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PAH?
I'm a 42 yr F athlete. 5'3"/115. Started cycling/run 4 yrs ago. About yr ago started feeling bad after races. Started having dyspnea esp. with climbing (hills while running/cycling), stairs, rendered me struggling to breathe. My dyspnea/fatigue/right side chest pain, non-prod cough slowly incr. the past 8/10 mths-  reading a book to my son causes me struggle to breathe. Also exp dizziness, swelling of hands, cold/heat intolerance. Dont notice worse symptoms when lying down.My PCP ord cardiac workup, had a stress echo, result below. Chest x-ray/CBC/TSH (all normal). My BP always 120/80. Now my BP  has been very low for me 109/67, 107/63, etc. I have never had anything lower than 120/80. The low BP reading have been in conjunction with the increase in my other symptoms. Been referred to pulmonary dr for lung function tests - suspicion of asthma (no history or family history). My appointment with the pulmonary dr is next week and I will definitely be discussing this with him.
My cardiologist said everything is normal with the exception of some mild aortic and mitral valve regurgitation which he wants to recheck in 6 months and yet he is attributing ALL of my symptoms to "aging" and has discounted the acute onset and progressive severity of symptoms.
My cardio results are listed below:
Preserved left ventricle systolic function without hypertrophy nor dilatation
Global left ventricle ejection fraction greater than 50%
No aortic nor mitral stenosis is present No evidence of classic mitral valve prolapse is noted
No significant pericardial effusion or intracardial masses are noted on the images obtained
Mildly technically difficult study
Not all views optimally obtained due to patient's physical characteristics
Mild mitral regurgitation
Mild aortic regurgitation
minimal tricuspid regurgitation, est RVSP= 30mmHg
Of course, my concern is PAH after google RVSP and then seeing the symptoms. Am I overreacting? Or is this a valid concern? I appreciate any input.
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1884349 tn?1353818598
Hello and welcome to the forum.

1. I am terribly sorry that you are experiencing these symptoms.  While I do not suspect PAH given how generally rare it is and the results of your testing, it would certainly be nice for you to get a diagnosis.  I think seeing a internist, lung doctor, and cardiologist who you trust is great.  Breathlessness while reading sounds quite extreme---either there is something serious that everyone is missing or you may be suffering from physical manifestations of anxiety or some other real stressor in your life...however, that should be what we call a "diagnosis of exclusion"...first got to make sure that nothing else is going on.  Perhaps a CT with contrast to look for blood clots in your lungs?

2. One can NOT make the diagnosis of pulmonary hypertension with Echo.  You would need an invasive right heart cath to make the diagnosis.  Your echo did not suggest how your right ventricle looked.  Again, I doubt PH but if you remain concerned, I would bring these things up with your doctor.

Wishing you only the best.

Dr. Rich
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