<s>[INST] I am having tingling to numbness on my left side.I have had a stroke in 2008. I found I had a hole in my heart. Dr Roberts from Miami inserted a closure, but found I have pulmonary arterial hypertention. but the tingling is getting in feet, arms and legs, and they turn blue on the end. [/INST] Hi welcome to HCM.I understand your query and concern.Elevated pulmonary arterial blood pressure in your case needs good control.I advise you to have a baseline 2 dimensional echocardiography,ECG and lipid profile to assess the basic cardiac reserve of your heart,CT Brain.Restrict the intake of salt to less than 6g/day.Regular physical exercise in the form of brisk walk for 20 min a day for 5 days a week is pretty useful.Drugs like antihypertensives like metolar xl 50 mg,Bosentans,Clopilet,Ecosprin,lipid lowering drugs will help.Reduce the intake of fatty and fried food.One pomegranate a day will help to keep your heart at good pace .In case if the symptoms has not resolved as of now,I recommend you to take early appointment with your doctor.Cough can be treated with syrup Zedex under medical prescription. Consult a Cardiologist and neurologist for further expert management.Post your further queries if any.Thank you. </s>