Changes to the pulmonary vasculature lead to the typical symptoms of pulmonary arterial hypertension (PAH). The symptoms are caused by the high resistance to blood flow through the lungs, which results in increased stress on the heart and a compromised blood circulation through the whole body as a result of decreased cardiac output. This can severely impact a patient's ability to exercise or carry out normal daily activities. Common early symptoms include:1-3
- Breathlessness (dyspnoea), particularly during physical activity
- 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.
- Gaine SP, Rubin LJ. Primary pulmonary hypertension. Lancet 1998;352:719-25.
- Barst RJ, McGoon M, Torbicki A, et al. Diagnosis and differential assessment of pulmonary arterial hypertension. J Am Coll Cardiol 2004;43(Suppl S):40S-47S.
- GalièN, Hoeper M, Humbert M, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J 2009;30:2493–537.