I am a 31 year old, obese female with severe asthma since the age of 16. I am on maximum therapy (multiple nebulizer medications every four hours, oxygen). I can't take oral or injected steroids because of an adverse reaction. About 2 years ago my pulmonologist suggested I may have ph because of a different type of shortness of breath I was having, he called it 'heavy lung'. I also have pvc's and tachycardia. My pulse is always above 100 and in one of the episodes caught on the holter, it hovered around 170. Because of the asthma I can't use beta blockers so I am on mexiletine and cardizem la. I have normal bp so it has been difficult getting the correct amount that doesn't lower the pressure too much. I have had several echos and a stress test which weren't abnormal at the time (when I asked for a copy, the diagnoses read "above findings are suggestive of hypertensive heart disease")
About a month ago I went to my pcp because of edema and increased s.o.b. at night. He did an echo and it found the following: Ejection fraction is 54%. Doppler suggests no aortic stenosis. Doppler suggests no aortic insufficiency. There is mild to moderate tricuspid regurgitation. The peak tricuspid regeugitant velocity was measured at 3 meters per second, suggestion mildly increased right ventricular systolic pressure. Evidence of mild ph. He put me on lasix and altace which increases my urination, but the edema just comes back by evening. He wasn't concerned with PH, he said just watch it for a year. I've heard what can happen if you delay treatment. Suggestions? TY