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Worried about Pulmonary Hypertension

21 year old male, 142 pounds, don't smoke, drink occasionally.

My symptoms started about 2 years ago. I was having trouble exercising, but figured it was because I was out of shape. Since I was having some chest pains, I decided to go to the doctor. After running a few tests [ekg, stress test, echo] they told me they found nothing wrong and that I was safe to exercise. The symptoms continued, so I saw a lung doctor. He ordered a cariopulmonary stress test which showed a severely reduced VO2 max among other things. Thinking it was my heart, they ordered an MRI and CT scan since my echo's wouldn't come back with a clear enough picture. My heart seemed to check out fine.

Fast forward to 2 months ago... I was on a strict exercise schedule to get back into shape. I got to the point where I could lightly jog for about 33 minutes. When I tried to increase the intensity [not even by that much. I went from running 12 minutes a mile to 10:30] I started to get short of breath. The shortness of breath continued every time I would exercise after that point. I started to feel short of breath at rest a little too.

I've noticed that my fingernails are always a blueish/purplish color. This morning when I woke up, my uncle commented on how I looked kind of pale. I looked in the mirror and noticed that my lips had a tint of blue/purple in them. I also feel fatigued a lot.

I'm now freaking out that I might have something seriously wrong, such as pulmonary hypertension.

Any insight on what could be going on? Thanks.
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1884349 tn?1353818598
Hello and welcome to the forum.

What stands out to me the most about your post is your description of the bluish discoloration in your fingers and lips.  That, coupled with your low VO2 on your CPX test, makes me wonder if you might have what we call a "shunt".  In other words, you might have an abnormal communication either in your heart or in your lungs that is allowing blood without oxygen to bypass your lungs (where it usually picks up oxygen) and dump this "deoxygenated" blood directly into your arterial blood stream (thus resulting in the blue color of your extremities, etc).

There are tests that can look for this and, if discovered, often things that can be done to fix the problem.  But this is where I think I would start.  Never hesitate to get a 2nd opinion if you are not getting the answers you need after months of testing.

Wishing you all the best,

Dr. Rich
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