Pulmonary Hypertension (PH)
Pulmonary hypertension is high blood pressure in the arteries of the lungs that strains the right side of the heart. It can cause shortness of breath, fatigue, chest discomfort, and swelling, but effective treatments can improve symptoms and quality of life.
What is pulmonary hypertension?
“Pulmonary” refers to the lungs and “hypertension” means high blood pressure. In PH, the pulmonary arteries and tiny lung vessels become thickened, stiff, or narrowed. This limits blood flow through the lungs, raises pressure in the lung arteries, and forces the right ventricle to work harder. Over time, this strain can weaken the heart muscle.
Because damaged vessels move less blood through the lungs to pick up oxygen, oxygen levels can drop—leading to shortness of breath, dizziness, and fatigue. PH is a serious, progressive condition, but with an accurate diagnosis and targeted care, many people experience meaningful symptom relief.
Pulmonary hypertension symptoms
- Shortness of breath (initially with activity, later possibly at rest)
- Fatigue and reduced exercise tolerance
- Dizziness or fainting (syncope)
- Chest pressure or pain
- Racing heartbeat or palpitations
- Bluish lips or skin (cyanosis)
- Swelling in ankles and legs; sometimes abdomen (edema/ascites)
Symptoms can be subtle at first and progress as lung vessel changes worsen. If you notice increasing breathlessness, chest discomfort, or swelling, a prompt evaluation can help identify the cause and guide treatment.
Causes and risk factors
PH can occur for multiple reasons. Clinicians often group PH into categories based on its cause, such as pulmonary arterial hypertension (PAH), PH due to left heart disease, lung disease or low oxygen states, chronic blood clots, or multifactorial/unclear causes.
Common causes
- Pulmonary arterial hypertension (PAH)
- Left-sided heart disease (e.g., valve disease, heart failure)
- Chronic lung disease and low oxygen (e.g., COPD, interstitial lung disease, sleep apnea)
- Chronic blood clots in the lungs (chronic thromboembolic PH)
- Liver disease, congenital heart disease, connective tissue disorders
- Certain medications or substances
Risk factors
- Family history of PAH
- Autoimmune/connective tissue disease
- Chronic lung or heart conditions
- Obstructive sleep apnea
- History of blood clots
Pulmonary hypertension diagnosis and testing
Because many conditions can cause PH, your clinician will review your medical history, examine you, and order tests to confirm PH and identify its cause. Testing may include:
- Blood tests and oxygen level checks
- Chest X-ray and electrocardiogram (ECG)
- Echocardiogram to assess right heart size and function
- Pulmonary function tests (PFTs) to evaluate lung capacity and rule out COPD or pulmonary fibrosis
- Imaging to assess blood flow and clots (e.g., V/Q scan or CT)
- Right heart catheterization (specialized test to measure lung artery pressures)
Pulmonary function tests (PFTs)
PFTs measure how well your lungs move air and exchange gases. Results help identify or exclude lung diseases that can contribute to PH and guide your treatment plan.
Treatment options
Treatment is individualized based on the cause and severity of PH. Plans may include lifestyle measures, oxygen, medications, and procedures when appropriate. Your specialist will tailor therapy to your needs.
Medications
- Diuretics to reduce swelling
- Oxygen therapy for low oxygen levels
- Targeted PAH therapies (e.g., endothelin receptor antagonists, PDE‑5 inhibitors, soluble guanylate cyclase stimulators, prostacyclin analogs)
- Anticoagulation for certain clot-related cases (when advised)
Procedures and advanced care
- Interventions for chronic clots (when appropriate)
- Specialized referral for advanced therapies
- Regular follow-up to monitor heart and lung function
Some patients benefit from supervised exercise programs and vaccination against respiratory infections. Your care team will discuss benefits, risks, and monitoring for each option.
Lifestyle and self-care
- Stay active with clinician-guided exercise; pace activities and rest as needed
- Aim for heart-healthy nutrition; discuss sodium and fluid goals with your clinician
- Use oxygen exactly as prescribed
- Keep vaccines up to date (e.g., flu, pneumonia)
- Avoid smoking and secondhand smoke; seek support to quit if needed
- Track symptoms, weight, and activity tolerance between visits
When to see a doctor
- New or worsening shortness of breath, especially with routine activities
- Chest pain, lightheadedness, or fainting
- Rapid heartbeat, swelling in legs or abdomen, or bluish lips/skin
If you experience severe chest pain, fainting, or breathlessness at rest, call emergency services right away.
Frequently asked questions
Is pulmonary hypertension the same as pulmonary arterial hypertension (PAH)?
PAH is one type of pulmonary hypertension. PH is an umbrella term that includes PAH, PH from left heart disease, lung disease/low oxygen, chronic clots, and other or mixed causes.
How is pulmonary hypertension diagnosed?
Evaluation typically includes an exam, echocardiogram, lung tests, imaging for clots, and sometimes right heart catheterization to measure pressures and confirm the diagnosis.
Can pulmonary hypertension be cured?
Some causes are reversible or highly treatable, while others are chronic. Many patients improve with the right combination of therapies and close follow-up.
Does sleep apnea affect pulmonary hypertension?
Yes. Obstructive sleep apnea can contribute to PH in some people. Evaluation and treatment of sleep apnea may be part of a comprehensive PH care plan.
Contact O2 Pulmonary & Sleep Group
For more information about pulmonary hypertension or to schedule an evaluation, call 214-919-0757 or use our online contact form.