Pulmonary hypertension and HIV

March 2002     View PDF     En español

Symptoms of pulmonary hypertension

The most obvious symptoms of PH are shortness of breath, dizziness, fatigue, swollen ankles, poor lung capacity and sudden fainting or loss of consciousness due to inadequate intake of oxygen for the brain. The process begins slowly and most people have the disease for a few years before getting a correct diagnosis because the early symptoms are similar to those of many other diseases. The diagnosis is made differentially—that is, by ruling out other causes. The disease is progressive for two reasons. (1) The underlying cause remains present despite treatment; and (2) the rising blood pressure in the lungs increases the speed at which blood must flow through the remaining open blood vessels, causing friction on the cells of the inner lining of the vessels, further thickening them, resulting in ever more constriction.

The symptoms of PH somewhat resemble those of asthma, a common lung disease that also results in poor oxygenation through the lungs (though by a different mechanism). A person with PH, however, does not experience the “wheezing” typical of asthma, since the problem is due to a lack of oxygenated blood, not a problem getting air into the lungs. Many types of heart disease can also produce symptoms that resemble PH as well.

One prominent PH specialist has likened PH to “a slow death by drowning.” The progressive inability of the lungs to supply oxygen can greatly restrict a person’s activity levels and lead to increased isolation. Although a person with PH might feel fine while sitting, a simple climb up out of a chair or a short walk can trigger shortness of breath, dizziness or even a blackout. Patients quickly lose confidence in their ability to cope with even the most basic daily activities. Without treatment, many people become housebound and in need of oxygen tanks and masks. Doctors discourage air travel due to the reduced cabin air pressure and lower oxygen levels maintained on commercial airliners, which further exacerbate the problem.

PH must be diagnosed by an experienced cardiologist (heart specialist), pulmonologist or a PH specialist. A similar level of experience is needed to treat the disease.

Introduction

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Pulmonary hypertension and HIV