Understanding Pulmonary Hypertension: Symptoms, Causes, and Hope
Pulmonary hypertension is a serious condition affecting the lungs and heart. Learn about its symptoms, causes, diagnosis, treatment options, and the hope available through early care.
Written by Dr. Siri Nallapu
Reviewed by Dr. Rohinipriyanka Pondugula MBBS
Last updated on 17th Sep, 2025
Have you ever felt unusually short of breath after a simple activity like walking up a few stairs? While often attributed to being out of shape, this can sometimes be a sign of a less common but serious condition known as pulmonary hypertension (PH). Unlike the well-known systemic high blood pressure, pulmonary hypertension specifically affects the arteries in your lungs and the right side of your heart. This guide will demystify this complex condition, breaking down its symptoms, the various types and causes, and the modern treatment strategies that offer hope and improved quality of life. Our goal is to empower you with knowledge, so you can better understand your body and know when it might be time to seek expert advice.
What is Pulmonary Hypertension?
When people hear "hypertension," they typically think of high blood pressure measured with a cuff on the arm. This is systemic hypertension, affecting arteries throughout the body. Pulmonary hypertension is fundamentally different. It is high blood pressure that occurs specifically in the pulmonary arteries—the vessels responsible for carrying blood from the right side of your heart to your lungs to pick up oxygen.
In PH, these arteries become narrowed, blocked, or stiff. This forces the right ventricle of your heart to work much harder to pump blood through the lungs. Over time, this extra strain causes the heart muscle to weaken and can lead to right-sided heart failure. It's a progressive disease, meaning it tends to get worse over time if not managed, but with today's treatments, many people can effectively manage their symptoms.
How Pulmonary Circulation Differs from Systemic Circulation?
Think of your heart as a double pump. The left side (left ventricle) is powerful, designed to pump oxygen-rich blood through the vast systemic circuit to your entire body. The right side (right ventricle) is a weaker pump designed for the low-pressure, short-distance pulmonary circuit to your lungs. Pulmonary hypertension disrupts this low-pressure system, placing a burden the right ventricle wasn't built to handle.
The Impact of High Blood Pressure in the Lungs
The increased pressure damages the artery walls and forces the right ventricle to thicken and enlarge—a condition known as right ventricular hypertrophy. Eventually, the ventricle can't keep up, and its pumping ability diminishes. This is why symptoms like extreme fatigue and swelling are common; the heart can't efficiently move blood through the lungs to get oxygen or return it to the rest of the body.
Symptoms of Pulmonary Hypertension
The symptoms of PH are often subtle in the early stages and are frequently mistaken for asthma, being out of shape, or other common conditions. This is one reason diagnosis can be delayed.
Early-Stage Symptoms Often Mistaken for Other Conditions
• Shortness of breath (dyspnea): Initially during exertion, but eventually at rest.
• Fatigue: A profound feeling of tiredness.
• Chest pain or pressure: Often felt during physical activity.
• Heart palpitations: A racing heartbeat or a sensation of fluttering.
Symptoms as the Condition Progresses
As the strain on the heart increases, more signs appear:
• Dizziness or fainting spells (syncope): Especially during activity.
• Swelling (oedema): In the ankles, legs, and eventually the abdomen.
• Bluish colour to the lips and skin (cyanosis): A sign of low oxygen levels in the blood.
• A feeling of fullness in the upper abdomen: Due to enlargement of the liver or fluid buildup.
If you experience persistent and unexplained shortness of breath, it is crucial to consult a healthcare professional for a proper evaluation. If your symptoms persist beyond two weeks, consult a doctor online with Apollo24|7 for further evaluation and to discuss the next steps.
The Five Groups: Understanding the Types and Causes of PH
The World Health Organization (WHO) classifies pulmonary hypertension into five groups based on the underlying cause. This classification is critical as it directly guides treatment.
Group 1: Pulmonary Arterial Hypertension (PAH)
This group involves PH that originates from the pulmonary arteries themselves. Causes can be idiopathic (unknown), heritable, or associated with conditions like connective tissue diseases (scleroderma, lupus), congenital heart disease, or portal hypertension.
Group 2: PH Due to Left Heart Disease
This is the most common type of pulmonary hypertension. It results from issues like heart failure or valve diseases on the left side of the heart, which cause a backup of pressure into the lungs.
