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The 23 Symptoms of Pulmonary Hypertension in Infant (PH) You Should Know

Symptoms Of Pulmonary Hypertension in Infant (PH)

Every month, about 500 children are born with PH and nearly half of all pulmonary hypertension in infants does not survive the first year of life.

The only way to know if your baby has pulmonary hypertension is to be aware of the symptoms. 

That means that your best bet is knowing the symptoms early because they can be life-threatening.

Many of the kids who are diagnosed with PH are misdiagnosed because the symptoms are easily confused with other serious illnesses.

As it gets worse it can affect the ability of an infant to breathe. Without treatment, it can be fatal.

Make sure you know the symptoms so you can get your baby to the doctor immediately if there is a suspected case of pulmonary hypertension.

Don’t forget that we have addressed the risk factors of pulmonary hypertension in newborns and you may find it useful afterwards.

Below Are the Symptoms of Pulmonary Hypertension in Infant You Should Know About

Dizziness, an inability to sleep and headaches are symptoms of neonatal pulmonary hypertension.

When an infant has pulmonary hypertension, they may not be able to breathe enough air to meet their body's needs.

This causes them to become exhausted without exerting any effort. The heart struggles to pump blood around the body.

Blood may accumulate in the lungs, and this can cause the blood to have a reddish appearance.

This, in turn, makes it difficult for an infant to breathe. Therefore, the infant may need to spend time in the hospital because they do not have enough oxygen in their blood.

1. Dizziness 

pulmonary hypertension in infant

Many people with pulmonary hypertension develop dizziness. Some doctors use the term "dizziness" when referring to a number of symptoms that are common to many conditions.

This can include vertigo, imbalance, and light-headedness. These symptoms can move from mild to severe.

Dizziness is one of the more common symptoms associated with neonatal pulmonary hypertension.

This is because the right side of the heart is typically underdeveloped when the baby is in the womb, and the left side is usually stronger.

In many cases, the body compensates for this by slowing down and the brain takes longer to register information from the eyes.

2. Foamy Mucus 

The baby may have a sticky, foamy substance on the lips, tongue, or mucous membranes in the mouth, throat, or lungs.

The foamy substance is called mucus or thick secretions. It can appear almost immediately or develop over time.

People with pulmonary hypertension can have thick secretions in the lungs. Also, they may have lung hypertension and enlarged veins in their hearts.

A baby may have a persistent cough that does not go away. Foamy secretions may be linked to the lungs, nose, and mouth glands venous malformations, and hyperbilirubinemia.

3. Water Retention 

A common sign of pulmonary hypertension in infants is the presence of fluid in the lungs.

The lungs of an infant usually fill with fluid shortly after birth. This is a normal process that ensures that the lungs are able to breathe efficiently when a baby's tiny airways are opened to allow them to take their first breath.

However, in infants with pulmonary hypertension, the lungs swell with fluid as the disease takes effect.

The presence of excess fluid in the lungs can cause the baby to feel as if they are drowning.

4. Congenital Heart Disease

Congenital heart disease is when a baby's heart doesn't develop properly, usually due to a problem with the valves.

In most cases, a baby's symptoms will be a result of their underlying medical problems, such as a congenital heart defect.

This is the most common cause of neonatal congestive heart failure (NCHF), which is the medical name for neonatal pulmonary hypertension.

There are three main types of congenital heart disease that cause NCHF but the two most common ones are explained here:

Pulmonary hypoplasia: This is the most common cause of NCHF and is a structural abnormality of the lungs that means they cannot fully expand and inflate.

Somatostatin receptor syndrome: This is caused by defects in the genes that make somatostatin receptors, which stop the lungs from expanding as fully as they should.

5. Infantile Haemangioma

Pulmonary hypertension in infant can often be caused by a benign growth called an infantile haemangioma.

This rare tumour is noncancerous and does not spread to other parts of the body.

It occurs mainly in infants and young children, and it usually results in the growth of a tumour on the face or neck.

6. Haemorrhagic Stroke

A haemorrhagic stroke is a type of stroke caused by a ruptured blood vessel in the brain. Haemorrhagic strokes are very serious, and they are often fatal.

Some symptoms of a haemorrhagic stroke in infants are loss, of consciousness dizziness, fever, dry skin, tiredness, and seizures.

