High Cardiac Output

[Mr. J.]

Hi,

I posted some questions last month and I appreciate the assistance you provided.  Just to recap - I may have some type of auto-immune collagen vascular disease.  Despite many tests, however, the docs are not able to come up with a name for the disease.  I have several heart-related symtpoms including:  SVT and sinus tach, high-cardiac output (diagnosed via right heart cath.), pounding heart, increased pulse rate, shortness of breath upon exertion.

My hands (and especially feet) are constantly cold - ALL the time.  I am also cold sensitive all over.  Despite negative inflammation blood tests, my doctor thinks it is possible that some type of inflammation is causing my blood vessels to constrict or to narrow thereby causing my heart to work harder to overcome the constricted blood vessels.

My questions:  1) If my doctor is correct in his theory, could this cause a high cardiac output?  2) My doctor says the most important thing to do is to protect my heart from overworking so I am taking 50 mg's Toprol to slow my heart and 2.5 mg's Norvasc to try to open up my blood vessels. His approach makes sense to me but would you agree that saving wear and tear on the heart is the most important thing in a case like mine?  3)  Have you ever heard of someone having a high cardiac output secondary to some type of vasculitis or collagen vascular disease? If so, what treatment is recommended?

I have an echo next month to check on my heart size.  If it is increasing over previous echos, what treatments should be explored? What questions should I ask?

Thanks.

[Cleveland Clinic]

Mr. J

First, the measurement of cardiac output is dependent on a number of factors in the catheterization.  Some caution should be used in the interpretation of the numbers, and without the primary data, I can only give you a few guide points.

First, High-cardiac output states by themselves are seldom responsible for heart failure. They are however, most often secondary to underlying systemic diseases.

Cardiac output should not be increased from the constriciton of blood vessels, and some other process should be evoked to explain the numbers.

While beta blockers are important in treating some causes of High output cardiac states, it it very important to locate the cause.

A few causes of high output failure are listed below (adapted from Dr. Brawnwalds text on cardiology).

Anemia
Acquired arteriovenous fistulas
  Post-traumatic
  Iatrogenic
  Infectious
  Surgical (hemodialysis)
Congenital arteriovenous fistulas
  Hemangiomas
  Hereditary hemorrhagic telangiectasia
Thyrotoxicosis
Beriberi heart disease
Paget's disease of bone
Fibrous dysplasia
Multiple myeloma
Polycythemia vera
Carcinoid syndrome
Pregnancy
Renal disease

I encourage you to further define your illness with a cardiologist or general internist.Hope this is a start

[Mr. J.]

Thanks so much for your thorough response.  I will discuss your comments with my doctor.

Thank you for this wonderful website.  It is such a nice thing for people to be able to pose questions and have them answered by physicians.

-Mr. J.

[tessa0825]

I know this is an unusual and off-topic question for this board..You mentioned an illness in your response to the original posted (Hereditary hemmoragic telangiectasia)....I wondered if you could tell me who at your facility I could contact to get information on this illness....My 31 yr old son has this as did his Father and grandmother and many members of his paternal family.....Thank-you, Tessa