Group 3: PH Due to Lung Disease
This group is caused by lung conditions that cause low oxygen levels, such as COPD, interstitial lung disease, or sleep apnea. The chronic lack of oxygen causes the pulmonary arteries to constrict.
Group 4: PH Due to Chronic Blood Clots
Known as chronic thromboembolic pulmonary hypertension (CTEPH), this type occurs when old blood clots (pulmonary embolisms) don't dissolve and instead scar and block the pulmonary arteries.
Group 5: PH Due to Unknown or Multifactorial Causes
This group includes PH with unclear or multiple causes, such as certain blood disorders, metabolic disorders, or kidney disease.
How Doctors Test for Pulmonary Hypertension?
Diagnosing PH requires a series of tests, as no single test can confirm it. The process often starts after a patient reports persistent symptoms like shortness of breath causes.
The Initial Tests: Echocardiogram and Beyond
• Echocardiogram: This ultrasound of the heart is the most important screening tool. It estimates the pressure in the pulmonary arteries and assesses the size and function of the right ventricle.
• Chest X-ray & ECG: May show an enlarged heart or right ventricle.
• Pulmonary Function Tests: Check for underlying lung disease.
• Blood Tests: Apollo24|7 offers convenient home collection for tests like NT-proBNP (a marker of heart strain) and others to rule out associated conditions.
The Gold Standard: Right Heart Catheterisation
This procedure is essential for confirming a diagnosis of pulmonary arterial hypertension. A thin tube (catheter) is inserted into a vein and guided to the right side of the heart and pulmonary arteries to directly measure the blood pressure. It provides the most accurate readings and is used to determine the severity of the disease and guide treatment decisions.
Consult Top Specialists
Treatment Options: Managing and Living with Pulmonary Hypertension
While there is no cure for most forms of PH, a range of treatments can significantly slow its progression, reduce symptoms, and improve quality of life. Treatment is highly specific to the WHO group.
Medications to Dilate Blood Vessels and Improve Blood Flow
For Group 1 PAH, advanced medications (vasodilators) are the cornerstone of treatment. These include endothelin receptor antagonists, phosphodiesterase-5 inhibitors, prostacyclin pathway drugs, and soluble guanylate cyclase stimulators. They work in different ways to relax and open narrowed pulmonary arteries.
Oxygen Therapy and Diuretics
• Oxygen Therapy: If blood oxygen levels are low, supplemental oxygen can reduce shortness of breath and ease the heart's workload.
• Diuretics (Water Pills): Help the kidneys remove excess fluid from the body, reducing swelling and relieving strain on the heart.
Surgical and Advanced Procedures
• Atrial Septostomy: A procedure to create an opening between the heart's upper chambers to relieve pressure.
• Pulmonary Thromboendarterectomy: A complex surgery to remove old clots for patients with CTEPH (Group 4).
• Lung or Heart-Lung Transplant: Considered for severe, advanced PH when other treatments are no longer effective.
Lifestyle and Home Management: Thriving with PH
Managing PH is a holistic endeavour. If your condition does not improve after trying these methods, book a physical visit to a doctor to create a personalised management plan.
• Diet and Nutrition Recommendations
A heart-healthy diet low in sodium (to prevent fluid retention) and saturated fat is key. Staying well-hydrated is important, but fluid intake may need to be monitored.
• Safe Physical Activity and Exercise Guidelines
While strenuous activity may be dangerous, supervised, gentle activity like walking can be beneficial. Cardiac rehabilitation programs are excellent for creating a safe exercise plan.
• The Importance of Vaccinations and Infection Prevention
Infections like flu and pneumonia can be very serious for PH patients. Staying up-to-date on vaccinations is a critical preventive measure.
• Mental Health and Emotional Wellbeing
A PH diagnosis can be overwhelming. Anxiety and depression are common. Seeking support from a therapist, counsellor, or a PH support group can provide crucial emotional tools and a sense of community.
Conclusion
Living with pulmonary hypertension presents undeniable challenges, but it's crucial to remember that it is a manageable condition. The landscape of treatment has evolved dramatically, offering new hope and significantly better outcomes than in the past. Understanding your diagnosis—knowing your specific WHO group, your treatment options, and the lifestyle adjustments that can help—puts you in the driver's seat of your health journey. From advanced medications to the support of a dedicated healthcare team and community, you have a toolkit available. If you or a loved one are navigating symptoms, take that first step. Seek answers, advocate for yourself, and build a partnership with your doctors to create a comprehensive care plan that allows you to live your life to the fullest.
