Pulmonary Hypertension Symptoms and Diagnosis

What Are the Symptoms of Pulmonary Hypertension?

Diagnosing PH can be difficult because many of the signs and symptoms are similar to other lung diseases, like asthma and chronic obstructive pulmonary disease, also called COPD, and these can be diagnosed in error when the real cause is PH. Common signs and symptoms of pulmonary hypertension include: 

• Shortness of breath 
• Fatigue 
• Chest pain or heart palpitations 
• Dizziness and fainting 
• Swelling of your ankles and legs 

Often people diagnosed with PH have also been diagnosed with another condition. These are called comorbidities and include type 2 diabetes, obesity, obstructive sleep apnea and thyroid disease. Because of this, diagnosing PH can be hard to do and often takes months or even years.   

How Pulmonary Hypertension Is Diagnosed

If your healthcare provider suspects that you have PH, they will want a detailed medical and family history, complete a thorough medical exam and will order diagnostic tests. Some of the tests that may be ordered include:  

• Blood tests: Your healthcare provider may check for anemia, blood clots or stress on the heart. 
• BNP Test, also called B-type natriuretic peptide test, is a simple blood test that helps to determine if your heart is working harder than it should which could indicate a certain type of pulmonary hypertension. Your provider may order a similar test called NT-proBNP which also checks how your heart is working. 
• Chest x-ray: Shows the shape, size and general appearance of the heart and lungs 
• Echocardiogram (Echo): Ultrasound of the heart to check the size and condition of the chambers of the heart. It can also be used to estimate the blood pressure in the pulmonary arteries and check for blood clots. This is the most useful test for screening for PH.
• Electrocardiogram: Shows the electrical activity of the heart and may help detect abnormalities. Your provider may also be able to detect signs of strain on the right side of the heart. 
• Genetic testing: Some types of pulmonary hypertension are genetic or inherited.  
• Lung function tests (breathing tests): Check for diseases like PH, asthma or COPD. 
• 6-Minute Walk Test: Objectively measures how far you can walk and to see if your oxygen levels drop when you are physically active.  

Finding a Specialist

If you are diagnosed with pulmonary hypertension, or if pulmonary hypertension is suspected, it is important to see a specialist. A specialist who treats pulmonary hypertension is usually a heart or lung doctor. Because PH is a rare disease, a healthcare provider who specializes in this condition will confirm your diagnosis before beginning treatment. It is important to get treated for the specific type of pulmonary hypertension that you have. 

A specialist can help ensure you receive tailored treatment to meet your individual needs and provide the most up-to-date treatment options. You can find a specialist by: 

• Talking to your primary healthcare provider to see if they have a PH specialist that they recommend. 
• Find a PH specialist through the Pulmonary Hypertension Association. They provide a list of providers who treat PH and PH accredited care centers.