Mild PAH or not?

[lightbluepuppy]

Hello, I'm new here and I'm hoping this might be a good place to sound off and maybe see if anyone else has been in a similar situation.

I'll try to keep it brief.

I'm 34, female, in relatively good health but I do smoke occasionally.

A few years ago I began having on and off episodes of chest pains and occasionally strange sensations down my right side. I got tests done through the NHS: several ECGs, a CT scan to check for pulmonary embolism, blood tests etc, all came back satisfactory, and the problem kind of went away on it's own after that.

Then, in 2019, I was travelling in India when the chest pains/sensations started happening sometimes again. I was also getting some swelling in my feet and ankles, however this was only in very hot climates, and would get worse throughout the day and be better upon waking in the morning. When I was in cooler climates in the mountains, the problem went away.

While in India, I had blood tests which all came back ok, plus and Echocardiogram. The Echo came back all fine, except for Mild PAH of 26 mmHg (cal PASP IS 21+5=26).

Upon my return to the UK, I had an echocardiogram and a treadmill stress test through the NHS. All these results came back absolutely fine. When I asked the cardiologist at the followup telephone appointment about the Mild PAH diagnosed in India, his answer was "don;t go back to India". In his view, I'm fine.

The sensations/pains in the chest area kind of subsided again, and I forgot about it.

But now they have returned a little bit. Nothing actually painful, they never really are, but the sensations are there quite often. It tends to be at rest more than anything, and doesn't seem to be brought on by exertion. I have also started taking stimulant medication for the first time, to treat ADHD. You are not supposed to take these meds if you have a heart problem, but of course, according to the NHS, I don;t.

I'm just not sure whether to write it off and put it down to anxiety, which I do suffer from somewhat. Or perhaps pay to get a private Echo to get a third opinion. I don't feel like I can go to the NHS with this again, I've had so many tests and they have come back fine, but the fact I got the PAH diagnosis in India makes me worry that something has been missed.

My father's father died in his early 50s of a sudden heart failure. Aside from this we have no real family history of heart problems.

I just don't know if I'm over worrying, or I'm right to be paranoid and I should take this further. Is mild PAH even that bad?

Anyone ever been in this kind of situation, where you have a foreign or private diagnosis that conflicts with the NHS diagnosis?

[lightbluepuppy]

Thank you