Could It Be Pulmonary Hypertension? Symptoms and Concerns

Could it be pulmonary hypertension?

Hello, I used to frequently dream about flooding while sleeping (this happened several times each month over the past ten years).
When I woke up, I felt like I was breathing heavily.
Later, after taking a sedative for a month, I started experiencing difficulty breathing and my breaths became shallow (a friend told me that medication shouldn't be taken regularly, especially since I have a history of asthma).
So, I became hesitant to take it.
After stopping the medication, for the past one to two years, I have often struggled to breathe, experienced palpitations, and my blood pressure has risen to 140-150 (it used to be only 120).
I feel very fatigued and unable to exercise; even a little activity leaves me breathless and unable to speak.
Sometimes, I feel breathless just sitting down.
Occasionally, it feels like there is a heavy weight on my chest and back, making it hard to breathe.
During the first month after stopping the medication, I thought it was a normal withdrawal reaction from the sedative, but nearly two years later, I still can't go out.
I suspect it might be heart disease, but it also resembles pulmonary hypertension.
I went to a clinic for an echocardiogram, but the doctor said everything looked fine except for slightly enlarged right ventricular arteries.
I wonder if the clinic's ultrasound equipment is outdated and not color Doppler, which might make it harder to detect issues.
I know there is a type of ultrasound called Doppler color ultrasound.
Perhaps my condition wasn't severe enough last month to be noticeable.
When I have my period, I feel completely weak and breathless, and my heart lacks the strength to speak.
I also struggle to breathe while eating.
I need to lie down for five hours before I can get up.
I used to visit doctors occasionally, but now I have no energy to see a doctor at all.
What should I do?

nv po, 40~49 year old female. Ask Date: 2022/10/17

Dr. Li Shengkai reply Cardiology

If it is pulmonary hypertension, an echocardiogram can detect it.
If you still have concerns, you may seek further evaluation at a higher-level medical facility.
Based on your description, in addition to cardiac issues, it is important to consider whether it may be "autonomic nervous system dysregulation" or "menopausal disorders." It is advisable to consult with a psychosomatic medicine specialist and a gynecologist.
Additionally, reducing work intensity and adjusting your daily routine can help you coexist peacefully with your body.

Reply Date: 2022/10/17

More Info

It sounds like you are experiencing a complex set of symptoms that could be related to pulmonary hypertension (PH), heart issues, or possibly anxiety and stress-related disorders. Let's break down your concerns and provide some insights into what you might be facing.

Understanding Your Symptoms
1. Breathing Difficulties: The sensation of not being able to breathe deeply, especially when you wake up, can be alarming. This could be related to several factors, including anxiety, sleep disorders, or even pulmonary hypertension. In PH, the blood vessels in the lungs are narrowed, which can lead to increased pressure and difficulty in breathing, especially during physical exertion or even at rest in severe cases.

2. Heart Palpitations: The feeling of your heart racing or pounding can be associated with anxiety, but it can also indicate underlying heart conditions. Given your history of high blood pressure and the reported enlargement of the right ventricle, it’s essential to consider that these palpitations could be related to your heart's response to increased pressure or strain.

3. Fatigue and Weakness: Chronic fatigue, especially when it feels overwhelming to the point of being unable to perform daily activities, is a significant concern. This can be a symptom of heart failure, pulmonary hypertension, or even anxiety and depression. The interplay between physical health and mental health is crucial, as stress and anxiety can exacerbate physical symptoms.

4. High Blood Pressure: Your blood pressure readings of 140-150 mmHg are elevated, especially if you previously had lower readings. High blood pressure can contribute to heart strain and may also be a response to anxiety or stress. It’s important to monitor this closely and discuss it with your healthcare provider.

Potential Links to Pulmonary Hypertension
Given your symptoms and the mention of right ventricular enlargement, it is possible that you could be experiencing pulmonary hypertension. The normal pulmonary artery pressure is typically below 25 mmHg at rest, and pressures above this can indicate varying degrees of pulmonary hypertension. If your pressure is indeed elevated, it could lead to symptoms like shortness of breath, fatigue, and palpitations.

