Pulmonary arterial hypertension symptoms: what to know

Some people notice that ordinary tasks, such as walking uphill or climbing stairs, require more rest than before. Later, breathlessness may occur with lighter activity or at rest. The pattern and speed of change vary, so new or worsening symptoms deserve assessment.

Pulmonary arterial hypertension affects the blood vessels carrying blood from the heart to the lungs. Narrowing or stiffening in these vessels makes it harder for the right side of the heart to pump blood forward. This can reduce how much oxygen-rich blood reaches the body during exertion.

Swelling of the ankles or legs, a fast heartbeat, or a bluish colour around the lips can occur when the heart and circulation are under strain. These symptoms can also have other causes, including heart or lung conditions, so symptoms alone cannot establish the diagnosis.

Arrange a medical appointment for unexplained breathlessness, reduced exercise tolerance, recurring dizziness or chest discomfort. A clinician may ask when symptoms began, what triggers them and whether they occur with sleep, infection or activity. Assessment can include listening to the heart and lungs and arranging tests such as an electrocardiogram, chest imaging or an echocardiogram.

Until you are assessed, pace activities, take breaks and record symptoms and triggers. Do not stop prescribed medicines without medical advice. Tell the clinician about fainting, ankle swelling, sleep-related breathing problems, or known conditions such as hypertension, heart failure, obesity or obstructive sleep apnoea.

Seek emergency help for severe or rapidly worsening breathlessness, fainting, chest pain that does not settle, marked blue or grey lips, confusion, or inability to speak in full sentences because of breathing difficulty. Sit upright, avoid exertion and follow local emergency guidance while waiting for help.

Ask what may be causing your symptoms, which tests are appropriate, whether activity needs to be limited temporarily, and which changes should prompt urgent help. You can also ask how existing heart, kidney or breathing conditions may affect the assessment.