Heart Disease Expert Forum
Chest pains, heart skips and extreme fatigue
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Chest pains, heart skips and extreme fatigue


  I am 44 years old and have always been extremely healthy.  For the last two years I have complained of discomfort in the left side of my chest.  In the last three weeks these sympomts have worsen. My heart skips constantly to the point that I can be awakened from sleep, I have chest pains (not severe).   I have extreme fatigue, it is very hard to breath after doing the most simple of things, like tying my shoes.  Due to fatigue I had to stop working (I needed to climb stairs many times a day), I also had to stop my daily walks.  My heart now skips constantly.  I have gone thru a thalium stress test.  During the test I had chest pains and the nurse informed me that I had turned very pale.  The thalium results were normal.  I have had a heart event monitor for the last 30 days, that only showed PVCs everytime I reported an event.  My chest Xrays are normal and my Total T4 Free by Dialysis is 1.0 and my Total T4 is 7.7.  I have seen a cardiologist who believes my heart is in fine working conditions.  We are still waiting for the results of the echocardiogram.  I have completely stoped any intake of caffeine, chocolate, even peppermints, per my doctor's request.  I do not feel any better, just worse by the day. I am extremely concerned and needless to say scare.  Any comments will be greatly appreciated.  Thanks.
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Dear Julia,
Firstly, fatigue is a very non-specific symptom, it has many causes.  Also shortness of breath has many causes.  It seems that your physician or physicians are ruling out the life threatening things first, and this is why they are examining the heart first.  The echocardiogram results will be very important, especially the status of your ventricles (the chambers that pump blood), valves, and whether or not there is any pulmonary hypertension; these are almost always routinely checked on echocardiograms.
If they find that your heart is perfectly normal they might then evaluate your lungs to further elucidate potential causes of your shortness of breath.  There are many syndromes, especially in women of your age that cause non-cardiac chest pain, but until a doctor can fully evaluate you with a history, physical, and some tests one can not be certain of that.  One last important point for you to know is that
very few if any test are 100% accurate, and for that matter most tests need individualization.  As the patient it would help a great deal for you to keep a diary of the different symptoms you are having and what actions provoke or relieve the symptoms over time.  Information provided in the Heart Forum is intended for general informational purposes only, any diagnosis and treatment can only be made by your physician(s).  





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