Diagnostic Considerations
1. Echocardiogram: While you mentioned having an echocardiogram that showed some enlargement, it's crucial to ensure that the right tests are performed. A Doppler echocardiogram can provide more detailed information about blood flow and pressures in the heart and pulmonary arteries.

2. Further Evaluation: If your symptoms persist or worsen, it may be necessary to seek further evaluation, possibly at a specialized center. This could include more advanced imaging or tests to assess lung function and heart performance.

Treatment and Management
1. Medication: Depending on the diagnosis, medications may be necessary to manage blood pressure, heart function, and any underlying pulmonary hypertension. It’s essential to follow up with your healthcare provider to discuss the best treatment options for your situation.

2. Lifestyle Modifications: Incorporating stress management techniques, regular physical activity (as tolerated), and a heart-healthy diet can significantly impact your overall health. Avoiding stimulants like caffeine and nicotine is also advisable.

3. Mental Health Support: Given the anxiety and stress you’ve described, it may be beneficial to seek support from a mental health professional. Therapy can help you develop coping strategies for managing anxiety, which may, in turn, alleviate some of your physical symptoms.

Conclusion
Your symptoms warrant careful evaluation and management. While pulmonary hypertension and heart issues are serious, many individuals can manage their conditions effectively with the right treatment and lifestyle changes. Please consider reaching out to a healthcare provider who can help you navigate these concerns and develop a comprehensive care plan tailored to your needs. Remember, you are not alone in this, and seeking help is a crucial step toward feeling better.

Similar Q&A

Understanding Hypertension-Related Heart Conditions and Pulmonary Hypertension

Hello: I have hypertension and recently experienced palpitations, fatigue, occasional chest tightness and pain, and difficulty breathing, which leads to easy tiredness. I visited a cardiologist (ultrasound + electrocardiogram), and the diagnosis revealed moderate to severe tricus...

Dr. Huang Yinghe reply Cardiology
Hello: The symptoms mentioned are likely related to hypertension. If your blood pressure is usually high, your doctor will likely prescribe medication, so please take it as directed. It is recommended to actively control blood pressure to below 130/80 mmHg, as good blood pressure...

Understanding Mild Pulmonary Hypertension: Concerns and Treatment Options

Hello Doctor, I am patient number 65279 inquiring about my echocardiogram report which indicates mild pulmonary hypertension, with a PA systolic pressure of 40 mmHg. Since my follow-up appointment is still some time away, I would like to ask you a few questions, and I apologize f...

Dr. He Dongjin reply Cardiology
Hello, not being very serious does not mean it will lead to a short life or that treatment is unnecessary. Occasionally, the heart may beat strongly, which is inevitable. It may not be related to pulmonary hypertension; it could be due to autonomic nervous system factors. Pingan ...

Understanding Pulmonary Hypertension: Diagnosis Challenges and Symptoms

I have recently been experiencing occasional shortness of breath to the point where I can't walk. Whether I'm walking or climbing stairs, I feel like I can't catch my breath, and it has become quite severe lately. However, there are times when it feels a bit better...

Dr. Huang Yinghe reply Cardiology
Hello: A cardiac ultrasound can provide a rough estimate of pulmonary artery pressure. If the ultrasound detects suspected pulmonary hypertension, hospitalization for cardiac catheterization is necessary for accurate confirmation. There are many causes of shortness of breath, and...

Understanding Pulmonary Hypertension from Amberning and Antihistamine Interactions

Hello, I would like to ask about my situation. I accidentally took a sedative called Ambien along with an antihistamine, and since then, I have been experiencing increasing shortness of breath. Initially, it wasn't so severe, but recently my heart has been racing. What start...

Dr. Wu Xueming reply Cardiology
Medications do not cause pulmonary hypertension; it is recommended that you go to the hospital for further evaluation.