Pulmonary Arterial Hypertension: Symptoms, Causes & Treatment

Pulmonary hypertension is a serious chronic condition in which blood pressure rises inside the pulmonary arteries, the vessels that carry blood from the right side of the heart to the lungs to be supplied with oxygen. This differs from usual (systemic) high blood pressure that affects the body's arteries generally.

When pressure rises in the pulmonary arteries, the right side of the heart is forced to work harder to pump blood through them, so it enlarges and gradually weakens over time. Pulmonary hypertension has multiple causes: it may be primary and rare without a clear cause, or secondary resulting from left-heart diseases, chronic lung diseases, recurrent pulmonary clots, or connective-tissue diseases. Its symptoms appear gradually and include shortness of breath especially with exertion, fatigue, dizziness or fainting, chest pain, leg swelling, and palpitations.

Pulmonary hypertension is often diagnosed late because its symptoms resemble other common conditions, so it needs specialized evaluation including echocardiography and sometimes right-heart catheterization to measure the pressure precisely and determine the cause and type. Although it is a chronic condition with no radical cure in many types, treatments have advanced greatly and now improve symptoms and quality of life and slow progression, especially in the arterial type, in addition to treating the underlying cause. Early detection and follow-up at a specialized center are very important to improve outcomes.

• Shortness of breath that increases with exertion, then at rest.
• Fatigue and reduced exercise capacity.
• Dizziness or fainting on exertion.
• Chest pain, palpitations, and leg swelling.

• Primary (arterial) and rare without a clear cause.
• Left-heart diseases (the most common cause).
• Chronic lung diseases and low oxygen.
• Recurrent pulmonary clots and connective-tissue diseases.

• Echocardiography to estimate lung pressure and assess the right heart.
• Right-heart catheterization to measure the pressure precisely (the gold standard).
• Tests for the cause: lung function, imaging, and tests for clots.

Targeted treatment

• Specialized medications that widen the pulmonary arteries in the arterial type and improve symptoms and progression.
• Treating the underlying cause (heart, lung, clots).

Supportive care

• Oxygen when needed, diuretics for swelling, and blood thinners in certain cases.
• Follow-up at a specialized center and avoiding sudden strenuous exertion.

This content is educational and does not replace consulting a cardiologist or pulmonologist.

• Right-heart failure.
• Heart-rhythm disturbances.
• Clots, lung bleeding, and declining exercise capacity.

• Treating contributing causes such as heart and lung diseases and clots early.
• Quitting smoking and treating sleep apnea.
• Early detection and follow-up in at-risk groups.