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Do I have MVP?
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Do I have MVP?

My age is 70 years and 7 months, but I look and feel maybe 10 years younger. I am very active outdoors especially, with a large garden and yard. It gives me a great deal of pleasure to dig dirt, clear land, cut up firewood with a chain saw, etc. Up until 5 months ago I could work fairly hard for 4 or 5 hours and then feel tired, but a good tired (if you know what I mean) - ready to eat, shower and go to Walmart with my wife.I smoked one PPD until 6 months ago when wheezing was interfering with going to sleep at night. I was able to abruptly quit with the help of nicotine lozenges, and my dosage of them today is down to about 20 mg./day. For one month after I quit, there was a dramatic improvement in my breathing and well-being - the wheezing disappeared after a few days.Then, 5 months ago, I started experiencing dizziness, tachycaria (120's),  hypotension (lowest 78/43 - barely able to make it back to the house from the yard)  and extreme fatigue - all this with any kind of exertion.

My hypertension disappeared a few months after smoking cessation except for something like 134/93 every few days whereupon I take 5 mg. of Lisinopril (half a little blue tablet) with good result. This fatigue is getting worse. Just bringing groceries into the house from the car is exhausting, and I'm very SOB. Occasionally I feel a tiny bit of pressure over my sternum, but nothing to run to the doctor with

My medical conditions: cervical spinal stenosis, hypertension controlled with lisinopril, left diaphragmatic hemiplegia, peripheral neuropathy, mild sleep apnea and moderate COPD. The CSS occurred about 6 years ago and was diagnosed with an MRI when I complained of very severe neck pain. They ordered daily morphine which I later refused, afraid of addiction. In any case the pain gradually faded. I believe it was around this time that the left diaphragmatic hemiplegia was diagnosed, but I'm not very good with placing and remembering the occurence of past events with accurately.A recent PFT showed an FVC of 4.16 L. with an increase of 20% with a bronchodilator. The interpretation was: " Spirometry reveals a moderate obstructive ventilatory impairment. There is a bronchidilator response.

My PCP has tried every blood test in the book. He ordered a sleep study, hence the "mild sleep apnea". I now sleep with a machine (or try to). I'm on my 3rd day with that.

I would very much appreciate any advice you may have for me. Thank you.
Avatar_dr_f_tn
Hello and hope you are doing well.

MVP can be detected by an ECHO. Also, it would help to check your ejection fraction. The ejection fraction is a useful measure of left ventricular performance. The normal range is 63-77% for males and 55-75% for females. It reflects the pumping capacity of the heart. If it is diminished, it can cause breathlessness. Certain systemic disorders like anemia, diabetes, vitamin deficiencies and thyroid disorders can cause these symptoms. So please consult your primary care physician who may ask for an EKG or a treadmill and an ECHO test to rule out a cardiac cause for the breathlessness. He may even ask for blood tests and an X ray chest.

Hope this helped and do keep us posted.
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