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likelihood of pulmonary hypertension

doctor suspected pulmonary hypertension. i am 31F. my symptoms are chest pain at rest and on exertion (radiate to back and scapular) hemoptysis, cough, RUQ pain, palpitation. Chest feeling hardened and tight. Difficulty breathing. Very worried.
i was told that LV function OK and R heart not particularly dilated. But no tricuspid regurgitation therefore cannot measure pulmonary pressure.
1. i'd like to know if i am still likely to have pulmonary hypertension provided with all the above info. (i previously have echo measurement of Pulmonary systolic pressure of 43mmHg)

2.for chest pain and palpitation immediately upon lying down + hemoptysis, am i looking at cardiac or respiratory disease?

3. my central chest pain and back/scapular pain is progressively getting worse. do i have cancer? lung cancer? GI cancer? or mediastinal cancer? or pleural cancer? (note i do cough up blood and blood rush up to throat immediately upon lying down and also difficulty swallowing+ severe palpitation). when i clear my throat or normal breathing my chest and back and RUQ will be painful and tight. i have throat pain also. it's like my breastbone and underneath breastbone all stuck together radiate to back. it's like carrying a stone inside chest. i keep thinking of having cancer. i have a feeling of having cancer or fibrosing mediastinitis. i am scared. scared of dying.

thank you for reading and hope that you can answer  my above questions.

i am really sick and worried and dying. i am scared.
God bless everyone.

-dead Zoe
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Avatar universal
First of all, I recognize your fear and don't really have a way for you to counter it other than what the CCF doc mentioned.  I just wanted to chip in and tell you that you are not alone and to never "quit" because you never know what is just around the corner.
I have had many of the same experiences as you have.  I have been pronounced "terminal" many times in the last 8 years with problems with no known cause.  A couple of years ago, I was certain I was on my way out, couldn't get off the couch, and the docs had basically written me off, and I had essentially given in to the idea that I wasn't going to last much longer.  At least I had MRIs and other tests to go beyond the "it's all in your head." (altho, I'd been that route, too.)  Something happened at my son's school that enraged me and I had to take action and that was the beginning of my slow recovery that has been nothing short of miraculous in terms of doing things.  I still have the core problem but I'm able to do "things."

Along the way, I have learned that there are many types of docs, just like we all differ in how we approach things.  I believe, that for the most parts, docs get into the business to help people.  For some docs, if they get stymied, they quit on you and are actually irritated/angry when you turn up on their doorstep because they are frustrated at not being able to help.  They feel bad/frustrated/confused and make you feel bad/frustrated/confused.  The majority of the docs seem to tell you, "I dunno." but at least listen to you and/or are willing to send you out to specialists.  The last group are the interested and curious (not many of these, in my experience, but they DO exist).  However, if you go the distance with these, they eventually will quit because they and their network have run out of ideas.  

There are some people who just plain don't get diagnosed.  Apparently, you and I are among those thousands of people.  Science has infinite possibilities but medical knowledge is finite (and, what one or a couple of docs can contain in their brains is even more finite).  All we can do is to continue the research on our own, follow every lead (even without support), and NOT quit.  New techniques appear every day and you never know when a couple of pieces of information come together to make sense.

Have you seen an oncologist (cancer doctor)?  That sure seems like a logical step since that seems to be your greatest fear.  I wouldn't let the bleeding go.  If you don't have what you consider a good primary doctor, go to the ER sooner and then find a new primary later.  Bleeding can occur for a number of reasons other than cancer but you really should have it checked out.
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Avatar universal
thank you jan for your kind message.

-Zoe
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Avatar universal
thanks for all the above postings.
it's not that i am reluctant to search help from doctors. people just don't understand. in fact over the past 3 years i've been seeing cardiologist, respirotologist, GI , rheumatologist, ENT etc etc. been to ER also. i have countless exams and by reading previous records doctors just say they don't know what they are dealing with and basically i have a feeling that they just don't want to see me anymore. But what frightens me is that my symptoms are getting worse and worse , not just the sensation of pain or tightness or difficulty breathing but teaspoon and teaspoon of blood coughed up! it means something is going on which is sinister since symptoms are worsening! people just don't understand the severity and how bad patients like me are suffering (simply they haven't suffered before), facing all the increasing progressive life threatening symptoms and yet getting no help from doctors. I lost all the minimal support from doctors and friends, it's sad. it's really scared to face this dying illness alone. if you all happened to be on my situation, you will understand how desperate and hopeless i am with no support and no caring and i am just fighting on my own, knowing that one day soon i will not breathe and just die, despite my strong persistent of seeing doctors! i used to be brave, at first, and i don't really mind being poked by all the needles and scopes and things, but now, after all these negative and depressive so called 'support' by friends and doctors, it seems that i am being labelled  the 'crazy' and troublesome patient misunderstood of not willing to seek for help. I am sure I have been suffering for more tests and investigations and hospital appointments than many of you here!
Sorry for being so frustrated. Through internet posting i thought at least i can get some positive support from other patients, if not advice, but in fact i got kicked out again in this forum. Please my dear, try to care more about patients and not discourage them please, this is not what we patients need and it just makes things worse. I do have a feeling of being discouraged by some of the postings here, and you know how many times it will make the patient feel even worse? million times worse.
FYI, please don't think i am crazy. i've been seeing clinical psychologist and even psychiatrist as suggested, they DO NOT think that my symptoms are due to psycho problems. ie i am not crazy and it's not coming from my head.
Anyway, thanks for all the doctors who have helped answer my questions here.
I just want people to know that patient do need caring both physically and mentally. Every word which discourage them have a big impact on the progression. I don't think what i did was wrong-- i have been attending doctors and doing investigations with no complaint, trying to be brave, although scared! this is my own body my own health. i know that nobody in this world will help but myself, but it seems that i am now in the dead end and am dying.
thanks for listening.
god bless everyone.

