Pulmonary Hypertension

I've been having tons of phlegm issues, sinus draining/coughing up. Started to feel very weird yesterday so went to Urgent Care. Started with EKG, but among blood work was a D dimen, because of that result, had a CT scan and chest xray. Doc said I didn't have any blood clots in my lung (had pulmonary embolism 7 years ago), but did think I had pulmonary hypertension. Seeing lung doc on Tuesday.

Been doing some online research, seems to be something that crosses the line between lungs and heart so might not be something just one expertise can handle. Anyone here deal with something like this before?

I was in afib (80s-110s hr) while there (had just kicked in that morning, is gone now). But nobody seemed at all concerned about the afib, which is unusual.
Nancy

Hi Nancy,

Doesn't sound like much fun. They probably weren't concerned about the afib because your heart rate wasn't very high and it's not a life threatening emergency. The lung issue is a much bigger deal. I hope you can find better care than an urgent care center. Let us know what the pulmonary doc has to say, okay?

I will. I've been doing research online and it's depressing as all get out. Cheery articles about increasing life expectancy to 8 years from 3 and things like that. Although one very cheery article said it's possible to get 20 years. And here I thought afib was my biggest problem.
Nancy

Are you seeing a cardiologist and/or pulmonologist?

If you have pulmonary hypertension (PHTN), its cause is related to outcome. Some things are progressive, others are not. So don't go to worst case scenario reading online.
I had a fungal infection in the past that cleared up. Because of some damage to my lungs I have had PHTN. It's mild and stable now. It probably influenced my a-fib. I am careful to avoid getting respiratory infections and have a plan with my pulmonologist if I do get sick. This past year I had an ablation. My chamber sizes are normal and I'm doing well. If you have issues from your past PE ask the pulmonologist how to best keep your lungs healthy. It's possible to get things in balance. I'm hoping that for you. Hoping you find doctors that will be good partners in health and are good communicators.

I've let my EP know about this and he's ordered an Echo to see if it's Pulmonary Atrial Hypertension (PAH). Seeing pulmonary specialist this afternoon. I already have issues with slightly enlarged heart so we figure it's tied to that. It's from my weight over the decades. Although I've managed to lose 40 lbs. in the past year & have continued to succeed at that, so part of me is pissed that this is happening after I finally figured out the right weight loss plan for me. Feel like I'm being punished for having finally succeeded at the big thing.
Nancy



Edited 1 time(s). Last edit at 02/26/2019 08:35AM by Nancy2.

Nice post Libby, it’s true PHTN is not always a worse case scenario DX. And one of the best ways I know of reducing any enlarged left Atrial size back toward normal range long term is freeing oneself from any AFIB at all, by whatever means one achieves that, which is most often via a successful expert ablation process.

Within 6 months after a completely successful ablation results in restoring durable NSR, any structural remodeling that has occurred due to having long-term active AFIB, will start to reverse itself to some degree. The longer one has been in active poorly managed AFIB , be that in the form of frequent PAF or Persistent/LSPAF, the greater the odds of increased scarring of the left or right atria which typically manifests as atrial enlargement.

Longer term atrial scarring is not always completely physically reversible leading to a limit on how much reverse atrial remodeling one can expect from restoration of durable NSR. But while any degree of reverse remodeling-induced LA size reduction is a good thing, this overall phenomenon is one of the best arguments for not procrastinating too long before starting (and most importantly finishing) a successful ablation process, once you have tried all the life-style risk reducing methods and electrolyte repletion protocols and found them not fully successful in essentially eliminating future AFIB episodes.

That is one good reason why we strongly urge new comers to our website to do everything they can to end their on-going AFIB experience and not settle for half measures, whenever possible.

There are other compelling reasons not to overly procrastinate once you have determined you are unlikely to be able to eliminate your AFIB by natural or life style means, such as the potential impact of accumulated SCI (Silent Cerebral Ischemia) from years of poorly controlled AFIB as well, but those details are better served in a separate thread.

Cheers!
Shannon

Sadly I'm not a candidate for ablation at this time due to weight issues. Consider surgery too risky. But have lost 40 lbs and am hoping to keep going & getting to good weight for life & surgery.

In other news, the lung specialist put me in a glass booth for breathing tests. I've got an Echo scheduled for 3/15. Won't know anything for real decisions until then. Diagnosed at moment with Pulmonary Edema and am using new inhalers (Advair for one) through 3/15 to see if that relieves some of the breathing issues. My breath test that has a normal result of 80 - mine was 48, which he called "severe." So that sucked. Am also adding 1 20mg Lasix pill to my schedule (had been taking 2 over the last week). My ankles and thighs swell up during the day (my job involves sitting for most of it unfortunately). Any suggestions for getting leg edema down welcomed!
Nancy

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Nancy2
Any suggestions for getting leg edema down welcomed!

Hi Nancy, this is a shot in the dark, but the natriuresis of fasting comes to mind. Because your situation is complex with afib & the pulmonary hypertension, I really thought hard about even posting this. Periodic fasting combined with a low carb diet could be useful. However, in your situation I would opt for supervision. I worked with the president of this organization <[idmprogram.com] , Megan Ramos, in conjunction with a family member with glioblastoma brain cancer. I thought her advice was spot on.

The natriuresis of fasting will change electrolyte balance - which can be a transient afib risk. There may impacts with your PH & meds, I have no idea. Hence my reluctance to post.

Good luck!

Thanks George, I'm open to anything. Have done fasts in the past for other things (back when I was riddled with anxiety I used it as a calming function).
Nancy

The posts above bring to mind Dr. Jason Fung and intermittent fasting. He gives options, for example eating in an 8- 12 hour window and not eating for 12-16 hours. Also, not eating in between meals. There are good youtube videos. It might be more doable with having multiple medical issues. Wishing you the best!!