Recurring CHF vs Anxiety

  I am very frustrated in the fact that I am having what I feel are recurring CHF episodes. I was diagnosed with PPCM in OCT. of 1997. I had 2 episodes of Flash pulmonary edema which I almost died from, my EF was 20 at the time. My EF has since improved to 45 so technically I should not be having these attacks.  I have had 2 this year one in  March which was precipitated by a cold. I also was admitted yesterdaywith all the same symptoms as in the past. My Drs. felt it was a panic attack I have never experienced these. In all the CHF attacks I will suddenly have an overwhelming sense of fatigue, followed by my voice changing to being very breathy sounding, then my lungs fill with fluid. In the first 2 episodes I could feel and hear the rales.  In the last 2 episodes no rales but neck vein distention and chest tightness SOB. They have all quickly  been resolved with Lasix and MS. Early yesterday morning I awoke with shortness of breath the overwhelming fatigue and the voice change. I have had a cough for the past 5 days and was planning on being seen by my PCP. SOB increased and I went to the ER where it was found that my right upper and middle lobe were decreased on auscultation but no change was seen on X-ray. I might add that even when I was first admitted for the CHF they have never seen dramatic Xray change. My O2 sats have always been 92-98% on room air. Even in the worst case. My cardiologists here have been puzzled by the dramatic onset and resolve of the past 3 episodes. They have seen me  in the ER heard the rales. Yesterday they thought it may be a panic attack. The problem with this is that I don't feel panicked when the episodes occur. I don't feel tingly. I don't feel
  an overwhelming sense of doom ect. My SOB lasted for 7 hrs then slowly resolved. My ABG showed that of someone who was hyperventilating.  I did not feel that I could slow the breathing but I did not feel panicked. The Drs. all agreed I did not present looking panicked but they could not come up with any other explaination. Have you ever seen something similar. I feel very frustrated. I am a ICU nurse in a large metropolitan area. I haven't had a episode in 7 months since the last time I was coming down with a cold/cough. Just thought I would check with someone who may see PPCM a little more often. My cardiologist said I was his first.
Dear Stacy
I am not sure what was causing your symptoms. CHF should not be causing your symptoms if your EF is 45%. However, if you are taking over the counter cold remedies that raise your blood pressure, that could lead to diastolic dysfunction and pulmonary edema. Alternatively, you could have a component of bronchitis when you catch a cold and this could lead to your shortness of breath. The hyperventilation is suggestive of panic attacks, but anyone that is short of breath may hyperventilate.
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