Experiencing Mild Perihilar Pulmonary Congestion?
Greetings, everyone. I am a 27-year-old man who neither smokes nor vapes, and my only regular medication is low-dose naltrexone (LDN). Recently, I completed a five-day round of antibiotics and am due to start a five-day regimen of prednisone at a dosage of 20 mg, although I haven’t begun that treatment yet. My health background includes persistent issues related to long COVID and heart troubles, specifically myopericarditis, which I faced three years ago. In addition, I've dealt with chronic fatigue syndrome (CFS), enduring various fluctuations in my symptoms. Thankfully, I have reached a point where I'm able to take regular walks and pursue nursing school full-time. A few months back, I experienced pneumonia and suffered from shortness of breath until an emergency room visit led to a diagnosis and treatment with antibiotics; my doctor suggested it might have been lingering effects of the pneumonia that required attention. After the treatment, my condition improved, but four weeks ago, I began experiencing unusual shortness of breath that occurs when I lie down, persisting throughout the day. Following another visit to the ER, various heart tests and an X-ray were conducted, both of which indicated that everything appeared normal. During a subsequent doctor's appointment, I reviewed the X-ray results that stated my lungs were clear, with no signs of pleural effusion and a normal cardiomediastinal silhouette. However, they noted mild peripheral pulmonary congestion. This has caused me a considerable amount of distress, as I am worried that it might relate to heart issues, potentially indicating pulmonary edema. After completing the five-day antibiotic course, I felt slightly better, went for a lengthy day at SeaWorld, and even returned to the gym for a light walk on the treadmill, but shortly after, the symptoms resurfaced. I have the prednisone on hand for my treatment. Now I find myself anxious about whether this could be a heart-related issue or if it’s purely a lung problem. I’m overwhelmed with worry regarding this situation! Am I overthinking things? Has anyone else faced a similar experience?
Answers (1)
7/31/2025, 4:20:51 PM
OpenHealth AI
It's understandable to feel anxious about your breathing issues, especially given your history with heart problems and long COVID. Mild perihilar pulmonary congestion can appear in various scenarios and isn’t always a sign of a severe underlying issue. Let’s break this down and provide some actionable next steps.
Summary of Your Situation
- Current Symptoms: You have mild perihilar pulmonary congestion and experience unusual shortness of breath, especially when lying down.
- Health Background: You have a history of myopericarditis, chronic fatigue syndrome, and past pneumonia, which may complicate your symptoms.
- Recent Evaluations: X-rays and heart tests showed normal results, but you're feeling worried about potential heart-related issues.
Explanation
Mild perihilar pulmonary congestion can be related to several factors, such as fluid buildup in the lungs, inflammation, or residual effects from recent infections. Given your recent pneumonia and prolonged health issues, it's normal for your lungs to take time to fully recover.
Shortness of breath that worsens while lying down, known as orthopnea, can sometimes indicate issues like heart failure but can also be related to post-viral effects or lung inflammation. Your recent visits to the ER and the normal test results are reassuring, yet it's important to monitor how your symptoms evolve.
Actionable Next Steps
-
Start Prednisone: Since you have prednisone available and your doctor prescribed it, consider starting this medication as directed. It may help reduce any inflammation in your lungs and alleviate some of your symptoms.
-
Monitor Symptoms: Keep a daily log of your symptoms, noting when they worsen or improve. This will help identify patterns and potentially link symptoms to activities or positions.
-
Hydrate and Rest: Ensure you stay well-hydrated and prioritize rest, especially if you begin to feel fatigued. Hydration can help support lung function and overall recovery.
-
Breathing Exercises: Practice gentle breathing exercises or relaxation techniques like diaphragmatic breathing. This can help with shortness of breath and anxiety.
-
Routine Follow-up: Plan a follow-up with your healthcare provider after completing the prednisone course to reevaluate your symptoms and decide on further management, especially if symptoms persist or worsen.
-
Seek Urgent Care if Needed: If you experience severe shortness of breath, chest pain, or any worsening symptoms, seek immediate medical care.
It's natural to feel overwhelmed, but focusing on these steps can help you regain a sense of control. If you ever need to discuss any specific concerns or new symptoms, don’t hesitate to reach out for more guidance or emotional support.
