Early symptoms of pulmonary arterial hypertension

Written by Li Qiang
Intensive Care Unit
Updated on May 09, 2025
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It depends on what disease causes pulmonary hypertension. There are several common causes of pulmonary hypertension, one of which is a pathological change in the pulmonary artery itself. Early on, there may be signs of mild increases in pulmonary artery pressure, possibly accompanied by slight right heart dysfunction. At this stage, symptoms such as mild hypotension and hypoxia might occur, manifesting as dizziness and fatigue. If the pulmonary hypertension is due to a disease of the lungs themselves, such as changes in the lung interstitium, then early symptoms of hypoxia will be more apparent, with chest tightness, slight breathing difficulties, and feelings of suffocation. If pulmonary hypertension is caused by conditions such as pulmonary embolism—specifically, an embolism in a smaller branch—the increase in pulmonary artery pressure may not be significant and will also be mild. This may be accompanied by a slight drop in blood pressure and mild breathing difficulties; however, because it is mild pulmonary hypertension, these symptoms are not severe and might include slight respiratory difficulty, mild chest tightness, shortness of breath, and mild dizziness. Therefore, early symptoms of pulmonary hypertension are typically not pronounced and generally do not attract special attention from patients.

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Pulmonary Arterial Hypertension Mild, Moderate, Severe Classification

Pulmonary artery pressure refers to the average pressure in the pulmonary artery when the body is at rest. Generally, the normal average pulmonary artery pressure is less than 25mmHg. Pulmonary hypertension is considered when the pulmonary artery pressure exceeds 25mmHg. The grading is generally divided into three levels based on the data: the first level is mild pulmonary hypertension with pulmonary artery pressure between 26-35mmHg; moderate with pressure between 36-45mmHg; and severe with pressure greater than 45mmHg. If classified by the functional impact of pulmonary hypertension, grade I pulmonary hypertension is characterized by patients who are not limited in daily activities, and do not experience symptoms such as shortness of breath, difficulty breathing, or chest tightness after physical activity. Grade II pulmonary hypertension patients are limited by mild activities, do not feel discomfort at rest, but experience symptoms like difficulty breathing, fatigue, chest tightness, and chest pain during everyday activities. Grade III pulmonary hypertension patients have significantly limited activity; they feel no discomfort at rest, but experience symptoms like difficulty breathing, fatigue, and chest pain after only mild activity, less than everyday activities. Grade IV pulmonary hypertension is severe, with patients experiencing symptoms such as difficulty breathing and feeling tightness in their chest even at rest without any activity.

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Written by Yuan Qing
Pulmonology
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Does pulmonary hypertension require oxygen therapy?

Whether pulmonary arterial hypertension requires oxygen therapy primarily depends on the patient's blood oxygen saturation level at rest. Generally, it is recommended to measure the oxygen saturation for patients with pulmonary arterial hypertension. Due to intrapulmonary shunting and shunting between the left and right heart during pulmonary arterial hypertension, arterial and venous blood mix directly, resulting in very low blood oxygen saturation in patients. Generally speaking, if the measured blood oxygen saturation at rest is below 90%, such patients often need oxygen therapy. Even if it does not drop below 90%, patients with moderate to severe pulmonary arterial hypertension also require oxygen therapy. Oxygen therapy can improve hypoxia, significantly dilating the pulmonary vessels and thus alleviating symptoms of high pulmonary artery pressure. It is very valuable for improving patient prognosis and survival time.

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Written by Li Qiang
Intensive Care Unit
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Is pulmonary hypertension serious?

Whether pulmonary arterial hypertension (PAH) is serious depends on the cause and the severity of the PAH. It is generally categorized into mild, moderate, and severe. If the PAH is caused by diseases such as pulmonary embolism and is severe, this condition is very serious and may lead to sudden death. If it is chronic pulmonary arterial hypertension with also a severe degree and lasts for a long time, it can lead to right heart failure, and subsequently right heart failure may cause left heart failure, which is also a very serious issue. If the pulmonary hypertension is a reversible, mild condition, such as due to embolism in the pulmonary artery branches which resolves after the embolism is cleared, then the PAH can easily recover, and in this case, it is not serious. However, if it is caused by chronic lung diseases such as chronic obstructive pulmonary disease or pulmonary interstitial fibrosis leading to chronic pulmonary hypertension, it is quite serious because it is a progressively worsening disease. The pulmonary artery pressure will not decrease, and over time it will gradually worsen, eventually leading to heart failure.

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Written by Li Hai Wen
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Mild pulmonary hypertension

Pulmonary hypertension is a relatively common disease in daily life. Many patients, when they go to the hospital for examination, often see reports from cardiac ultrasound indicating mild pulmonary hypertension, moderate pulmonary hypertension, or non-severe pulmonary hypertension. So, what are the criteria for mild pulmonary hypertension? Generally, pulmonary artery pressure is measured using right heart catheterization or cardiac ultrasound. If the pressure is between 30 to 50 mmHg, this is often considered mild pulmonary hypertension. Generally, the prognosis for mild pulmonary hypertension is quite good, typically not producing noticeable symptoms or affecting health.

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Written by Di Zhi Yong
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Where can moxibustion be applied for pulmonary hypertension?

If the patient has pulmonary arterial hypertension, it is advisable for the patient to actively monitor their blood pressure changes sometimes. This type of pulmonary arterial hypertension may sometimes require drug treatment. The disease primarily manifests as the patient experiencing coughing, phlegm production, palpitations after activity, shortness of breath, and occasionally accompanied by difficulty breathing, especially worsening at night. Sometimes there may also be swelling in the lower extremities. Regarding Traditional Chinese Medicine, herbal medicine, and acupuncture, these treatments can relieve symptoms. However, pulmonary arterial hypertension can sometimes further develop into cor pulmonale, which is irreversible. In such cases, it is recommended to be hospitalized for infusion therapy.