating symptom for people with PH. The heart is working harder than ever, but the body may not be receiving enough blood and oxygen. You may feel especially tired after exercise or exertion.

Skin Symptoms

If your skin is not receiving enough blood and oxygen, it may appear pale gray or blue, especially on your lips and nails. This discoloration is called cyanosis. Some people with PH develop Raynaud’s phenomenon, a condition involving the small blood vessels of the fingers that can cause them to turn red, white, blue, or a combination of these colors. Cold temperatures sometimes provoke color changes for those with Raynaud’s phenomenon.

Swelling

If your heart is having trouble pumping blood around your body, you may notice edema (swelling) in the legs, abdomen, or around the eyes. Edema in the abdomen is also referred to as ascites. Edema may also occur in the hands, ankles, or feet.

Cognitive Symptoms

Cognitive changes, often referred to as “cog fog” or “brain fog,” can include problems with memory, focus, paying attention, processing information, forgetting words, learning and remembering new things, staying organized, and getting lost in familiar places.

Other Symptoms of Pulmonary Hypertension

Depression, anxiety, and insomnia are common in those with PH, as with many chronic illnesses. People with some types of PH may experience heart palpitations or changes in the heart rate.

Complications of Pulmonary Hypertension

Pulmonary hypertension can cause serious health complications. People with PH can develop arrhythmia, or abnormal heart rhythms. The pulmonary artery may dilate (widen) and put pressure on the coronary artery that supplies the heart muscle with blood. Compression of the coronary artery can result in chest pain, a heart attack, or even death. Dilation of the pulmonary arteries can also cause compression of the airways, leading to coughing and wheezing that sound like asthma. Rarely, the pulmonary artery may rupture — usually a fatal complication.

Pulmonary hypertension can cause heart failure, also known as congestive heart failure or CHF. Heart failure is not a specific heart disease, but rather an advanced state of heart disease when the heart can no longer supply enough blood and oxygen to keep all the tissues of the body healthy.

Approximately half of people with PH develop pericardial effusion — excess fluid in the protective sac that surrounds the heart. If too much fluid builds up, it can exert pressure on the heart that makes it difficult to beat. This life-threatening condition is called cardiac tamponade.

Dangerous lung complications in PH can include bleeding and the formation of blood clots. Some people with PH have a greater risk for developing severe pneumonia and other serious lung infections. Those who have central venous catheter lines for the infusion of medication can develop infections due to pathogens introduced via the line.

PH can also cause liver damage known as cardiac cirrhosis.

It is important to treat PH symptoms early and to attend all follow-up appointments with your doctor. Effective treatment can relieve symptoms and slow the disease progression for many people with PH.

Learn more about treatments for pulmonary hypertension.

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Join myPHteam, the social network for people diagnosed with pulmonary hypertension and their loved ones. More than 50,000 members from across the globe come together to ask questions, offer support and advice, and share stories of life with pulmonary hypertension. It’s a place where you can be completely honest about your journey and know those reading your words truly understand.

Have you experienced any of these symptoms of pulmonary hypertension? Share your experience in the comments below or by posting on myPHteam.

Updated on June 2, 2023
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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
Kelly Crumrin is a senior editor at MyHealthTeam and leads the creation of content that educates and empowers people with chronic illnesses. Learn more about her here

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