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Dizziness and fainting are common symptoms of pulmonary arterial hypertension (PAH). Dizziness may be described as a woozy, weak, or unsteady feeling. Fainting (passing out) is a temporary loss of consciousness.
Many myPHteam members have these symptoms. One member shared, “I experience dizziness and lightheadedness, but I guess it comes with the disease.”
Dizziness can also affect your quality of life. Another member commented, “Personally, dizziness and brain fog bother me more than breathing.”
If you also experience dizziness and fainting with PAH, this article will help you understand what causes these symptoms and how some treatments may be able to help.
Dizziness and fainting may be a symptom of PAH or a side effect of certain medications.
Dizziness and fainting can be caused by poor circulation to your brain. PAH can lead to heart and lung problems that make it harder for oxygen-rich blood to circulate through your body.
PAH is a form of pulmonary hypertension (PH) that’s caused by thickening and narrowing of the pulmonary arteries — blood vessels that bring blood from the heart to refill the lungs with oxygen. When your pulmonary arteries become thicker and narrower, the blood flow between your heart and lungs is partially blocked and the blood pressure in your lungs increases.
The right side of the heart is responsible for pumping blood to the lungs. Over time, the strain of pumping blood through pulmonary arteries with high blood pressure can lead to right-sided heart failure.
High blood pressure (hypertension) in your lungs and right-sided heart failure make it harder for oxygen-poor blood to make it to your lungs and refill with oxygen, leaving all your organs with less oxygen than they need. If your brain doesn’t get enough oxygen, you may feel dizzy, lightheaded, or even faint.
Other common symptoms of PAH include:
Medications can help slow the progression of PAH. However, some medications that may be used to treat PAH can make you feel dizzy or faint if they lower your blood pressure too much. These types of drugs include:
Some myPHteam members have noticed dizziness as a side effect of other PAH medications. “Does anyone else have a problem with dizziness with their PH medication?” asked one member.
Sildenafil (Revatio) can treat PAH by dilating (widening) the blood vessels in your lungs. However, this drug may also reduce blood pressure in the rest of your body, causing low blood pressure. This can make you feel dizzy.
It’s important to note that if you develop hearing loss or ringing ears along with dizziness while taking sildenafil, it can be a sign of a serious health problem, and you should get medical care right away.
In addition, seek medical help right away if you experience sudden dizziness or fainting while taking sildenafil or warfarin (Coumadin), a medication to prevent blood clots.
Dizziness can also be a side effect of medications unrelated to PAH, such as antidepressants, anti-seizure drugs, and sedatives. If you’re experiencing dizziness, talk to your health care provider to find out if it could be caused by a medication you take for PAH or another condition. They may recommend changing your medication or dose to improve this side effect.
The goal of PAH treatment is to slow the progression of your disease and reduce symptoms, including dizziness and fainting.
PAH treatments target different pathways to help dilate blood vessels in the lungs. This can lower the blood pressure in your lungs, reducing the strain on your heart. Your heart can then work more efficiently so that you get proper blood oxygenation and blood flow around your body, including your brain.
“I have been on my PAH medications for a year, and it helps me so much. I can clean my home and walk without feeling dizzy. I feel great since I have been on the medication,” shared a myPHteam member.
PAH symptoms, including dizziness and fainting, are typically related to poor right-sided heart function and oxygen passage from the lungs to the blood. PAH treatments that boost your heart and lung function can improve these symptoms. Medications that may address PAH symptoms include prostaglandins, endothelin receptor antagonists, and phosphodiesterase type 5 (PDE-5) inhibitors.
Prostaglandins are medications made in a laboratory that mimic naturally occurring prostaglandin, a substance that helps open up narrow blood vessels in the lungs. Prostaglandins can be taken orally (by mouth), injected into a vein or under the skin, or inhaled. Examples include:
Endothelin receptor antagonists work by preventing the blood vessels in your heart from narrowing. Examples include:
PDE-5 inhibitors work by helping your body make more substances to dilate the blood vessels in your lungs. Examples include:
New PAH medications target different pathways to open your lungs’ blood vessels. For example, selexipag (Uptravi) works by relaxing muscles in the walls of the blood vessels. Sotatercept (Winrevair) helps regulate the growth of the blood vessel walls to prevent further narrowing.
As previously discussed, you may feel dizzy or faint if your heart can’t pump enough oxygen-rich blood to your brain. Oxygen therapy can help increase oxygen levels in your blood to make sure your brain and other organs can get the amount they need to function properly.
Lifestyle changes may be able to help you manage symptoms of PAH, such as dizziness and fainting.
Regular physical exercise is important for people with PAH. Pulmonary rehabilitation may be helpful to teach you how to exercise with less shortness of breath and dizziness. Talk to your health care provider about the best exercise plan for you.
A heart-healthy diet low in salt and saturated and trans fats is an important part of managing PAH. If you have right-sided heart failure, you may also have to monitor your daily fluid intake.
It’s important to talk to your health care provider about your PAH symptoms, such as dizziness and fainting. They may change your treatment plan based on your symptoms and medication side effects.
You can also try to avoid activities that make you feel dizzy or faint, such as:
With the right treatment plan and lifestyle approaches to manage your PAH symptoms, you may be able to minimize dizziness and fainting and improve your quality of life.
On myPHteam, the social network for people with pulmonary hypertension and their loved ones, more than 55,000 members come together to ask questions, give advice, and share their stories with others who understand life with pulmonary hypertension.
What PAH treatment options have you tried? Have any treatments improved symptoms like dizziness and fainting? Share your experience in the comments below, or start a conversation by posting on your Activities page.
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Vedran Radonić, M.D., Ph.D.
completed medical school and his Ph.D. at the University of Zagreb, Croatia.
Learn more about him here.
Amanda Jacot, PharmD
earned a Bachelor of Science in biology from the University of Texas at Austin in 2009 and a Doctor of Pharmacy from the University of Texas College of Pharmacy in 2014.
Learn more about her here.
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