Symptoms of Pulmonary Heart Disease
Discover the key symptoms of pulmonary heart disease, including shortness of breath, fatigue, chest discomfort, and swelling in the legs. Learn how early detection and management can improve heart and lung health.
Written by Dr.Sonia Bhatt
Last updated on 3rd Jul, 2025
Understanding Pulmonary Heart Disease
Pulmonary heart disease, also known as cor pulmonale, occurs when a lung condition leads to an enlargement of the right ventricle, ultimately causing heart failure. The right ventricle pumps blood to the lungs through the pulmonary artery, but certain lung conditions increase pressure in this artery, making it harder for the heart to function. Over time, the right ventricle enlarges and weakens, leading to heart failure. This blog explores all about pulmonary heart disease.
Types of Pulmonary Heart Disease
Pulmonary heart disease or cor pulmonale can be classified as:
Acute cor pulmonale: A short-term condition that arises suddenly due to a pulmonary embolism or severe lung infection.
Chronic cor pulmonale: A long-term condition caused by chronic lung diseases like COPD or pulmonary fibrosis.
Causes of Pulmonary Heart Disease
Several factors contribute to pulmonary heart disease, primarily conditions that lead to pulmonary hypertension. Common causes include:
Chronic obstructive pulmonary disease (COPD): The leading cause of chronic cor pulmonale.
Pulmonary embolism: Blood clots in the lungs restricting blood flow.
Pulmonary fibrosis: Scarring of lung tissue causing reduced oxygen exchange.
Obstructive sleep apnoea: Repeated breathing interruptions during sleep, leading to increased pressure in pulmonary arteries.
Kyphosis (curved spine): Puts pressure on the lungs and reduces breathing capacity.
Risk Factors of Pulmonary Heart Disease
Risk factors include:
Smoking and Tobacco Exposure: Smoking is the leading cause of lung damage and pulmonary hypertension, which can lead to cor pulmonale. Long-term exposure to cigarette smoke, even second-hand, increases the risk of respiratory conditions that contribute to pulmonary heart disease.
Air Pollution Exposure: Continuous inhalation of polluted air, including vehicle emissions, industrial fumes, and household pollutants (such as smoke from cooking fuels), can damage lung tissue and reduce oxygen exchange, eventually straining the heart.
Pre-existing Lung Conditions: Chronic lung diseases like COPD, pulmonary fibrosis, and obstructive sleep apnoea increase the likelihood of developing cor pulmonale. These conditions lead to long-term breathing difficulties and increased pressure in the pulmonary arteries, which can overwork the heart.
Common Symptoms Manifestation
Pulmonary heart disease symptoms progress gradually, becoming more severe over time. They can be categorised into:
1. Respiratory Symptoms
The respiratory symptoms includes:
Shortness of breath (Dyspnoea): Initially noticeable during physical exertion but gradually occurring even at rest as the disease worsens. This is due to reduced oxygen exchange in the lungs.
Chronic cough and wheezing: Persistent coughing and wheezing are common, often resembling symptoms of asthma or COPD. This occurs due to airway obstruction and inflammation in the lungs.
2. Cardiac-Related Symptoms
Cardiac-related symptoms includes:
Chest pain or tightness: As the heart struggles to pump blood against increased pulmonary pressure, strain on the heart can cause discomfort, tightness, or even pain in the chest.
Swelling in legs and feet (Oedema): Poor circulation leads to fluid buildup in the lower extremities, causing noticeable swelling in the ankles, feet, and sometimes the abdomen.
3. General Symptoms
The general symptoms includes:
Fatigue and dizziness: As oxygen delivery to the body becomes compromised, individuals may experience persistent tiredness, weakness, and occasional dizziness or fainting spells.
Cyanosis: A bluish tint on the lips, fingers, or skin due to insufficient oxygen in the bloodstream, indicating severe disease progression.
Sweating: Unexplained episodes of excessive sweating, even while at rest, can occur due to the body’s effort to compensate for inadequate oxygen levels.
How Symptoms Develop Over Time?
Pulmonary heart disease progresses in stages, with symptoms ranging from mild to severe as the condition worsens. Understanding these stages can help with early diagnosis and timely intervention.
1. Acute vs. Chronic Symptoms
The symptoms of pulmonary heart disease can appear suddenly or develop gradually, depending on the underlying cause.
Acute cor pulmonale: Symptoms appear suddenly and can be life-threatening. A rapid heart rate, severe chest pain, and difficulty breathing may occur due to conditions like a pulmonary embolism or lung injury.
Chronic cor pulmonale: Symptoms progress over months or years due to chronic lung diseases like COPD or pulmonary fibrosis, gradually leading to heart strain and failure.
2. Stages of Symptom Progression
As pulmonary heart disease advances, symptoms become more noticeable and impact daily life.
