Congestive Heart Failure Community
Is this chf?
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Is this chf?

I am 39, a non-smoker, and exercise daily by walking 30-60 min.  I've managed to gain 100 pounds in a decade, most of it fluid.  I have Hashimoto's and adrenal issues.....severe AF that doctors refuse to treat.  I am borderline diabetic and heart problems run in my family.  My pharmacist thinks I have CHF but still waiting for some kind of diagnosis.  I found out 6 months ago I have MVP but very mild and nothing to worry about it and referred myself to a cardiologist who didn't seem too concerned.  Still having problems, I contacted cardio before Easter and complained about the edema.  He did a second echo and this one was worse.  At my visit, he mentioned I have an ejection fraction of 45% and my heart is "lazy everywhere."  What does that mean?   He didn't explain in too much detail....just gave me a statin and a beta blocker, had me do a stress test a week ago and I see him again next week.  

I went to ER last night with complains of upper left chest pain that lasted 3 days.....chest still feels heavy.  I've been sleeping more than usual.  The swelling bothers me greatly and the weight gain.  In spite of this, I had a normal chest x-ray in the ER and all my bloodwork was fine.  The attending doctor was a PA who admitted he knew I have an ongoing problem but couldn't find it.  The tests showed nothing and EKG normal.  So what gives?   I don't get it.            
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159619_tn?1318997813
It's not CHF unless your EF% drops below 30%. Nothing you mention would make me believe you are on CHF either. Your chest pains are not typical for heart disease as pains that last long periods of time or over days are not generally heart related.

The lazy heart muscle is called hypokinesis and means just what he said, your heart muscle is not contracting as hard as it should. In your case it's global hypokinesis which means over the entire heart.

Are you on any meds?
12 Comments Post a Comment
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159619_tn?1318997813
It's not CHF unless your EF% drops below 30%. Nothing you mention would make me believe you are on CHF either. Your chest pains are not typical for heart disease as pains that last long periods of time or over days are not generally heart related.

The lazy heart muscle is called hypokinesis and means just what he said, your heart muscle is not contracting as hard as it should. In your case it's global hypokinesis which means over the entire heart.

Are you on any meds?
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Avatar_f_tn
I'm on Losartan and Metoprolol.  I have chronically low potassium and magnesium, even though I take supplements.
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Avatar_m_tn
I do not understand, you have Hashimoto and you are not taking tiroxine?
You gain 100 pounds in liquid and you are not taking diuretic?
You say your Dr.  does not treat your AF and are taking Metoprolol?

I think that you probably suffer metabolic syndrome, probably you need
to take treatement for your borderline diabetes and your thyroid should be properly monitored.  

I am pretty  sure that you have low levels of vitamin D that needs to be monitored and treated.

If you really have cronic (chronic) deficiencies of K and Mg  you need not supplements but prescribed medication for that.  This can justify your AF.

Be sure that you are not taking any stomach protector, like  omeprazole, since that can bring your calcium and magnesium down.

Jesus


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Avatar_f_tn
I am taking 20 omeprazole and 90 Armour thyroid.  I also take multi vitamins including D, potassium and magnesium.  I've been to several unhelpful doctors and my current family doctor threatened to fire me if I continued taking supplements. My endo's not much better.  
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159619_tn?1318997813
I have to think along the same line as jrbon, sounds like metabolic X syndrome. Your meds would indicate your doctor is treating the lazy heart which if improved would help your edema, Also, some supplements will counter act these drugs, that's most likely why your doctor wants you off of them.
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Avatar_f_tn
I've been on the heart meds for 2 weeks; I have not seen my primary doctor since Jan and not happy with him.....he prefers specialists treat me.  I've been through 5 primary doctors, 5 endos......nobody's really helping.  Here's the supplements I am on.

CoQ10 30
Balance B-50 Complex
Kelp (Iodine Source)
Licorice Root
Calcium Citrate Plus Magnesium
L Carnitine
Gummy vits
Hawthorn Berry
Super Stress Vitamin B-Complex
Albion Complexed Selenium
Potassium Citrate
Raw Adrenal Glandular
High Potency Vitamin D-3
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Avatar_m_tn

You say that you suffer chronic low potassium and magnesium but, apparently drs. do not think so... (you say that your blood work are normal).

Still,I do not see that you are taking any diuretic to eliminate fluid. Do your drs. agree that you are accumulating liquid?

I have review each of the supplements that you take and this is what I have found so far:

1) You take up to 2 different supplements with Vitamin B and one with Calcium and magnesium which are absolutely useless if you take them while taking Omeprazole and Licorice. Both suppress acidity in the stomach and therefore neither Vit. B or calcium can be absorbed.

2) You take Kelp that contains Iodine which benefit for hypo thyroid it is, at least, highly arguable (my wife suffer it and all the endocrinologist that she has seen in the last 25 years tells her not to take even sea salt to avoid iodine).

