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Forum Name: Cardiology Symptoms

Question: Short of breath, fatigued, PPH? anxious


 fran - Sat Jun 18, 2005 7:54 pm

I am a 33 year old female and for the last couple of months I have noticed shortness of breath after climbing a few flights of stairs and unexplained fatigue. I am nervous I may be developing PPH. I do have iron-deficiency anemia (for the last three years)-could this be related to shortness of breath and fatigue?

I'm anxious because normally I have lots of energy, running after two children and somedays I feel like I can't get out of bed.

Also, the more I focus on my breathing, the more I anxious I get about it and it seems like I can't get a deep breath.

I have an appt with my GP next friday but would appreciate any thoughts. To be perfectly honest, I didn't know this disease existed, or rather, that there was an idiopathic form, until I did some Internet symptom surfing.

Thank you.
 Shannon Morgan, CMA - Sun Jun 19, 2005 8:09 am

User avatar Is your iron deficiency severe? Have they done ferritin and tibc blood tests? Have they found the cause of it? Do you take iron supplements? If so, are your iron levels normal?

More serious iron deficiency can cause fatigue and SOB, but usually not if controlled with iron supplements.

Fatigue and SOB are definitely symptoms to be evaluated, and can also be solely from anxiety. Definitely see your doctor for a complete physical, including thyroid, ECG, chest xray and spirometry (measure of inspiration and exhalation). He will probably be able to do all of this in his office. There is really no way to even give you a close diagnosis on the internet, but it really doesn't sound like PPH.
 fran - Sun Jun 19, 2005 9:47 am

Thank you so much for your response.

I am curious-why do you say it doesn't sound like PPH? Aren't the hallmarks of PPH fatigue and SOB early on and then other symptoms as it progresses?

Regarding my anemia here is a brief history-two years ago my hemo. and ferritin levels were very low, they gave me iron supplements, i couldn't keep them down so I stopped taking them and tried to treat the anemia through diet, more spinach, beans etc. I rarely eat meat and haven't eaten red meat since I was a teenager.

Then last year it was checked again and I was still anemic, though not as bad.

Isn't anemia symptomatic only when it's severe? If I've been borderline anemic for a few years, wouldn't my body compensate for that? I did learn something-my mother told me when I was 4-5 I was anemic and had to get iron shots for awhile. I don't know why I was anemic at that age, my current anemia is due to heavy, close together periods (that's what the doctor suspected).

That's why I'm concerned it's something more sinister-I know PPH tends to strike women from 20-40 (I'm 33) and presents with the symptoms I have. And that it appeared out of the blue, within the last two months I get winded going up stairs, feel dizzy if I stand up too quickly, etc.

The reason I say that is because you notice the SOB with physical exertion, not constantly even at rest, dizziness is the second most common complaint in the doctor's office, and iPPH is very rare. Your symptoms cover so many other things, dizziness can even be simply from not eating enough, or going too long in between meals. Of course, that may or may not be the case, it's just an example. It would be very alarmist to jump to the conclusion of PPH.

I did say if your iron was slightly low, you shouldn't be experiencing these symptoms due to that.

Have you ever had an echocardiogram? That will measure the pressure and your doctor may do that to rule out any heart involvement. You will have all sorts of testing to rule out anything serious, of course, but try to relax. Your anxiety about having a fatal disease is more than likely making your symptoms worse. There are only 500-1000 cases of PPH diagnosed per year!

It's just very unlikely, relax! :D
 fran - Sun Jun 19, 2005 4:36 pm

No, I've never had an echocardiogram, is that something that can be done during my doctor's visit or is it more involved?

If one has SOB, is respiration rapid? I don't just feel winded after climbing stairs but if feels like I have to struggle a bit to get a really deep breath, as if I were wearing a corset. Is that sympomatic of something?

I must confess, I do tend to worry about my health and fret over any symptom, last year I was convinced I had motor neuron disease. But this time, the symptoms seem real, more objective, not like last year when I was imagining symptoms.
 Shannon Morgan, CMA - Mon Jun 20, 2005 9:01 am

User avatar Hi, Fran,

SOB can be on exertion, but can also be at rest. Most complaints about SOB in young people are anxiety related, but it's always important to rule out cardiac and pulmonary causes first.

An echocardiogram measures pressures within the heart, like the pulmonary artery (which is what causes PPH), and gives a live visual of all four sections of the heart and valves in action. It rules out things like mitral valve prolapse, which is not serious and even fairly common. It seems to have a connection with anxious people, although it physical in nature, but the anxiety makes it worse. Chest pain, palpitations and shortness of breath with worsening anxiety are common features.

You do sound like you get overly anxious about your health. Perhaps if there is nothing cardiac or pulmonary involved, you could discuss with your doctor something to treat that.
 fran - Mon Jun 20, 2005 1:13 pm

I know anxiety can make it worse, the more I focus on my shortness of breath, the worse it seems. It feels like it's hard to take a deep breath but when I consciously try I can easily take a deep breath. From what you say, it is more likely anxiety related, but I will definitely get it checked out, I have an appt on Friday.

Thank you for your help.
 fran - Fri Jul 01, 2005 10:23 am

Just an update-I went to my GP, explained my symptoms. I had blood tests (counts normal, no thyroid problem, borderline low hemoglobin) and a chest xray, completely normal heart and lungs, normal vital stats, etc.

So how to explain my SOB? He said I had hyperventilation! I was making myself hyperventilate, because of anxiety and stress. I didn't believe it at first, I thought hyperventilation was dramatic, almost passing out, breathing into a paper bag, but he said not necessarily.

I asked him about PPH and he said it usually presents with chest pain along with SOB.

I am relieved to say the least and will start working on my anxiety issues. Thank you for your help.

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