Asthma, Enlarged Heart, Arrhythmia, and more..

I've had Asthma all my life, but some new things are starting to occur. When I was an infant, I had a lung collapse, and in junior high school, I developed my first Pneumothorax during an extremely bad Asthma Attack.

Just under two years ago, I had viral pneumonia, and was hospitalized for 5 days. Just prior to being admitted, I noticed bubbles under my skin around my neck... another Pneumothorax.

Now, however, I'm having a lot of issues with my medication not helping my breathing difficulties nearly as much as they used to. Instead of a couple puffs from my albuterol inhaler and continuing with my day, I have to keep using it regularly all day.. every day. The same can be said for my nebulizer, which is also albuterol. They always help, but it's as if it doesn't completely solve the problem.

Now I've just recently been back in the hospital for my Asthma, after getting to the point of running to the ER because my medicines weren't helping enough, and found out my heart has enlarged and I seem to have some form of an Arrhythmia. These findings combined with my doctor's nurse noticing my very low pulse (40 bpm) regularly sent me into panic mode regarding my heart.

My doctor sent me back to the hospital this past Thursday for an echocardiogram, but I've yet to hear back from them. I've called a few times now, but they keep telling me it's still being reviewed. I can't help but be terrified, so I've been researching as much as possible regarding all these symptoms.. to no avail.

Here's the kicker, I'm a 24 year old male. I'm a computer programmer, and quite the video game geek. I know I should, but I never exercise. My blood pressure is almost always very good.

What are the chances I should be worried about cardiomyopathy, heart failure, etc?
How often do asthma sufferers have Enlarged Hearts and Arrhythmia, from something not to worry over?
Can medicines that elevate heart rate potentially cause these heart problems?

[National Jewish Health]

What you have described is worthy of concern.  The 3 bouts of pneumothorax, especially if of the same lung, raise the question of whether surgery to prevent future recurrence might be considered.  On the other hand, the fact that you have not had another for 2 years may mean that scarring may have occurred with the 3 episodes and that your lung may now already be adherent to your chest wall, which would be the goal of any surgery.  You would do well to consult with a lung specialist, also known as a pulmonologist, regarding the best path to take, taking all things, including your age, into account.  It would appear that this problem is unrelated to the other two.

It sounds like your asthma is being treated with a short-acting bronchodilator and is definitely sub-optimally controlled.  Asthma of this implied severity should definitely be treated with an inhaled steroid.

Asthma is almost never a cause of enlargement of one’s heart.  More likely, if your heart is truly enlarged, the diagnosis of a cardiomyopathy would have to be at the top of the list, especially with the slow heart rate and rhythm.  Your doctor should be able to tell you what the EKG showed and, certainly by tomorrow, what the echocardiogram showed.   The findings of a slow rhythm and an apparently enlarged heart would be of less concern for a conditioned athlete, but are definitely abnormal for a person who is mostly sedentary.

The question of whether medicine, known to elevate the heart rate, poses a threat in your circumstance can only be answered when the nature of your heart problem is identified.  In general, however, a slow rate could predispose one to arrhythmias and the possible adverse effect of long-acting bronchodilator medicines.

If your heart is as described, your doctor may want to seek consultation with a heart specialist, also known as a cardiologist.

Good luck.

[mandi817]

A related discussion, Cushing and Heart Disease was started.