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Is IPH a possibility?

I'm 22, female, normal weight. A year ago, I started getting extreme exercise intolerance and tachycardia during a flu. These symptoms did not entirely go away afterwards and I was diagnosed with postural orthostatic tachycardia syndrome and tendency towards neurocardiogenic syncope.

However I have had a very bad time with it, haven't responded well to medications and am still housebound. Initially I was only breathless during exercise, but now I often spend hours sitting down very short of breath, sweaty, nauseous and unwell. Since February 2013 I have had chest x-rays, chest CT,  exercise EKG, echocardiogram and CT angiogram. I have a pulse oximeter which usually reads 98 or 99 at rest.

Would pulmonary hypertension have been spotted or ruled out during those tests? I am aware that POTS in and of itself can cause breathlessness, but mine seems to be particularly severe. Thanks.
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1884349 tn?1353818598
Hello and welcome to the forum.

While I can not say for sure, I have a very low suspicion for pulmonary hypertension in your case.  The vast majority of patients with pulmonary hypertension will have an abnormal ECG and an abnormal echo (ie a big right ventricle, etc).  Based on your report, sounds like these were normal.

What you are going through sounds very frustrating but I would continue to slowly go through the evaluation to see if you find anything (ie check thyroid tests, look for anemia, etc etc).  But, I know easier said than done, if after all testing is done and everything checks out normal, I would try your best to truly convince yourself that you are ok (because in that case you probably are), and slowly build back up your stamina and endurance.  And also ask yourself if you could possibly be suffering from stress/anxiety---because physical manifestations of these conditions are absolutely real and can be quite debilitating.  But treatment ultimately helps a lot.

Wishing you the best.

Dr. Rich
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