dizziness after excersise

[Phani2010]

I recently started feeling dizzy after excersise. What would cause this? Also my recent echo showed that I have mild PAH. Is is dangerous?

[kenkeith]

It can be either.  If there is a blood clot in pulmonary vessel, that could happen quickly. Clots or other conditions for respiratory inflammation or disease, etc. can be a slow process.  Usually, it is a gradual process.

[Phani2010]

Only abnormal findings were trivial TR and mild PAH with 40mm hg. There is no other mention. Is is possible to pick up PAH all of a sudden or deos it happen gradually?

[kenkeith]

Actually PAH  cannot be defined with echocardiography alone. There is agreement with the medical community, and most widely agreed upon definition of PAH is a hemodynamic one, the components of which can only be obtained only by cardiac catheterization: normal pulmonary artery has a mean (average) pressure ≥ 25 mm Hg.

Right Ventricle systolic pressure greater > 35 mm hg can be problematic.  There would evidence of right heart pressure overload (right atrial enlargement, right ventricular enlargement, hypertrophy or dysfunction, significant tricuspid regurgitation, etc). Is your condition any of the above? That would support a finding of PAH.

[Phani2010]

Would appreciate replay from anyone...

[Phani2010]

Thanks all of you for sharing my concerns.

One more piece of information is that just before my current echo, an echo was done it showed that the pressure was 23 mm/hg and now it is 40 mm/hg. How can it change all of a sudden in 2-3 weeks? Is it possible?

[kenkeith]

Don't let the sudden attention unnecessarily concern you, but probably well meaning and I am begining to feel embarrassed to continue...its like hitting a fly with a sledgehammer.:)  

I have minor PAH for years and no advancement...The underlying cause was found when I had a CT scan for the heart that included respiratory system and descending  aorta. The test I had minimal atelectasis of thw lower right lobe....meaning destruction and scarring.  I'm not surprised as I was careless with my health for years. Take care and don't be overly concerned...

[kenkeith]

Absolutely, you should see a pulmonologist.  The fact that it has been mentioned in a report indicates some  concern. Consideration is important, given that early treatment for PAH while you are less symptomatic, and treatment is associated with improved exercise tolerance and pulmonary hemodynamics.

[ed34]

absolutely. Taking it your cardiologist has correctly diagnosed it, maybe  a second opinion is worthwhile, then the sooner you begin a therapy the better. It's a bit like a cardiologist discovering you have early signs of atherosclerosis and saying nothing to give you obvious options which can greatly improve and extend your life, such as lifestyle changes.

[Phani2010]

So I get the message that even mild PAH should be treated seriously. ??

[ed34]

I'm sorry to hear about your condition, but I would have a look at this site....

http://www.phassociation.org/Patients/NewlyDiagnosed

I think it will give you good advise and it mentions people who have had this condition for a long time.

[kenkeith]

Phani2010, I have provided a link to pulmonary forum.  You may get a better idea regarding PAH from other members as well as ask question.  Take care and good luck.

http://www.medhelp.org/search?query=pulmonary+forum&camp=top_nav_search

[kenkeith]

I have read cardiologists don't have very much knowledge regarding PAH and don't treat.  It is a serious problem and should be treated.  You may need to go to a pulmonary specialist (pulmonologist).

[Phani2010]

My doc isn't willing to the cause for PAH for some reason. I am worried because I already have palindromic arthritis which is a sort of connective tissue disorder. Why isn't he taking evaluation of PAH further?  He just said mild PAH isn't an issue.

[kenkeith]

Hi Phani, if unteated the progression can be rapid, if primary.  If secondary HAP, it may depend on the underlying cause.  It is a serious disease and unfortunately many patients do not get treatment until there are symptoms. Indivduals have such a variation in their physiology that any predictive prognosis is not reliable and just conjecture.

[Phani2010]

Thanks a bunch.

How quickly does this condition progress if it is untreated? Any ideas here?

[kenkeith]

There is no cure, but there is effective treatment that can slow or stop the process. When available treatment is not successful, then a lung transplant would be an option.
However, the past decade has seen remarkable progress, prior the condition was devastating now often respond to one form of therapy or another, leading to improved functional capacity and even survival.

[Phani2010]

Is mild PAH fatal?

[kenkeith]

For some insight: PAH is pulmonary arterial hypertension is high blood pressure that supplies blood to the lungs...it is directly assdociated with the right side of the heart.  If not successfully treated the heart's rightside can/will enlarge.
The blood vessels that supply the lungs constrict and their walls thicken, so they can’t carry as much blood. To illustrate as an anology with a kinked garden hose, pressure builds up and backs up.   The heart works harder, trying to force the blood through. If the pressure is high enough, eventually the heart can’t keep up, and less blood can circulate through the lungs to pick up oxygen. Patients then become tired, dizzy and short of breath
Thanks for sharing.  Take care, and if you have any further questions don't hesitate to ask.

[kay2486]

im not sure what a PAH is? your bp could have dropped really low after exercise

[erijon]

The main cause of dizziness after exercise is an improper cool down period. Exercise pushes a large volume of blood to your large muscle groups which can lead to low blood pressure and dizziness if you stop too quickly. The cool down period helps to keep your blood pressure from dropping as happens when you stop too suddenly. I usually cool down for 3-5 mins after a 45 - 60 min ride on the exercise bike, works every time.

Good luck,

Jon