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Obesity and high pulse - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Heart Rate and Rhythm Disorders
Answered by

General & Family Physician
Practicing since : 2009
Answered : 594 Questions
User :   I'm seriously fatigued and have labored breathing when I get out of the recliner. Resting BP is 138/98, pulse 60, ox 98. Walking pulse 102, ox 95.
What are the most probably causes, and what tests should be done next?
Doctor :   Hi
Doctor :   Your age?
Doctor :   Your weight and height?
User :   63 years old, 5'1", 255 lbs
Doctor :   ok
Doctor :   Your BMI is very high and falls under highly obese
Doctor :   I guess that the most probable cause for breathless on exertion
Doctor :   Otherwise your BP, pulse are obsolutely normal
Doctor :   Do you consume any medications for Hypertension
Doctor :   As you have mild hypertension in thevalues suggested
User :   mild L ventricular hyper-something, mild right bundle branch block, diabetes mellitus, nephrogenci diabetes insipidus, cannot take meds--highly reactive
Doctor :   I also cannnot go with self measured values as there alwasys an error of 10 mmhg in self measured and electronic devices
Doctor :   Ok
User :   Why do you assume self-measure? Actually, physician assistant and nurse
Doctor :   Ok
Doctor :   If you have severe difficulty in breathing due to exertion then it signifies the heart is not pumping enough blood for the organs
Doctor :   the other cause id funtional impairment in lungs
User :   What tests for definitive diagnosis?
Doctor :   It like when the work load on heart increses, being an heart which is funtionally impaired to minimal extent will not pump suuficient blood during mild to moderate physical activity
Doctor :   First ECG, then an ECHO
Doctor :   I would also suggest an HOLTER
User :   Impact of chronic renal failure?
User :   GFR 41
Doctor :   First there is signs of Pulmonary odema
Doctor :   Thats will also cause difficulty breathing but to very great extent, you will not be able to sustain breathing at all'
Doctor :   Followed by drastic raise in BP
User :   Systolic or diastolic?
Doctor :   Both
User :   What are signs of pulmonary edema?
Doctor :   1.Breathless even at rest
Doctor :   2. severe hypoxia
Doctor :   3. Drastic fall in BP
User :   Hypoxia? Oxygen level below what?
Doctor :   Saturation less than 70%
User :   You say pulmonary edema causes "drastic raise in BP" then you say "3. Drastic fall in BP"
Doctor :   I sai it related to Chronic renal failure
User :   Renal failure causes rise; heart failure causes lower?
Doctor :   Yes
Doctor :   Renal will cause pulmonary oedema and high BP
Doctor :   Thanks for consulting me
Doctor :   BYe for now
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