A few treatments exist for haemorrhagic stroke in infants. However, the results can be inconsistent and sometimes require additional medical treatment.

pulmonary hypertension in infant
7. Tachypnoea In Infants

Tachypnoea is less common than the symptoms of neonatal pulmonary hypertension.

In a baby with pulmonary hypertension, there can be a lack of oxygen in the blood that affects their breathing and heart rate.

A baby with tachypnoea may not be able to catch their breath when they inhale or exhale. This can be due to their lungs not working as well as they should.

If an infant is having too much tachypnoea, there is a higher risk of becoming tachypnoeic, which is when they are unable to breathe.

8. Cyanosis of the Infant

Cyanosis is a skin colour change that shows that the oxygen levels in the blood are low.

If a baby is in cyanosis, their lips, fingernails, and skin are darker than their skin colour. Cyanosis is a sign of neonatal pulmonary hypertension.

It can also, be called low-tone cyanosis or blue baby syndrome. If an infant has a very low oxygen level in the blood, the lips, hands, feet, and fingernails will turn blue or purple.

This purple colour change is a sign that the infant is not getting enough oxygen.

Symptoms of cyanosis typically start developing in the first few hours after birth and worsen as the baby grows older.

Many babies will have a positive smear test for cyanosis when they are two to three days old.

It is an important initial test that will detect the condition. However, it is only a confirmation of a diagnosis of cyanosis in the infant.

Other medical issues that can cause cyanosis in the infant include atelectasis, blood clot in the lungs, difficulty and breathing.

The medical term for cyanosis of the infant is atelectasis. Cyanosis of the infant is not a sign of an infection or other related illness.

9. Apnoea of Prematurity

A baby's apnoea of prematurity (AOP) is a sudden pause in breathing. This type of breathing pattern is usually experienced in the final minutes or hours of an infant's life.

The AOP is often a sign that the infant is not getting enough oxygen and that it is in distress. It can cause high levels of fluid in the blood vessels and in the lungs.

The high levels of fluid in the blood vessels and in the lungs are often the cause of infant pulmonary hypertension.

10. Hematemesis of Birth

Moms-to-be with pulmonary hypertension may experience premature rupture of membranes or early contractions. During a vaginal birth, the amniotic sac breaks.

The baby then moves into the pelvis and is born. In the early stages of childbirth, the baby's head can cause the umbilical cord to squeeze its windpipe, causing them to spit up amniotic fluid.

Making women with pulmonary hypertension experience premature rupture of membranes.

This can cause the baby to be born while the sac is still intact, resulting in a chylothorax.

11. Gastroesophageal Reflux in Infants

Gastroesophageal reflux is a condition that develops when food and fluid come back up into the baby's oesophagus, stomach, and throat.

The doctor may monitor infants with gastroesophageal reflux, as well as signs of premature birth if their symptoms are severe.

Although this condition can affect anyone, it is more common in infants. However, it can be difficult for a doctor to identify the cause of gastroesophageal reflux in a baby.

They may also not be able to do much about the symptoms, other than recommending treatment.

12. Poor Feeding

Some babies who have pulmonary hypertension will have difficulty sucking and swallowing, as the blood vessels in their airways have become narrowed.

Sucking and swallowing are essential for the proper development of the lungs and digestive tract.

pulmonary hypertension in infant

13. Pain in the Chest

Suffering chest pain or tightness in the chest, especially if it lasts for longer than a few minutes may be a sign of infant pulmonary hypertension.

14. Fever

A fever is a sign of infection in the lungs, and it may occur as early as 1 to 4 days after birth.

If fever persists for longer than 4 days or occurs with or without a fever, it could be a sign of pulmonary hypertension.

15. Lethargy

If a baby has pulmonary hypertension, it is likely they will be lethargic because they are often unable to take in enough oxygen.

16. Breathing Fast

Babies breathe slowly. Their lung development is slower than that of adults, so their lungs do not fill with air quickly.

To compensate for this, babies breathe faster than normal to make up for this. This is why it can be difficult for them to get enough oxygen from their lungs.

When babies breathe fast, they get tired quickly. Their heart rate also increases. This can be a sign of a problem that may require treatment.

17. Hyperventilation

Hypoxia can cause a rise in a baby's heart rate, which can be alarming to parents. This is because hyperventilation usually happens when the baby is under stress.

In stressful situations, the body responds by releasing the hormone adrenaline, which helps with the body's stress response. These conditions could result in neonatal pulmonary hypertension.

