During the compensation stage, pulmonary hypertension can be asymptomatic, leading to the often late diagnosis of severe forms of the disease. Initial signs become noticeable when the pressure in the pulmonary artery system exceeds twice the physiological norm.

The first indications of pulmonary hypertension include:

  • Increased fatigue.
  • Weakness.
  • Shortness of breath upon exertion.
  • Discomfort in the left half of the chest, occasionally accompanied by compressive pain behind the sternum during physical activity.

As the disease progresses, additional symptoms may manifest:

  • Escalating shortness of breath, which can be present even at rest and intensify significantly with physical activity.
  • Weakness during exertion, sometimes leading to fainting as the heart struggles to supply sufficient blood flow to the brain.
  • Nonproductive cough.
  • Decreased ability to travel distances without rest.
  • Pain in the heart area.
  • Pain in the right hypochondrium associated with liver enlargement.
  • Persistent fatigue.
  • Hoarseness due to compression of the recurrent nerve.
  • Dizziness and fainting.
  • Clinical signs of right heart pumping function insufficiency, such as edema in the lower extremities.
  • Raynaud's phenomenon (bluish discoloration of fingers, observed in less than 50% of cases).
  • Swelling of the neck veins with visible pulsation.
  • Bulging of the right ventricle of the heart.
  • Enlarged liver palpable during examination.
  • Changes in breath sounds.
  • Alterations in the structure of fingernails, resembling watch glasses.
  • Palpitations.
  • Generalized body aches due to tissue oxygen deficiency.
  • Severe lung pain.
  • Ascites, marked fluid accumulation in various body parts.