Assessing Heart Factors in Sleep-Related Breathing Issues and Chest Pain

Q: Assessing Heart Factors in Sleep-Related Breathing Issues and Chest Pain

Hello, this echocardiogram report is normal and does not have a direct correlation with the symptoms you described. <br>It is advisable to discuss this further with your physician. <br>Changhua Hospital cares about you.

Pulmonary artery systolic pressure and impaired left ventricular diastolic relaxation?

Hello, Director.
I recently sought medical attention due to respiratory wheezing, and my lung function was diagnosed with asthma, confirmed by MAST testing for allergies.
After using medication for a while, my asthma has mostly been controlled, but I still experience abnormal shortness of breath during sleep, along with chest pain that has persisted for some time (especially near the mid-sternum).
Gastroesophageal reflux has been ruled out (I do not experience heartburn, and I hypothetically took proton pump inhibitors for a period without improvement).
I recalled that I previously underwent a cardiac ultrasound, and the results were: 1.
sPAP = 28.1 mmHg, 2.
impaired left ventricular diastolic relaxation, 3.
E/A < 1.4.
Aside from the aortic valve, the other three heart valves showed grade I impairment.
I would like to ask if cardiac factors should be considered in relation to the abnormal shortness of breath during sleep and chest pain.
Is there a need to follow up on my cardiac ultrasound results? Thank you very much!

Le Mei, 40~49 year old female. Ask Date: 2013/07/12

Dr. He Dongjin reply Cardiology

Hello, this echocardiogram report is normal and does not have a direct correlation with the symptoms you described.
It is advisable to discuss this further with your physician.
Changhua Hospital cares about you.

Reply Date: 2013/07/12

More Info

When assessing the relationship between heart factors and sleep-related breathing issues, as well as chest pain, it is essential to consider various aspects of both respiratory and cardiovascular health. Your situation involves a history of asthma and allergies, which can significantly impact your respiratory function, especially during sleep.
Asthma is a chronic condition that can cause airway inflammation and constriction, leading to symptoms such as wheezing, coughing, and shortness of breath. These symptoms can be exacerbated during sleep due to factors like lying flat, which may increase airway resistance, or exposure to allergens in the sleeping environment. The fact that you have experienced episodes of rapid breathing during sleep could be linked to your asthma, particularly if these episodes occur during the night when asthma symptoms can worsen.

Regarding the chest pain you mentioned, it is crucial to differentiate between potential cardiac and non-cardiac causes. Given your history of asthma, the chest pain could be related to bronchospasm or muscle strain from coughing. However, since you have also undergone an echocardiogram that revealed impaired left ventricular diastolic relaxation and mild valve impairments, it is prudent to consider whether these cardiac factors could contribute to your symptoms.

The echocardiogram results indicate that while there are some mild abnormalities, they may not be directly responsible for your current symptoms. The sPAP (systolic pulmonary artery pressure) of 28.1 mmHg is within normal limits, suggesting that there is no significant pulmonary hypertension. Impaired diastolic relaxation can occur in various conditions, including hypertension or aging, but it does not necessarily indicate a severe cardiac issue. The E/A ratio being less than 1 suggests impaired filling of the left ventricle, which could lead to symptoms like shortness of breath, particularly during exertion or when lying down.

Given your symptoms of shortness of breath during sleep and chest pain, it is advisable to follow up with your healthcare provider. They may recommend further evaluation, such as a sleep study, to assess for conditions like obstructive sleep apnea, which can cause breathing difficulties during sleep and may also contribute to cardiovascular strain. Additionally, considering your anxiety history, it is essential to address any psychological factors that may exacerbate your physical symptoms.

In summary, while your heart factors may not be the primary cause of your sleep-related breathing issues and chest pain, they should not be entirely ruled out. It is essential to maintain regular follow-ups with your healthcare provider to monitor your heart health, especially given the mild abnormalities noted in your echocardiogram. A comprehensive approach that includes managing your asthma effectively, evaluating for sleep disorders, and addressing any potential cardiac concerns will be crucial in improving your overall health and quality of life.

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