Pulmonary Hypertension Symptoms: Breathlessness, Swelling and When to Be Seen

What it involves

MedlinePlus explains that pulmonary hypertension is a serious condition that affects the blood vessels in the lungs. Blood moves from the heart to the lungs through the pulmonary arteries. If those arteries are damaged, narrowed or blocked, blood flows less easily and the pressure rises, which makes the right side of the heart work harder. It can develop on its own or be caused by another condition.

Who this is for

• Adults with shortness of breath on light activity that has no clear explanation.
• Patients with lung disease, sleep apnea, heart failure or a past blood clot in the lungs.
• People with swelling of the ankles or belly, fatigue and lightheadedness.
• Anyone with scleroderma or another autoimmune disease who is newly short of breath.

What to expect

• Questions about when you get short of breath, swelling, dizziness, sleep, smoking and your medicines
• An exam of the heart, lungs, neck veins, legs and oxygen level
• Blood work and an EKG at the Loxahatchee and West Palm Beach offices, among the services the practice lists
• A referral for echocardiogram, chest imaging or lung and heart specialists when tests point that way

Why the diagnosis is often late

MedlinePlus says the symptoms are hard to recognize because they resemble those of other conditions, and that diagnosis can take years. The encyclopedia adds that early exams may look normal and that asthma and other conditions with similar symptoms must be ruled out. Symptoms can also come and go, with good days and bad days. Early on, breathlessness or lightheadedness happens with activity, and later it can occur with lighter activity and at rest. The shortness of breath guide describes the broader list of causes.

What can cause it

The condition can have no known cause, or it can follow another problem. MedlinePlus lists left-sided heart failure, congenital heart disease, lung diseases such as COPD, interstitial lung disease and emphysema, sleep apnea, liver disease, sickle cell disease, blood clots in the lungs and connective tissue disorders such as scleroderma. It is usually diagnosed between ages 30 and 60 and is more common in women. Related pages cover COPD symptoms, sleep apnea and heart failure.

Swelling and other clues

Beyond breathlessness, the encyclopedia lists leg and ankle swelling, bluish lips or skin, chest pressure, fatigue, weakness and abdominal swelling from fluid. A provider may hear abnormal heart sounds or see enlarged neck veins. Swelling that appears with breathing trouble is worth an early visit, and the leg swelling guide explains the common causes. Because these clues overlap with heart and lung disease, the first visit often means sorting out which organ is under strain before any lung pressure testing is considered.

How it is evaluated

MedlinePlus says a provider reviews your history, examines you and likely orders tests. These include blood tests, an electrocardiogram, a chest X-ray, heart imaging and lung tests, and the encyclopedia also lists echocardiogram, chest CT, a six-minute walk test, a sleep study and cardiac catheterization. At the office, blood work and an EKG at two locations can start the picture. Echocardiograms, imaging and catheterization are arranged by referral to cardiology or lung specialists, who direct pulmonary hypertension treatment.

Treatment and daily life

According to MedlinePlus, there is often no cure, but treatment can manage symptoms and prevent further lung damage. Treating a cause such as sleep apnea, lung disease or valve disease matters. Specialists may prescribe medicines that relax blood vessels, blood thinners, diuretics and home oxygen. Practical advice includes less salt, regular activity as advised, no smoking, and yearly flu, pneumonia and COVID-19 vaccines. Never stop a prescribed medicine without asking. The quitting smoking guide describes help with tobacco.

When to get help right away

MedlinePlus advises contacting a provider promptly for new or worsening shortness of breath with activity, chest pain, lightheadedness or dizziness, persistent palpitations or any new symptoms. Call 911 or go to the emergency room for fainting, chest pain or pressure, severe breathlessness at rest, or bluish lips. Sudden breathing trouble after a long trip or surgery can be a clot, and the pulmonary embolism warning signs guide explains why that is an emergency.

Sources

• MedlinePlus: Pulmonary Hypertension (health topic)
• MedlinePlus: Pulmonary hypertension (encyclopedia)