35-Year-Old Male with Narrow Pulse Pressure, Heart Palpitations, and Chest Discomfort
For the past few months, I have had my vital signs regularly assessed by a nurse following the commencement of treatment with Lisdexamfetamine. Recently, I concluded this monitoring and reviewed the correspondence intended for my general practitioner, where I noticed some disconcerting trends. I would greatly value an expert's insight into my condition. **Personal Information** - Age: 35, Gender: Male, Height: 168 cm, Weight: 67 kg - Current Medications: Nortriptyline and Duloxetine (prescribed for Long COVID associated pain); Lisdexamfetamine (for ADHD) - Lifestyle: Abstains from alcohol and narcotics - Medical History: Orthostatic intolerance, Long COVID, ADHD **Vital Measurements** - All readings were taken while seated in the afternoon under rest conditions, consistently monitored by the nurse over several months: - Heart Rate: Approximately 100 BPM (± 3) (this rate was also my baseline before starting Lisdexamfetamine) - Blood Pressure: Around 93/78 mmHg (± 3) - Resulting in a narrow pulse pressure of about 15 mmHg **Current Symptoms** - Noticeably reduced pain and cognitive fog compared to previous experiences - Experiencing shortness of breath - Episodes of dizziness - Sensation of tightness in the chest - Occasional heart palpitations - Feelings of fatigue **Points of Concern** - How significant is a narrow pulse pressure at this level? - Are there specific symptoms or tests I should bring up with my physician? - Could my ongoing medications or the effects of Long COVID be influencing these symptoms? Initially, I attributed my symptoms to Long COVID, yet the recent decline in pain and cognitive fog has left me uncertain about this assessment.
Answers (1)
8/13/2025, 4:31:43 PM
OpenHealth AI
It's understandable to feel concerned about the symptoms you're experiencing, especially with a narrow pulse pressure combined with heart palpitations and chest discomfort. While some of these symptoms may relate to your medications and the effects of Long COVID, it's important to approach this situation thoughtfully.
Key Points:
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Narrow Pulse Pressure: Your blood pressure of 93/78 mmHg results in a narrow pulse pressure of 15 mmHg (normal adult pulse pressure is typically around 40 mmHg). This can indicate underlying cardiovascular issues or other health concerns that warrant attention.
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Heart Symptoms: The palpitations, chest tightness, and shortness of breath you're experiencing, especially with a history of elevated heart rates, may relate to the stimulant effects of Lisdexamfetamine or stress on your autonomic system due to orthostatic intolerance.
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Ongoing Monitoring: Since your symptoms have changed and your overall situation is complex, ongoing observation is crucial.
Next Steps:
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Record Specific Symptoms: Keep a diary of your symptoms, including their frequency, intensity, and any potential triggers. This can help your physician understand your situation better.
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Address Symptoms with a Physician: When you meet with your doctor, emphasize:
- Continued shortness of breath and episodes of dizziness.
- The sensation of tightness in your chest and heart palpitations.
- Any correlations you've noticed with medication changes, activity levels, or dietary factors.
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Potential Evaluations: Discuss the possibility of additional tests such as:
- An ECG (electrocardiogram) to assess heart rhythm.
- Echocardiogram to evaluate heart structure and function.
- Blood tests to check for any imbalances or underlying conditions that might influence your symptoms.
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Medication Review: Given that Lisdexamfetamine could play a role in your symptoms, ask your physician about reviewing and possibly adjusting your medications.
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Lifestyle Adjustments: Focus on hydration, rest, and gradual increases in activity to help manage symptoms associated with orthostatic intolerance and overall fatigue.
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Emergency Signs: Be alert to any worsening symptoms like severe shortness of breath, chest pain that feels like pressure, or fainting, and seek immediate medical attention if you encounter these.
Your situation is nuanced, and these steps will offer a structured approach to addressing your concerns with your healthcare provider effectively. Compassionate communication with your doctor will be key in navigating these developments! Let me know if you need further details on any point.
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