EAR DR. DONOHUE: I have been losing energy for years and thought it was due to aging. I am 67. This past year, I went downhill quickly. I became nauseated, dizzy, short of breath and tired. I had increased headaches and lost 30 pounds (the only good thing to happen). In December, I had severe chest pains, and my blood pressure shot up. Emergency docs and a heart specialist looked at my heart for months after, but nothing showed up. By April, I was barely able to do basic things. Crossing two rooms left me winded. All the doctors I saw scratched their heads.

Then I read your article on pulmonary hypertension. Everything fit my picture. I asked two docs to consider it. They said it was unlikely, because it was so rare. Yesterday the heart doctor gave me a stress test with ultrasound. I couldn’t breathe after three minutes on the treadmill. After I recovered, the doctor said, “It looks like you may have pulmonary hypertension.” I have been online looking it up and am worried about longevity. Thank you for your article. It put me on track to getting treatment. — R.M.

ANSWER: Thank you for your kind and informative letter. Your story isn’t unique. If you polled a hundred people diagnosed with pulmonary hypertension, I bet half would give a story similar to yours. It’s high blood pressure confined to the lungs. The lungs are such delicate structures that they cannot withstand normal body blood pressure. Their pressure is only one-fifth of the body’s pressure. You describe the signs and symptoms of lung high blood pressure far better than I could.

An echocardiogram, a soundwave picture of the heart, provides valuable information for making the diagnosis of this condition. The most useful test is catheterization of the right side of the heart, a test done by threading a soft tube into the right side of the heart through a vein and measuring pressures there. Those pressures reflect lung blood pressure.

The sources you read online might not provide the most current outlook and treatment for this condition. I can’t mention all treatments, but epoprostenol, given by continuous infusion into a vein; treprostinil, injected under the skin; bosentan and ambrisentan, oral drugs and an inhaled medicine present a much more upbeat outlook for pulmonary hypertension. Sildenafil and tadalafil, drugs famous for treating erectile dysfunction, also are used for lowering lung blood pressure.

DEAR DR. DONOHUE: I read your column every day, and I was wondering if anyone has written to ask a question about burning in the throat.

I was a smoker for years. It’s been five months since I have had a cigarette. This throat burning occurs when I walk or try to exercise or even carry laundry. I would like to know what it means. It feels like hot ice in my throat. — F.R.

ANSWER: I don’t want to alarm you, but I will breathe more easily if you see a doctor very soon. What you describe could be a sign of angina, pain caused by the narrowing of a heart artery or arteries. More often, people describe angina as chest tightness or discomfort that occurs when they’re active, as in walking, exercising or carrying laundry, and then lets up when they stop. The variations on angina pain are many. It can be felt as jaw pain, shoulder and arm pain (on the left more often than the right) or neck pain. People use words like “squeezing,” ”crushing” or “suffocating.” Some say it feels like throat tightness. Burning throat pain could be another variant of angina.

Do see a doctor quickly. Stop doing things that bring on this pain until you do.

The booklet on angina and coronary artery disease explains this common malady and how it’s treated. Readers can obtain a copy by writing: Dr. Donohue — No. 101, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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