3) Potassium citrate it is good to eliminate kidney stones, but I do not think that it does anything to increase your potassium levels. For that Potassium Chloride should be used.

4) There are reports of low potassium, to lethal levels, due to high ingestion of licorice.

5) Licorice will elevate your blood pressure.

6) I do not know what problem you have with your adrenal glands (that could also be aggravated by licorice), but I do not think that Raw Adrenal Gland can be a solution. Think that every animal has a different gland and the amount of any active product there cannot be guarantee at all.

7) I do not know what makes you think that you need L-Carnitine but be aware, that normally your body is able to produce it but for its biosynthesis needs Vit. B6 do to so. Your omeprazole intake makes that you cannot assimilate B6 and therefore your body is not able to produce it.

Jesus
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Avatar_f_tn
Thanks for the useful information.  My saliva cortisol levels have hovered around the 4-5 mark in the mornings, when it's supposed to be much higher, and around 1 in the evening.  Traditional doctors don't believe in adrenal fatigue unless you have Addisons so I thought maybe the AF was the reason why my heart function is declining.  I can't tell you how many doctors have fired me for being a difficult patient and wanting my problems treated properly.  So I started self-treating with supplements I Googled online.  
I'm going to talk to my gastro doctor about coming off the acid reflux meds.....my potassium is low normal and just on the cusp of being normal.  Same goes for magnesium.  
I've been on Lasix before but it doesn't get rid of the swelling.  I'm swollen all over and carrying so much fluid.  Gone are the bathing suit days.  I can't even wear jewelry anymore, my hands and neck has swelled so much.  Depressing to look in the mirror.  
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Avatar_m_tn
Let us speak about your weight,

I am not sure that this is all liquid, 10 pound per year it is more likely to be fat, I am in HF and I gain 1 pound/day that I reduce with the diuretic that I take every second day. So if diuretics did not worked on me I would gain about 350 pounds per year.

Lasix (Furosemide) it is the most used diuretic, but you can be insensible to it, now I take Torasemide because Furosemide no longer works on me.

I really think that your problem i to have properly controlled your thyroid. You should get blood test every 3 months and measure not only the T3 but also the T4 and the free thyroxine.

By the way, your weight and your Hashimoto (if not controlled) are more that enough reasons for your fatigue.

I also think the you should treat your high glucose levels.

If you stop salt intake, this will help you to reduce fluids.

Licorice acts as a sort of Aldosterone hormone, therefore will make you to retain more fluids.

By the way I tried, about  2 years ago, to take L-carnitine and had to to stop because stomach problems.

Jesus
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Avatar_f_tn
My long-awaited appointment was today and I'm not happy with this doctor. Or maybe it's me and nothing wrong with him,I don't know. He is young---around my age, and admitted he has no idea what's wrong with me but gave me diagnosis of cardiomyopathy, idiopathic and a low dose Lasix and an increase of the beta blocker from 25 to 50. Okay, all good, right?

Then he gives me a lecture on how anxious I am over all this and I have nothing to worry about since he's seen a lot worse patients. He's not worried about my condition,he said,and my ejection fraction rate is almost normal at 45% so what am I fretting about? He made me feel like a mental case. Never mind I am so swollen I can't wear jewelry anymore and have gained quite a bit of weight in spite of daily exercise. Yeah,I have thyroid problems and pre-diabetes but on meds for that,too,but back to the heart doctor...he must have told me ten times per visit I have nothing to fear and my heart's probably recovered from now. I got so upset that I actually cursed at him and he changed his tactic slightly, saying sometimes bad things to people for no reason and I will recover from this eventually. I have a follow-up with him in 2 months.  Not sure if I should like him or not.  What do you think?    
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Avatar_m_tn
I feel to agree with your Heart doctor, you have to consider that he ONLY looks at you from the heart point of view.... and in this aspect, he is probably right

As I already had told you, I think that your main problem is the control of thyroid and glucose. Do not go for limit values, try to have average values. And get them checked periodically.

You mention your gastro doctor, but I have not read anything about you having gastro problems... what the issue is?

Jesus
I really think that you will benefit from stopping omeprazole. In Spain the mandatory information indicates that only should be take for a maximum of 4 weeks.

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Avatar_f_tn
I get my thyroid levels checked every 3 months and told that my numbers are fine and my pre-diabetes are controlled, too.  I have Gerd, that's why I take the acid reflux meds.  You're the only one agreeing with heart doctor; everyone else I talked to said to fire him for his attitude and so I already have.  I already found another cardio....I go to him May 28.  I didn't appreciate the doctor dismissing my problems and making me feel like nothing.  Maybe we just have a clash of personalities and different expectations, I don't know, but not going back to him now.      
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