-dead Zoe
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Avatar universal
thanks marina!

-Zoe
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Avatar universal
jan
Fortunately I am not in your shoes.  I have many things wrong with me, but I have received diagnoses for all, with all drs. in agreement.  I don't have much advice, either, but was driven to respond because of your desparation.

Will you do as this dr. suggested? "Fortunately, a solid diagnosis of pulmonary hypertension can be easily made from a right heart catheterization, if you wish to pursue this finding."  I think that is the next step you can take.  Maybe you could take this next step somewhere like CCF.  I was wondering if there would be anyway you could ask for a commitment from them such as making "a team" effort with drs. of different specialties putting their heads together. It is  difficult when you have to see one after another and I wonder how many people could be helped if one dr. spoke with another.  Maybe some of these problems aren't related, but it seems that it is time for a "team effort" on the drs. part.

After years of suffering I had a dr. tell me he would get to the bottom of it (that particular issue) and he did.  Why aren't more like that?!

I wish you well!

Hugs
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Avatar universal
fwilson, i agree with your posting.
people with minor symptoms thought that other people also suffer from minor illness. they simply don't see deep enough. have they ever experienced even being taken active role in own healthcare, by the end of the day one might just being labelled 'crazy' or received just a shrug of shoulder, simply because nobody knows  what's wrong?
AND THEN came people like some of the authors here, they just thought that diagnosing illness is easy (because their illness are common and minor and got diagnosed) and those people kept posting and complained of their illness (like myself) are simply being labelled crazy or inactive who don't lead an active role in seeking for help.
As i said in my previous posting, do you know how many specialists i've seen throughout the years and how everytime it eats away my mental and physical status with no progression on health but progressive getting worse on own health? Being humilitated by doctors or friends or anyone is not something a patient wants and whom can bear. Our mind will explode one day.
I hope that there are more caring people out in the world.

-Zoe
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Avatar universal
Hi Zoe,
-
Get away for a while from the 'common' doctors and find an electro-acupuncturist or a naturopath, they'll test you and for sure will find what ails you...
I mean this!!!!!
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Good luck -*Ianna*
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Avatar universal


Zoe,

You have to hang in there, continue advocating for yourself. I know it's difficult to have serious symptoms,and not get the answers you so desperatly seek. However,there are cases out there that baffle and bewilder doctors leaving them not knowing what to do next.These cases are sometimes labeled, "Too time comsuming",for which alot of doctors don't want to deal with. The good news is they're few and far between. If you feel you're not getting what you need from the doctors you are seeing,You owe it to yourself to find someone else. If you decide to go to another doctor make sure you obtain copies of your medical records,test,etc... From (all) doctors you have seen, this will give them the ability to see what procedures and test each individual doctor has completed and then hopefully, they will know where to go from there.
Good Luck
Marina*
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Avatar universal
THanks Ianna for your advice.
i've tried alternative medicines as well eg acupuncture etc. i've been looking into any options available.
i've been trying to do more exercise as suggested by doctors, but my exercise tolerance is decreasing but doctors just don't understand they thought that i am a lazybone and useless.

-Zoe
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Avatar universal
Hi Hank (C5)
Thank you so much for your blessings and support. I know it's not right to think of dying, but i am so sick physically and depressed and scared and worried and cannot persuade myself for not thinking about it, when symptoms are worsening each day and have not one second of getting any better.
Thanks for your thoughtfulness and may god bless everyone too.

-Zoe
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Avatar universal
zoe i would not hesitate another second before going to the dr,with the symptoms your describing especially coughing up blodd,and blood rushing up to your throat upon lying down i would get yourself to the er!
best of luck and godbless
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Avatar universal
Why don't you call your Dr., The one who ordered these tests, and say to his office staff that you would like an appt. with the Dr. to completely discuss your test results and medical problems.....Once there, make sure you understand exactly what he/she is telling you...In the meantime, write out every question and concern you have and take the list with you....You might find things not as bad as what you are fearing...Good luck, Tessa
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Avatar universal
I am personally more worried by the progression in how you sign your posts.."dead Zoe" chills me to the bone, and I think that depression and fear are BY FAR the greatest threats to you right now.

Please see a doctor at once, for your mental health as well as physical health.
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Avatar universal
Zoe,

I've read this post, and your previous posts (most recently on 10/4/03).  What strikes me most about your posts is the combination of fear and lack of progress in diagnosis or treatment.

Either you are seeking care from extraordinarily inept doctors, or you are not seeking consistent care with someone with whom you have a relationship.  I will gladly answer your questions today, but I will strongly reiterate what BKJ suggested on 10/4/03 -- your healthcare will not be substantially improved by this post.  You need to seek personal care.

(1) PA pressures of "43" are mildly elevated and may indicate a mild degree of pulmonary hypertension.  This degree of pulmonary hypertension would be associated with symptoms only in rare circumstances.  Fortunately, a solid diagnosis of pulmonary hypertension can be easily made from a right heart catheterization, if you wish to pursue this finding.

(2) Chest pain with hemoptysis could be from cardiac, respiratory, GI, rheumatologic, or vascular disease.  A good internist can help you sort this out by starting with a history and physical.

(3) A diagnosis of cancer certainly cannot be made through the internet.  I would strongly encourage you to seek a good internist to help with your medical care.  A CT scan, if an H&P don't help, may help establish a diagnosis for the chest symptoms.

For your own sake, please seek care from someone with whom you can establish a relationship.

Good luck.

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