OpenHealth Q&A

Challenges with Pulmonary Artery Imaging on CT Scan

For nearly a year, I have been grappling with unexplainable breathing difficulties and episodes of faintness, despite undergoing a comprehensive examination of both my cardiac and pulmonary health. Unfortunately, no clear diagnosis has emerged, and the symptoms persist without any discernible intervals of relief. Recently, I underwent a chest CT scan to investigate the condition of my pulmonary arteries and to explore any additional potential causes. During this procedure, the technician struggled to obtain a satisfactory image of my pulmonary arteries, requiring two attempts to capture the necessary visuals. During the first attempt, as the dye was injected into my arm, I experienced a sensation as though it had become lodged in my neck and shoulder area. I felt a notable burning sensation extending along the sternocleidomastoid and into my deltoid on the injected side, where the muscle even twitched on a few occasions. This discomfort lasted for about ten seconds and thankfully did not lead to the warm sensation in my lower body that is usually mentioned as a possible effect. After this initial attempt, the radiologist reviewed the scan and subsequently asked me to return to the imaging room for another try. In the second attempt, the dye seemed to have a less pronounced effect in my shoulder area, and I did notice a mild warming sensation in my lower extremities this time. Upon receiving my results, I learned that the assessment of the pulmonary arteries remained inadequate due to poor opacification even during the second try, leaving me both perplexed and hopeful that it might provide some clues toward a diagnosis. This ongoing health issue has significantly affected my quality of life. I encounter a variety of fluctuating symptoms, but two primary physiological indicators stand out: firstly, I present with mild compensated acidosis, consistently showing a VBG PCO2 in the range of 52 to 69 mmHg, while my lungs exhibit no signs of chronic obstructive pulmonary disease (COPD) or other abnormalities, and neurological disorders have been excluded. Notably, across six VBG tests, I recorded true acidosis only once (7.28), while my bicarbonate levels routinely exceed 29 mmol/L. The second persistent symptom is the frequent dilation of veins throughout my day. Prolonged sitting results in dizziness or presyncope and breathlessness, but symptoms tend to improve upon standing, accompanied by significant peripheral vein bulging. This reaction is so pronounced that my limbs resemble those of a bodybuilder, with superficial veins appearing engorged, despite the absence of tissue swelling. Additionally, I grapple with chronic hypertension, at times reaching a hypertensive crisis (above 180/130), although medications like clonidine and propranolol have helped to manage these levels. Has anyone ever faced similar complications with CT dye injections that ultimately contributed to a diagnosis? I suspect my symptoms may be linked to vascular compression, given the correlation between my seating position and the resultant dizziness and shortness of breath, coupled with the dramatic vein dilation that follows. I appreciate any insights or relevant experiences you might share! Your feedback can be invaluable to my ongoing quest for understanding my condition.

Answers (1)

6/20/2025, 12:02:25 AM

OpenHealth AI

It sounds like you've been facing significant challenges with your health, especially regarding your breathing and the effects of recent medical tests. It’s important to acknowledge how frustrating and concerning it can be to deal with persistent symptoms without a clear diagnosis. Let's break down your situation and explore potential next steps that may help.

Key Points:

1. Your breathing difficulties and faintness persist, with no definitive diagnosis after extensive evaluations.
2. There were complications with your recent CT scan, limiting the assessment of your pulmonary arteries.
3. You experience symptoms that appear to be linked to vascular changes, particularly when sitting.

Explanation:

The symptoms you describe—such as breathlessness, dizziness, and the noticeable dilation of your veins—suggest there could be several contributing factors, including potential vascular compression, postural changes affecting circulation, or perhaps an undiagnosed condition affecting your autonomic nervous system. It’s noteworthy that the sensation during the dye injection indicates heightened sensitivity in that area, although that may relate more to the injection experience itself rather than the underlying issue.

Your persistently elevated CO2 levels could hint at a respiratory or metabolic issue, where even without COPD, your body may be struggling to manage metabolic gas exchange effectively. The fluctuations in blood pressure and pronounced vein dilation with certain postures may indicate some vascular responsiveness.

Next Steps:

1. Tracking Symptoms: Keep a detailed diary of your symptoms, including activities, positions (sitting or standing), and associated symptoms (e.g., dizziness, shortness of breath), to share with a healthcare provider. This can provide valuable insights into patterns.

2. Hydration and Posture: Ensure you're well-hydrated, especially when seated for long periods. Try to position yourself upright and take frequent breaks to stand or move around, which seems to alleviate symptoms when you change position.

3. Controlled Breathing Techniques: Practice slow, deep breathing exercises to help manage anxiety and support breathing efficiency, particularly when experiencing breathlessness.

4. Further Evaluation: Given your symptoms and the complexities around your pulmonary function, consider discussing with your healthcare provider the possibility of further vascular imaging (like an MRI or ultrasound) to assess for compression issues, or even referral to a specialist such as a cardiologist or pulmonologist who focuses on complex cases.

5. Consider Autonomic Testing: Given your symptoms during different positions, inquire about autonomic function evaluation to see if there’s a dysfunction contributing to your symptoms.

6. Emergency Plan: Since you've experienced hypertensive crises, ensure you have a clear plan for how to manage those situations. This could involve monitoring at home and medications as prescribed.

If you continue to face challenges or feel that your concerns aren't being addressed, advocating for yourself or seeking a second opinion may be necessary. Remember, it’s crucial to stay proactive and informed about your health journey. Please keep track of your symptoms and observations, as they may ultimately guide further evaluations and therapeutic approaches.