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Perhaps the most troubling characteristic of pulmonary hypertension is the inability to directly connect symptoms with the disease. Many of the symptoms of pulmonary hypertension, such as shortness of breath, are seen in other lung diseases and heart disease. Pulmonary hypertension may even occur without medical symptoms making it difficult to diagnose. As the disease progresses, symptoms begin to resemble those associated with congestive heart failure. Since PH is a rare disorder most doctors try to exclude other diseases before making a medical diagnosis of PH.
Cyanosis
Cyanosis is the medical term for a bluish cast to the skin and mucous membranes, especially the lips, cuticles, edge of the ears, and tip of the nose. While temporary cyanosis may occur due to cold temperatures, cyanosis due to lung or heart disease is an indication of low oxygen levels. By the time cyanosis appears, other symptoms of pulmonary hypertension might also be present. Syncope may accompany cyanosis caused by disease.
Fatigue
Fatigue is a common symptom of many diseases including the common cold. Most of us have at one time or another felt fatigue but not all of us have had extreme fatigue, the type of fatigue often seen in pulmonary hypertension. Extreme fatigue is a medical symptom that can indicate the onset of heart failure. Extreme fatigue is the response to try to keep up with the body's demand for oxygen. If the heart cannot keep up with the body's demand for oxygen, the muscles lose oxygen and become fatigued.
Shortness Of Breath
Breathlessness and shortness of breath are more advanced symptoms of pulmonary hypertension. As the heart becomes weaker its contractions are not strong enough to pump blood to the rest of the body. Sometimes, blood is left in the heart and backs up into the lungs. In order to meet the oxygen demand the lungs breathe more rapidly. Shortness of breath may be present only with exertion, or in severe cases even at rest.
Peripheral Edema
With inadequate circulation of blood peripheral edema, or fluid build-up, in other areas of the body can develop. The most common area of edema is the ankle. Edema in the ankles may be an indication that edema is also present in other parts of the body.
Resources
American Lung Association. (November 2003). Primary pulmonary hypertension (PPH) fact sheet. Beers, M. H.