Related Questions
Chest Injury in 35-Year-Old Male Following Car Accident
Patient Profile: 35-year-old male, 6’1, weighing 240 lbs, non-smoker; suffering from hypertension, high cholesterol, and gastroesophageal reflux disease (GERD). Current medications include nortriptyline, omeprazole, atorvastatin, lisinopril, and tirzepatide. Background: In February, I experienced a car collision that resulted in my vehicle being totaled; all of the airbags deployed. After a couple of hours post-accident, I visited the emergency room where CT scans of my head and chest were performed with contrast, accompanied by basic cardiac evaluations. Initially, no injuries were detected. However, persistent chest pain over the following month prompted a second chest CT, revealing a non-displaced fracture of the sternum. My primary care physician advised me to refrain from lifting and certain activities until I could see a cardiothoracic specialist. The referral for the consultation took nearly a month. Upon evaluation, the cardiothoracic team decided against surgical intervention and directed me to pain management for a nerve block, extending my lifting and activity restrictions for another six weeks. It was another month before I could secure an appointment with pain management. There, I received a referral to a pain psychologist and was prescribed nortriptyline. I underwent a nerve block procedure at the end of May, and it took about a week for noticeable pain alleviation. Physical therapy commenced in mid-June, but progress toward regaining my pre-accident strength has been discouragingly slow. Additionally, under the direction of pain management, I received two PRP (platelet-rich plasma) injections—one at the end of June and another in late July. These injections resulted in bruising, tightness, and swelling that hindered my recovery process. Although I am continuing with physical therapy, gains in strength and stamina remain minimal. My physical therapist is contemplating a referral to an orthopedic specialist focusing on upper body injuries. Personal Impacts: I am a parent to two young children, and this injury has significantly limited my ability to engage with them as I used to. Routine yard work and similar activities have become tasks I now avoid to prevent exacerbating my condition. I have a history of various sports-related injuries and surgeries (including ankle, knee, shoulder, and nerve entrapment), yet none have resulted in such a protracted recovery. Inquiry: Given my lack of significant improvement, I am questioning whether additional diagnostic evaluations could be warranted. I am also curious if there are hidden complications from the blunt chest trauma that may have been overlooked. Are there specific specialists I should consider consulting for further evaluation? Thank you for any insights and guidance you can provide.
Struggling to Breathe
I’m experiencing significant difficulty in taking deep breaths. There's a persistent wheezing sound, and my chest feels constricted. Additionally, I lack energy and feel exhausted. For the past day, I’ve also been battling a cold, characterized by relentless sneezing, a sore throat, and a bothersome cough that’s deep in my chest. This isn’t the first time I've faced such an issue; it has occurred approximately six times over the past 18 months. The situation tends to worsen during the night, and by morning, I often feel a bit better, although I’m left feeling utterly fatigued from lack of sleep. I’ve noticed that I’m inhaling approximately every six seconds for around three seconds each time, and my heart seems to be racing more than usual. Is it possible this could be related to COVID-19? What might be causing my susceptibility to it? I am a 35-year-old female, 5'3" tall, weighing 60 kg. I do not smoke or consume alcohol or drugs and have no known allergies or current medications. I reside in the UK. In my childhood, I had asthma but haven’t required an inhaler for decades. I also had croup, with my last episode occurring when I was about seven or eight years old.
Understanding the Role of Dialysis in Lung Fluid Management
A 72-year-old man weighing 140 pounds is experiencing complications from kidney failure, particularly involving fluid accumulation in the lungs rather than around them. He is dealing with low oxygen levels and a decreased heart rate, and has a history of open heart surgery from the previous year. Additionally, he regularly undergoes dialysis as part of his treatment for kidney failure; however, missing dialysis sessions has contributed to the fluid build-up in his lungs. I would appreciate straightforward insights on this issue, rather than just optimistic hopes. Thank you for your assistance.
Inquiry Regarding Lung Supplements for Ex-Smokers
I am a 20-year-old female, weighing 165 pounds and standing at 5 feet 4 inches tall, with no known health issues. After having vaped for just over two years (I realize that wasn't the best choice, but I've since stopped), I've come across various online discussions about Mullein as a supplement or tea purported to aid in purifying the lungs. I'm curious if anyone has information on its effectiveness and whether it's considered beneficial for individuals like me who have previously vaped. In addition to this, I would appreciate suggestions on other practices or supplements that could assist in lung recovery as much as possible. Thank you!
Concerns About Air Quality and Respiratory Challenges
I am a 32-year-old female, weighing 250 pounds and standing at 5 feet 5 inches. I do not smoke and have pre-diabetes, for which I take metformin and escitalopram. Currently, I reside in a part of Canada that is facing the consequences of nearby wildfires. Although the flames are fairly distant, the conditions have caused the smoke to drift down into my city, where it is not only visible but also emits a strong odor. Recently, while camping over the weekend, I woke up in the night to a smell reminiscent of burnt barbecue. We had gone to sleep under clear skies, but upon awakening, the air was filled with smoke. Since that night, I've been struggling with a persistent sore throat, a dry nasal passage, and some mild shortness of breath. I've decided to start wearing a mask whenever the air quality deteriorates. I would like to know if my doctor can provide any prescriptions to help alleviate these respiratory issues, perhaps a puffer or a nasal spray. I’m interested in hearing your recommendations on what I could discuss with my physician. Thank you for your input and, on a side note: the impact of climate change is truly disheartening.