My mom has severe breathing problem with PAH and right heart failure. Kindly help.

Question

Hello doctor,

My mother has been suffering from breathing problems for quite a long time. Local doctors used to provide inhalers and Deriphyline tablets for that. Since last year, it went severe, and lately, it has been diagnosed with severe pulmonary arterial hypertension (PAH) and right heart failure. She is unable to walk or do regular activities. With a small exertion, she feels breathless. I am seeking an opinion. I can send all the test reports for evaluation. She is currently on Dytor 20 mg every day, Telsar, Thyrox 75, Pan 40, Levolin inhaler, Aerocort inhaler (sos), and Festal N.

Answer 1

Hi,

Welcome to icliniq.com. I can understand your concern. According to your statement, your mom has been suffering from severe breathing problems in a little activity for a long time. According to the ECHO report, severe PAH (pulmonary arterial hypertension) and right heart failure, but EF (ejection fraction) 60%, within the normal limit. Her CXR (chest x-ray) has revealed bilateral pleural effusion, cardiomegaly, and pulmonary hypertension features due to fluid overload or edema. Fluid in the lungs makes her breathing difficult. She has already been prescribed Dytor (Torsemide) 20 mg, which excrete more fluids from the lungs. I think a pulse oximeter should monitor her oxygen saturation rate. If her diuretics like Dytor 20 mg cannot excrete fluids from the body, then the accumulation of extra fluids can make such type of respiratory distress. So, repeat echo and CXR should be done to monitor her heart and lungs' present status. She can be admitted to the hospital for further monitoring and evaluation as she had a history of pleural effusion, PAH, and heart failure. At home, keep her in a propped up position, and give her oxygen therapy after watching her oxygen saturation rate, and injectable Dexamethasone and diuretics with broad-spectrum antibiotics may be needed after watching the reports of echo, CXR. Nebulization with Salbutamol or Budicort can be given too.