Pulmonary Hypertension and EKG--Fastin use

[dtharvey]

I recently went to the Dr. asking for weight loss med. New Dr.-we just moved. I had major reactions from previous wt loss med from prior Dr.-'Fastin' but couldn't remember the name.  He put me on Meridia (haven't taken it yet). I did some research so to take any precautions and not wanting the same reactions. After being on the Fastin for three weeks I started getting odd symptoms. (Also note that at this time I was also under a tremendous amount of stress with our upcoming recent move, work resignation, children, etc.)  I also started an exercise regimen to help with wt loss-never having SOB problems before. Symptoms-facial flushing, extreme sob with minimal exertion, extremely sensitive emotions, increased heart rate. I started getting very concerned. At my checkup my BP was 180's/100, EKG was somewhat erratic (incr. HR ?anxietly) also stating RT sided hrt failure. My Dr. looked at this and stated it "looked okay and not to be concerned"..pass off due to anxiety? Due to my concern of the SOB he ordered CXR-results were neg-no abnormalities. I stopped the Fastin and he put me on low dose BP med temporarily. Recheck showed normal EKG, BP was still elevated but better. I still feel sob occasionally. Was the boat missed? Should I be concerned with PPH?-especially with use of Fastin and EKG result?Isn't RT side heart failure PH? Should I ask current Dr. for further investigative testing?  Also and important fact to possibly know-I am also on Zoloft. Can Serotonin syndrome come in to play with PH?  I didn't realize that PH was a disease rather than just a temporary condition!?

[National Jewish]

No reports were found of any interaction between Zoloft® (sertraline) and the weight loss medicines.  The weight loss medicines you have mentioned are to be avoided.  They have considerable risk of serious side effects.  As you have mentioned, one possibility is pulmonary hypertension.  This can be severe and relatively irreversible.  Pulmonary hypertension can cause an erratic EKG.  However an erratic EKG doesn’t mean that pulmonary hypertension is the problem.  Pulmonary hypertension can still occur even with a normal chest x-ray.  You should ask your doctor to order an echocardiogram to know for sure if pulmonary hypertension is your problem.  Attempts should also be made to determine the cause of your high blood pressure (BP).

Pheochromocytoma is a relatively rare, metabolically active tumor that could cause your symptoms of “facial flushing, extreme shortness of breath (SOB) with minimal exertion, extremely sensitive emotions, increased heart rate”.

[T-Mo]

Hi dtharvey,

A few months ago I also took a weight loss drug called phentermine which is similar to fastin I think.  After a couple of weeks of taking it with exercise I also had sob along with chest pains. I went to a doc in box and after an ekg and a couple of tests were ran the Dr. suggested that I go to the ER.  There they didn't see any major concerns with my ekg so advised me to go home and see my primary care physician.  Once I saw my PP I had an echo that stated mild tricuspid regurgitation and elevated pulmonary pressure.  Of course I've been online and am very stressed by the results because PH seems like a really big deal.  My PP and the Cardiologist who reviewed the echo told me there was nothing to be concerned about.  They didn't provide any meds only suggested I come back in 6 months for another echo.  

It's been only 4 months but I've recently started to feel dizzy when I walk and somtimes while sitting. I made another appointment with a cardiologist for tomorrow morning.  I'm praying that my condition has gotten better and at least not worse.  Anyway, I said all this to say that I think the condition is serious and that Dr's aren't very knowledgable concerning the disease and as a result underestimate the severity.  I would get a second opinion.  I'll keep you posted on my second opinion if you like.  Good luck to you!