What Are the Signs and Symptoms of Pulmonary Arterial Hypertension?

Difficulty breathing or shortness of breath (dyspnea) is the main symptom of pulmonary arterial hypertension (PAH). If you have PAH, you may feel that it is difficult to get enough air.

Other Common Signs and Symptoms

• Fatigue
• Dizziness
• Fainting spells (syncope)
• Swelling in the ankles or legs (edema)
• Bluish lips and skin (cyanosis)
• Chest pain
• Racing pulse
• Palpitations (a strong feeling of a fast heartbeat)

As the disease advances:

• The pumping action of your heart grows weaker.
• Your energy decreases.

In the more advanced stages, you:

• Are able to perform very little activity
• Have symptoms even when resting
• May become completely bedridden

Limitations on Physical Activity

Doctors may classify your symptoms based on how much activity you can comfortably undertake. The classes are the same as those for heart failure. They are:

• Class 1: No limits—Ordinary physical activity does not cause undue tiredness or shortness of breath.
• Class 2: Slight or mild limits—Person is comfortable at rest, but ordinary physical activity results in tiredness or shortness of breath.
• Class 3: Marked or noticeable limits—Person is comfortable at rest, but less than ordinary physical activity causes tiredness or shortness of breath.
• Class 4: Severe limits—Person is unable to carry on any physical activity without discomfort. Symptoms may also be present at rest. If any physical activity is undertaken, discomfort increases.