What should you know about severe pulmonary hypertension?

The arteries carrying blood from the heart to the lungs become harder for blood to pass through. The right side of the heart must work harder, which can lead to breathlessness during activity, tiredness, dizziness, fainting, chest pressure, a racing heartbeat, or ankle and abdominal swelling. Causes and related conditions differ between people. Assessment may consider heart function, lung disease, clots, medicines, and conditions such as [Heart Failure](/conditions/heart-failure/), [Obstructive Sleep Apnoea](/conditions/obstructive-sleep-apnoea/), or [Chronic Kidney Disease](/conditions/chronic-kidney-disease/).

Follow the plan from your cardiology or pulmonary hypertension team and attend monitoring appointments. Take prescribed medicine exactly as directed, and ask before using decongestants, supplements, or over-the-counter pain medicines. Pace activity, rest when breathless, and discuss travel, altitude, pregnancy, vaccines, and exercise before making plans. Record changes in breathing, swelling, dizziness, chest symptoms, and weight if your clinician has asked you to monitor it. Do not stop pulmonary hypertension medicine without medical advice.

Call emergency services for severe or sudden breathlessness, fainting, blue or grey lips, new confusion, severe chest pain, or symptoms of a [Stroke](/conditions/stroke/) such as facial drooping, arm weakness, or speech trouble. Seek urgent medical advice when breathlessness is clearly worse than usual, swelling increases quickly, or prescribed oxygen or medicine is not helping as expected. Keep your medication list available for emergency teams.

Ask what type of pulmonary hypertension you have, how heart and lung function will be monitored, which activities are suitable, and which symptoms require emergency action. Discuss related risks such as [Angina](/conditions/angina/), [Hypertension](/conditions/hypertension/), or [Obesity](/conditions/obesity/), and whether another condition is contributing.