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Forum Name: Other infections

Question: Hypotension or Mono?


 FLAEMT - Wed Dec 29, 2004 6:13 pm

Hi, I have been experiencing some shortness of breath and strong rapid heart rate lasting 30 seconds when sitting up after laying down for a while. These symptoms don't seem to arise after physical exertion. I check my blood pressure regularly and it is always in the 100/70 range ( I am 20 y/o and 135 lb. and workout 5 days a week). I also feel my ears clog when this happens and everytime I workout. I have no medical hx besdies mono (2 years ago) and acne but my mother tells me that she experiences the same type of feeling when she sits up. No cardiac hx in my famly. I am also easily fatigued during the day and have a lack of energy at times. Could hypotension possibly be the cause or could this be a reoccurance of mono? Thanks for any replies.
 Dr. Anthony Solomon - Mon Jan 03, 2005 7:52 am

Normal blood pressure lies within a range - it is not one set of numbers. Optimal blood pressure is now clearly defined as a reading below 120 / 80. If your blood pressure is always in the 100/70 range, you do not suffer from hypotension.

You state that you experience shortness of breath and rapid heart rate when changing from a supine to a sitting position and it is of very short duration (30 seconds), and not sustained. There is a rare condition known as platypnea which is characterized by shortness of breath that worsens in the upright position. It is unlikely that you have this problem because your shortness of breath lasts only 30 seconds and you do not experience it during or after exertional workouts. Several pathophysiologic processes contribute to shortness of breath and it would be out of place to list them here. If symptoms persist, both cardiac and pulmonary evaluations are recommended under the respective specialists.

Your other complaints of easy fatigability and lack of energy are suggestive of
chronic fatigue syndrome (CFS). Unfortunately, you do not state duration of these complaints. CFS is characterized by a minimum of 6 months of severe physical and mental fatigue and fatigability made worse by minor exertion. Apart from profound fatigue, there are no other symptoms or physical signs which distinguish the illness. Anxiety and depression are commonly associated with the syndrome but are not part of it. No laboratory tests can confirm the diagnosis, but it is advisable to consult your doctor who may wish to conduct the following laboratory tests to exclude other causes of fatigue:

Full Blood Count, ESR, CRP and CK;
Renal, liver and thyroid function tests.

I hope this information has been helpful.


Dr Anthony Solomon
MB BS DTM&H DIP.VEN FRSM
Consultant Physician, Tropical & Genitourinary Medicine

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