What If Your Breathlessness Is Not Stress or Asthma?

Do you get out of breath doing simple things, like walking or climbing stairs? It might seem like stress or asthma, but sometimes, it’s something more serious.

Pulmonary arterial hypertension, or PAH, is a rare disease that affects the heart and lungs.

Ten years ago, Amy Burant started experiencing strange symptoms that didn’t feel like her usual asthma. She had shortness of breath, heart palpitations, and constant tiredness. At first, she thought it was just stress or her job as a nurse. Her doctors agreed and blamed her asthma and weight. They gave her inhalers, but nothing worked. Her health kept getting worse. Even walking short distances left her out of breath, and her heart would race for no clear reason.

In 2013, Amy finally got a clear answer. She was diagnosed with pulmonary arterial hypertension, or PAH. This is a rare disease where high blood pressure builds up in the lungs. That pressure makes the heart work harder and can eventually lead to heart failure if left untreated. The diagnosis was scary, but it also explained everything she had been going through.

Amy worked closely with her doctors to build a treatment plan. It included medications, oxygen therapy, and something called pulmonary rehabilitation.

That rehab became a turning point. At first, everyday tasks felt nearly impossible. Using oxygen was a big change. But slowly, Amy’s body got stronger. She could go on hikes with her daughter again—something she once thought she’d never do. Thanks to her treatment, Amy found a better rhythm in life.

She managed her PAH, began raising awareness, and now works with the Pulmonary Hypertension Association to help others get the care they need.

Her story shows how medications and exercise—through rehab—helped her take control of PAH and live a more active life again.

How PAH Affects the Body

Pulmonary Arterial Hypertension (PAH) is a rare and serious disease that affects the lungs and heart. It happens when the small arteries in the lungs become thick and narrow, making it harder for blood to flow through. This raises the pressure in the lungs and forces the right side of the heart to work harder. Over time, the heart weakens and may fail.

PAH is part of a larger group of diseases called pulmonary hypertension, and it is classified specifically as Group 1. It is most common in women aged 30 to 60 and tends to affect African American and Hispanic women more than others. Each year, about 500 to 1,000 people in the U.S. are diagnosed with it. While there’s no cure, treatments can help manage symptoms and improve quality of life.

The causes of PAH can be different. Sometimes, doctors can’t find a reason—this is called idiopathic PAH. In other cases, it’s inherited through genes, known as heritable PAH, which makes up about 15–20% of cases. It can also be triggered by other diseases such as lupus or scleroderma, by drug use like methamphetamine or cocaine, and by infections like HIV. Some people develop PAH due to heart defects present at birth or liver disease.

Symptoms develop slowly and may not be noticed for a long time. These include shortness of breath, chest pain, feeling dizzy or fainting, tiredness, and swelling in the legs or belly. In more severe cases, the skin may turn a blue or gray color, and the heart may beat fast or pound heavily.

If PAH is not treated, it can lead to dangerous problems. The right side of the heart can get bigger and weaker, a condition called cor pulmonale. Blood clots may form in the lungs. Irregular heartbeats, bleeding in the lungs, and serious complications during pregnancy are also risks.

There are several forms of PAH, including:

1. Idiopathic PAH, with no known cause.
2. Heritable PAH, passed through families, sometimes involving specific genes like BMPR2.
3. Drug- and toxin-induced PAH, caused by things like meth or certain weight loss drugs.
4. Associated PAH, linked to other diseases such as lupus, HIV, or liver disease.

Though rare, PAH is a serious condition that requires lifelong management. Treatments can help slow its progress and allow patients to live longer, more active lives.

Final Thoughts

Pulmonary arterial hypertension may be rare, but it's real—and it's serious. It can creep in quietly, often mistaken for stress, asthma, or fatigue. But left unchecked, it puts major strain on the heart and lungs.

That’s why early diagnosis and treatment matter. With the right care plan—medications, oxygen, and rehab—your body can get stronger. You can regain movement, energy, and control.

If something feels off, don’t ignore it. Trust your body, ask questions, and push for answers.