Early stage: Mild shortness of breath, especially during physical activity, and occasional swelling in the legs due to fluid retention.
Moderate stage: Breathing difficulty becomes more persistent, fatigue increases, and chest discomfort may develop.
Severe stage: Severe shortness of breath even at rest, fainting episodes, and intense chest pain signal significant heart failure and reduced oxygen circulation.
Respiratory Symptoms Explained
Pulmonary heart disease significantly impacts lung function, leading to noticeable respiratory symptoms that worsen over time.
1. Shortness of Breath
Breathing difficulty is one of the earliest and most persistent signs of pulmonary heart disease.
Initial stage: Shortness of breath occurs only during physical activity but improves with rest.
Advanced stage: Breathing difficulties become constant, even while resting or performing minimal tasks.
2. Wheezing and Chronic Coughing
Persistent coughing and wheezing can often be mistaken for other respiratory conditions like asthma or bronchitis. It may be accompanied by increased mucus production, leading to further airway obstruction.
Cardiac Symptoms Explained
As the condition progresses, increased pressure on the heart leads to cardiovascular symptoms that impact circulation and overall heart function.
1. Chest Pain and Tightness
Chest discomfort results from the heart struggling to pump blood through narrowed pulmonary arteries.
Caused by increased pressure in the pulmonary artery, making it harder for the heart to function.
Often worsens with exertion, as the heart works harder to circulate blood.
2. Swelling in Legs and Feet
Fluid retention due to right-sided heart failure leads to noticeable swelling, particularly in the lower extremities. It initially affects the legs and feet but can extend to the abdomen in more severe cases.
Less Common but Important Symptoms
Some symptoms may be less obvious but still indicate significant progression of pulmonary heart disease.
1. Fatigue and Dizziness
A decrease in oxygen supply affects the brain and muscles, leading to chronic tiredness and episodes of dizziness.
2. Cyanosis and Sweating
Low oxygen levels in the blood cause visible changes in skin colour and excessive sweating.
Bluish skin tone (cyanosis) particularly noticeable in the lips, fingers, and toes.
Profuse sweating can occur even without physical exertion, signalling worsening oxygen deprivation.
Diagnostic Process for Pulmonary Heart Disease
Diagnosing pulmonary heart disease involves a thorough medical evaluation and specialised tests to determine heart and lung function.
1. Medical History and Physical Examination
A comprehensive assessment helps doctors identify risk factors and early signs of pulmonary heart disease.
Doctors review symptoms, lifestyle habits (such as smoking or exposure to pollutants), and pre-existing medical conditions.
A physical examination using a stethoscope may reveal abnormal heart or lung sounds, indicating circulation or respiratory issues.
2. Diagnostic Tests and Procedures
Advanced imaging and functional tests are essential to confirm the diagnosis and assess the severity of the condition.
Echocardiogram: Evaluates heart size, function, and any signs of strain on the right ventricle.
Chest X-ray: Identifies lung abnormalities, such as fluid buildup or structural changes.
Electrocardiogram (ECG): Detects irregular heart rhythms and signs of right-sided heart strain.
CT scan or MRI: Provides detailed images of the heart and lungs for a more precise diagnosis.
Right heart catheterisation: Directly measures pulmonary artery pressure to assess the extent of hypertension.
Treatment Options for Symptom Management
Treatment focuses on managing the underlying lung condition, improving heart function, and alleviating symptoms to enhance quality of life.
1. Medications and Therapies
A combination of medications and supportive therapies helps reduce symptoms and prevent complications.
Oxygen therapy: Ensures adequate oxygen supply to tissues, reducing breathlessness.
Bronchodilators and corticosteroids: Help relax airways and reduce inflammation, improving breathing.
Diuretics: Assist in removing excess fluid buildup, reducing swelling in the legs and abdomen.
Anticoagulants: Lower the risk of blood clots, preventing further strain on the heart and lungs.
2. Lifestyle Changes and Rehabilitation
Adopting healthier habits and participating in rehabilitation programmes can significantly improve long-term outcomes.
Smoking cessation: Crucial to slowing disease progression and preventing further lung damage.
Cardiac rehabilitation: A structured programme combining monitored exercise, lifestyle guidance, and education.
Dietary changes: Reducing salt and fluid intake helps manage swelling and supports heart health.
Regular exercise: Low-impact activities such as walking and breathing exercises improve circulation and lung capacity.
Conclusion
Pulmonary heart disease is a serious condition that arises due to chronic lung disorders leading to right-sided heart failure. Early detection, lifestyle modifications, and medical management can help slow its progression and improve life expectancy. If you have lung conditions or risk factors, regular medical follow-ups and proactive care are essential to maintaining heart and lung health.
Consult Top Respiratory Disease Specialist
Consult Top Respiratory Disease Specialist
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