Pulmonary Arterial Hypertension Symptoms and Diagnosis

What Are the Symptoms of Pulmonary Arterial Hypertension?

In the early stages of PAH, you may not notice any symptoms at all. As the disease progresses, you will start to experience symptoms common to other lung diseases, such as asthma, emphysema or chronic obstructive pulmonary disease (COPD). The most common symptoms of PAH are:

  • Increased shortness of breath
  • Fatigue
  • Edema, or swelling of the feet, legs and eventually the abdomen and neck
  • Dizziness and fainting spells
  • Chest pain
  • Heart palpitations (racing or pounding)
  • Lips and fingers turning blue

When to See Your Doctor

If you have shortness of breath that does not improve with treatment for common diseases such as asthma and COPD; fainting or chest pain with exertion; unexplained swelling in your legs or abdomen and extreme fatigue; you should contact your healthcare professional.

How Pulmonary Arterial Hypertension Is Diagnosed

Because symptoms are similar to other common lung diseases, it can often be hard to diagnose PAH. Diagnosis is a process of eliminating other diseases. With the help of lung and heart specialists (pulmonologist and cardiologist) you will need to take a number of tests, such as:  

  • Blood tests: Include HIV, thyroid tests, autoimmune disease panels (test for systemic lupus erythematosus, scleroderma, and rheumatoid arthritis), liver tests and blood chemistry tests.
  • Electrocardiogram: Shows the electrical activity of the heart and may help detect abnormalities. Doctors may also be able to detect signs of strain on the right side of the heart.
  • Lung function tests (breathing tests): Check for diseases like asthma or emphysema.
  • 6-Minute Walk Test: Objectively measures how far you can walk and to see if your oxygen levels drop when you exert yourself.
  • Echocardiogram: Ultrasound of the heart to check the size and condition of the chambers of the heart. It can also be used to estimate the blood pressure in the pulmonary arteries.
  • Right Heart Catheterization:  This test is invasive, so it is not usually performed unless other tests cannot produce a firm diagnosis. It involves inserting a catheter (small tube) into a large vein in either the neck, arm, or groin, and threading it through the right side of the heart and into the pulmonary artery. This allows measurement of the blood pressure in the lungs.

Reviewed and approved by the American Lung Association Scientific and Medical Editorial Review Panel.

Page last updated: November 17, 2022

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