Pulmonary hypertension signs and symptoms include:

• Blue lips and skin (cyanosis)
• Chest pressure or pain.
• Dizziness or fainting spells (syncope)
• Fast pulse or pounding heartbeat (palpitations)
• Fatigue.
• Shortness of breath (dyspnea), initially while exercising and eventually while at rest.

Other symptoms include:

• Chest pain
• Fatigue
• Passing out
• Swelling in your ankles and legs

If you have shortness of breath and see your doctor, they will ask you about your medical history. They may also ask:

• Do you smoke?
• Does anyone in your family have heart or lung disease?
• When did your symptoms start?
• What makes your symptoms better or worse?
• Do your symptoms ever go away?

Your doctor may order tests, including: Echocardiogram: This ultrasound picture of the beating heart can check blood pressure in the pulmonary arteries. CT scan: This can show enlarged pulmonary arteries. A CT scan can also spot other problems in the lungs that could cause shortness of breath. Ventilation-perfusion scan (V/Q scan): This test can help find blood clots that can cause high blood pressure in the lungs. Electrocardiogram (EKG or ECG): An EKG traces the heart's activity and can show whether the right side of the heart is under strain. That's a warning sign of pulmonary hypertension. Chest X-ray: An X-ray can show if your arteries or heart are enlarged. Chest X-rays can help find other lung or heart conditions that may be causing the problems. Exercise testing: Your doctor may want you to run on a treadmill or ride a stationary bike while you are hooked up to a monitor, so they can see any changes in your oxygen levels, heart function, lung pressure, or other things. Your doctor may also do blood tests to check for HIV and conditions like rheumatoid arthritis or lupus. If these tests show that you might have pulmonary hypertension, your doctor will need to do a right heart catheterization to be sure. Here's what happens during that test:

• The doctor places a catheter into a large vein, most often the jugular vein in your neck or femoral vein in your leg, and then threads it into the right side of your heart.
• A monitor records the pressures in the right side of the heart and in the pulmonary arteries.
• The doctor may also inject medicines into the catheter to see if the pulmonary arteries are stiff. This is called a vasoreactivity test.

Right heart catheterization is safe. The doctor will give you a sedative and use local anesthesia. You can usually go home the same day, although you will need someone to drive you home.