What are the symptoms of PAH?

The changes to the pulmonary vasculature described above lead to the typical symptoms of Pulmonary arterial hypertension (PAH). The symptoms are caused by the high resistance to blood flow through the lungs and result in increased stress on the heart.  This can severely impact the ability to exercise or carry out normal daily activities. Common early symptoms include:^1-3

• Breathlessness (Dyspnoea), particularly on physical activity
• Fatigue
• Dizziness 
• Syncope, also on physical activity (rare)
• Peripheral oedema
• Chest pain, again particularly during physical activity.

The symptoms may not be obvious at first and are often attributed to more common conditions such as asthma, general fatigue, or lack of physical fitness. Over time, however, they can become more severe and begin to limit normal activities.  As the disease progresses, some patients may experience constant dyspnoea and fatigue so that even simple tasks such as getting dressed and walking short distances become difficult.

References
1. Rubin LJ. Therapy of pulmonary hypertension: the evolution from vasodilators to antiproliferative agents. Am J Respir Crit Care Med 2002;166: 1308-9
2. Ono F, Nagaya N, Okamura H et al. Effect or orally active Prostacyclin analogue on survival in patients with chronic thromboembolic pulmonary hypertension without major vessel obstruction. Chest  2003;123: 1583-8
3. Galie N, Manes A, Branzi A. Emerging medical therapies for pulmonary arterial hypertension. Prog Cardiov Dis 2003:45: 213-24