Questions posted in the Heart Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: exertional dyspnea and

Forum: The Heart Forum
Topic: Heart Disease


Just recently, since May, I've started experiencing exertional
dyspnea. It's usually associated with bending down in the yard,
turning on sprinklers, etc. Not hard work. Also, have been
waking during the night with shortness of breath, but not
every night. I'm also experiencing pain in my upper back
of a squeezing nature. On a couple of occasions I have awakened
feeling very nauseated and dizzy.

I've been to the ER 3 times after these episodes and EKG and
blood tests have been normal. It seems as though I'm fine
after a few minutes of waking, but the exertional shortness of
breath is always present.

I saw a cardiologist the other day and he said my heart sounded
fine, maybe it was anxiety. I really don't think so because I can
be feeling really good, happy, etc. and then I'll do something exertional
and get really short of breath. Doesn't fit with anxiety to me.

I finally went to a sleep clinic and they diagnosed obstructive
sleep apnea. I'm very thin, 33 years old, don't smoke, etc. and
I don't snore. So, wouldn't this be central sleep apnea? Also,
alcohol, sedatives, etc. intensify the sleeping breathing difficulty.

Any suggestions? I can't get a stress test until the 7th, but
I'm having such a rough time that I can't do anything, and the
problem is so bad on many nights that I just can't sleep.

Also, on a beta blocker for brady-tachy syndrome and one previous
episode of a-fib.

Thanks

_____
Dear Lynn,
I am not sure of your exact question, however I would like to make a few comments,
your dyspnea(shortness of breath)on exertion is quite concerning in that if there is no
disease of your lungs to explain this (evaluate lungs with pulmonary function tests)
then it is likely your heart. It just so happens that a chronically stressed right side of the heart
is what can result from longstanding sleep apnea. What happens is the pressures on the right side
of the heart(that side which is responsible for pumping blood to the lungs)increase significantly
in response to the apneic episodes. There is also a chance that the pressures in your heart are abnormal
for some other reason. You still need cardiac work-up and probably would benefit from a right heart catheterization
whereby small catheters are placed into the right side of your heart to measure pressures and volume of blood flow.
One other comment I will make is that beta blockers tend to make the heart slow down (bradycardic) and if you really have
a bradycardic syndrome you should have a holter monitor done while on the beta blocker to make sure your heart rate is not
too slow as this alone could explain shortness of breath on exertion. Feel free to submit more questions when you have more cardiac
testing (sress test, catheterization,echocardiography,etc.) Good Luck. Information provided in the heart forum is intended for general medical informational
purposes only, actual diagnosis and treatment can only be made by your physician(s).



[The Heart Forum]      [The Heart Forum Archives]

[Todays Health]