18. High-Pitched Cry

At birth, infants usually make a soft sound called a cry. However, some babies who are born with pulmonary hypertension make a high-pitched cry that can be frightening to their parents and caregivers.

If the cry is accompanied by tightness in the chest, it can be an indication of pulmonary hypertension.

Wheezing, Grunting or Gasping

Pulmonary hypertension can affect the lungs. This condition causes the right and left sides of the lungs to swell and expand, which can result in a wheezing or gasping noise.

 According to research in the European Journal of Paediatric Radiology, about 60 per cent of infants with pulmonary hypertension have a wheezing sound when inhaling.

Other infants have less frequent wheezing or silence when inhaling. When a child has an enlarged right lung, he or she may make wheezing noises as well.

An enlarged left lung makes a quieter noise.

19. Narrowing of the Left Ventricle

In many cases, an infant with pulmonary hypertension will have a narrowing of their left ventricle, which is the main pumping chamber of the heart. In this area, blood flows into the lungs when the lungs are empty.

In infants with pulmonary hypertension, the right side of the heart begins to overcompensate, causing the left side to enlarge and the left side to get smaller.

This can affect how the heart responds to blood pressure, so it is likely that an infant with pulmonary hypertension will need treatment to help maintain a healthy blood flow.

20. Mouth Breathing

An infant's breathing may be seen as little rasps of breath. Most doctors consider normal infant breathing to be simple and to follow a pattern.

An infant's breathing will vary over time, becoming more rhythmic and regular in length and frequency.

However, it is not uncommon for a baby to make little rasps of breath while they are asleep or relaxed.

This condition is known as breathing rasps and has no symptoms. It can be difficult to diagnose, however, as it can be present from the moment an infant is born.

If breathing rasps are present and are more pronounced in the lungs, they may be symptoms of infant pulmonary hypertension.

21. Nasal Flaring and Retractions

It may seem strange for an infant to have air in their nose, but this is a symptom of pulmonary hypertension.

Air entering the lungs can affect the way they expand and collapse. As the lungs continue to grow, they fill with air in small spaces between the cells.

This can lead to a build-up of pressure in the arteries that supply the lungs.

When the pressure in these arteries rises above a certain level, a blood vessel in the lung may break down.

This occurs when the arteries and veins do not drain the excess blood, leading to swelling.

The blood will then begin to drain into the arteries that supply the heart and other organs.

22. Heart Murmur and Abnormal Heart Rhythm

Pulmonary hypertension can cause a heart murmur and abnormal heart rhythm.

Pulmonary hypertension can cause a heart murmur that may not respond to treatment. In addition, it may lead to an abnormal heart rhythm called atrial fibrillation.

An abnormal heart rhythm is a medical condition where the heart beats erratically or too fast.

This is due to abnormal electrical signals that travel through the heart, which affects its rhythm.

Some people with atrial fibrillation may have a heartbeat that is too fast, even when resting.

Children with atrial fibrillation may not experience any symptoms, but they may still be at a higher risk of sudden death.

Therefore, babies with heart problems can have very fast, irregular heartbeats.

23. Swelling of the Legs and Abdomen

symptoms of pulmonary hypertension in infant

Swelling of the abdomen is a common symptom of neonatal pulmonary hypertension.

Pulmonary hypertension may cause the kidneys to be overworked. As a result, some of the blood that is collected in the kidneys is sent back to the heart and lungs. This causes the blood to become trapped.

A baby with pulmonary hypertension may develop a form of necrosis. This is when cells in a person's body are killed. The part of the body affected is known as the necrotic portion.

However, as the blood fills the lungs, the lungs swell as a result. This is called haemorrhagic pulmonary oedema.

This swelling of the lungs may cause the abdomen to swell. In some cases, the liver and spleen may also become enlarged.


Pulmonary hypertension in infants can either be congenital or acquired. Congenital is a form of the disease that may occur in an infant from birth, while acquired is when an infant develops this disease later in life.

Pulmonary hypertension can interfere with the growth and development of the heart,  blood circulation and lungs.

The severity and type of pulmonary hypertension determine what symptoms and problems an infant might experience.

One needs to understand the symptoms of pulmonary Hypertension in order to be able to identify it early before it becomes a big problem. 

In our next article, we shall try to explore the best diagnostic methods  of pulmonary hypertension in neonates

You can always refer back to the risk factors of pulmonary Hypertension in newborns here.

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