Consult Top Specialists
Consult Top Specialists
Dr. P Sravani
Pulmonology Respiratory Medicine Specialist
3 Years • MBBS, MD
Visakhapatnam
Apollo Clinic Vizag, Visakhapatnam
Dr. Hyder
Pulmonology Respiratory Medicine Specialist
5 Years • MBBS, MD (PULMONOLOGY)
Guntur
Kalam chest and multi-speciality clinic, Guntur
Dr. K Prasanna Kumar Reddy
Pulmonology Respiratory Medicine Specialist
16 Years • MBBS, DTCD (TB&CHEST), DNB (PULM MED), FCCP
Hyderabad
Apollo Medical Centre Kondapur, Hyderabad
Dr. E Prabhakar Sastry
General Physician/ Internal Medicine Specialist
40 Years • MD(Internal Medicine)
Manikonda Jagir
Apollo Clinic, Manikonda, Manikonda Jagir
(125+ Patients)
Dr. Aakanksha Chawla
Pulmonology Respiratory Medicine Specialist
9 Years • MD (Pulmonary Medicine), IDCCM, IFCCM (Indian Fellowship in Critical Care Medicine)
Delhi
Apollo Hospitals Indraprastha, Delhi
(250+ Patients)
Consult Top Specialists
Dr. P Sravani
Pulmonology Respiratory Medicine Specialist
3 Years • MBBS, MD
Visakhapatnam
Apollo Clinic Vizag, Visakhapatnam
Dr. Hyder
Pulmonology Respiratory Medicine Specialist
5 Years • MBBS, MD (PULMONOLOGY)
Guntur
Kalam chest and multi-speciality clinic, Guntur
Dr. K Prasanna Kumar Reddy
Pulmonology Respiratory Medicine Specialist
16 Years • MBBS, DTCD (TB&CHEST), DNB (PULM MED), FCCP
Hyderabad
Apollo Medical Centre Kondapur, Hyderabad
Dr. E Prabhakar Sastry
General Physician/ Internal Medicine Specialist
40 Years • MD(Internal Medicine)
Manikonda Jagir
Apollo Clinic, Manikonda, Manikonda Jagir
(125+ Patients)
Dr. Aakanksha Chawla
Pulmonology Respiratory Medicine Specialist
9 Years • MD (Pulmonary Medicine), IDCCM, IFCCM (Indian Fellowship in Critical Care Medicine)
Delhi
Apollo Hospitals Indraprastha, Delhi
(250+ Patients)
Frequently Asked Questions
1. Is pulmonary hypertension the same as having regular high blood pressure?
No, they are completely different. Systemic hypertension (regular high blood pressure) affects arteries throughout your entire body. Pulmonary hypertension is specific to the arteries that carry blood from your heart to your lungs, and it is a much rarer and more serious condition.
2. What is the life expectancy for someone diagnosed with pulmonary arterial hypertension?
There is no single answer, as life expectancy with PH depends heavily on the specific type, how early it's diagnosed, the severity at diagnosis, and how well a patient responds to treatment. With modern therapies, many patients live for decades after their diagnosis, with a good quality of life.
3. Can pulmonary hypertension be cured?
For most groups, PH is a chronic condition managed long-term. However, Group 4 (CTEPH) caused by blood clots can potentially be cured with a specialized surgery called pulmonary thromboendarterectomy. For other types, treatment focuses on effectively managing symptoms and slowing disease progression.
4. Are there any natural remedies for pulmonary hypertension?
There are no natural remedies that can replace proven medical treatments. However, lifestyle choices like a low-sodium diet, approved physical activity, and avoiding pregnancy and high altitudes are natural complements to your prescribed treatment plan. Always discuss any supplements or major lifestyle changes with your PH specialist.
5. Can I exercise if I have pulmonary hypertension?
Yes, but it must be done carefully. Strenuous activity can be dangerous. Your healthcare team can help you develop a safe exercise plan, often involving supervised cardiac rehabilitation. Gentle activities like walking are usually encouraged to maintain strength and cardiovascular health.