Why Does Pulmonary Hypertension Cause Shortness of Breath?

Catching one’s breath after mild or no activity could be a sign of a rare but serious condition affecting the body’s ability to circulate oxygenated blood to the heart.

7:00 AM

Author | Kevin Joy

There are many reasons a person might feel winded after climbing a few flights of stairs or some other brief physical activity.

MORE FROM MICHIGAN: Sign up for our weekly newsletter

Among them? Pulmonary hypertension or high blood pressure in the loop of vessels connecting the heart and lungs. Shortness of breath is a telltale sign of the condition.

"That is the most common presenting symptom," says Vallerie McLaughlin, M.D., director of the Pulmonary Hypertension Program at the University of Michigan Frankel Cardiovascular Center.

It's because "the right side of the heart is having trouble pushing blood flow through the lungs and it's not getting to the left side of the heart and body," McLaughlin says. "It puts strain on the right side of the heart, which is not used to pushing against the high pressure."

Patients with PH have blocked or narrowed arteries in their lungs. As a result, the system designed to carry fresh, oxygenated blood into the left side of the heart and then to the rest of the body is affected.

Other indicators of PH include fatigue, lightheadedness, chest pain, racing heartbeat and swelling in the ankles or legs.

Despite those distinct warnings, PH is often misdiagnosed. "Your primary care doctor is going to rule out the common stuff first," McLaughlin says, such as asthma or another heart or lung problem.

Patients, she adds, should request an echocardiogram — an ultrasound of the heart — if a cause of the symptoms isn't found. That could prompt a right-heart catheterization, which can measure the pressure of the heart and lungs.

Other tests may follow to determine the underlying cause of an individual's PH.

Pulmonary hypertension isn't necessarily caused by something a person did. And sometimes we don't find a cause.
Vallerie McLaughlin, M.D.

Causes and treatment

One type of PH, known as pulmonary arterial hypertension, causes blood vessels of the lungs to become thick and narrow, resulting in an elevation in pressure. About 10 percent of such cases are genetic, and people with a family history have a greater risk of developing it, McLaughlin says.

The remainder of PH diagnoses, grouped into five types by the World Health Organization, are linked to a variety of factors, including left-heart and lung diseases, blood clots and conditions such as HIV, sickle cell disease and scleroderma. Certain drugs, such as methamphetamines and the now-banned diet pill known as fen-phen, can also trigger it.

"It's not necessarily caused by something a person did," says McLaughlin. "And sometimes we don't find a cause."

SEE ALSO: 5 Basics to Know About Bicuspid Aortic Valve Disease

PH affects more women than men and can occur at any age, including in children, McLaughlin says. It most typically develops in people in their 30s and 40, she notes, and it can go undiagnosed for years.

Each patient's treatment will vary based on the severity of his or her condition.

Some individuals could receive oral, inhaled, IV or subcutaneous (beneath the skin) drugs to dilate blood vessels or increase the supply of blood and oxygen to the heart, among other objectives. Those with blood clots in their lungs may require surgery to remove them.

Lung transplantation is an option when all other medical therapies fail, though McLaughlin views that as a last resort: "That's really trading one disease for another."

Vallerie McLaughlin, M.D., consults with a patient.

Lifestyle shifts

All PH patients should also make lifestyle changes to keep their symptoms, including shortness of breath, in check.

"Sodium restriction is probably the most important thing," says McLaughlin. The American Heart Association recommends a healthful diet that's also low in fat, cholesterol and sugar.

Key, too, are staying active, maintaining a proper weight and quitting smoking.

And it's important to maintain contact with your health care provider during treatment and beyond, McLaughlin stresses.

"Patients have to be watched closely; the death rate is still high from this disease," she says. "We need to make sure they're improving and reach the goals that we set for them."


More Articles About: Heart Health Cardiopulmonary Care Hypertension and High Blood Pressure Frankel Cardiovascular Center Cardiac Medications Lungs and Breathing
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of health care news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]

734-764-2220

Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Subscribe
Featured News & Stories stethoscope blue yellow
Health Lab
Researchers uncover novel mechanism that leads to high blood pressure
Researchers at Michigan Medicine have uncovered a key mechanism that regulates blood pressure and vascular remodeling in people with a genetic variant linked to high blood pressure.
lungs beating pink and orange and yellow and white circles floating around
Health Lab
Protein found in rheumatic diseases causes inflammation in COVID-19 patients
Research on the inflammatory mediator called sCD13 has identified this molecule and its receptors as new targets for treatment of autoimmune rheumatic diseases. The data suggests that sCD13 may also be of great importance in severe complications of COVID-19.
woman looking at orange empty pill bottles with daughter on couch
Health Lab
Medicaid unwinding disrupted young people’s access to chronic disease medicines
Children and young adults living in the states with the highest Medicaid enrollment drops during the “unwinding” process were more likely to have disruptions in mental health, asthma and epilepsy medication.
up close doctor in hospital with cardiology close up scans on monitors
Health Lab
Researchers find significant differences in care of life threatening shock after heart attack
A study finds most hospitals don’t see many cardiogenic shock patients. When they do, providers often do not have a standardized way of treating them.
inhaler green money sign floating in cloud and little girl with black hair coughing
Health Lab
Children on Flovent for asthma more likely to stop inhaled steroids after drug pulled from market
The discontinuation of a popular asthma medication was linked to a higher rate of children stopping inhaled steroid therapy altogether, a study suggests.
woman with brown hair smiling and painting on right
Health Lab
Finding a 'beautiful gift' within stage 4 lung cancer
How one woman found 'a beautiful gift' within stage 4 lung cancer.