Is my exercise intolerence related to my recently diagnosed VSD?

[tjw01]

I am 42, female, and recently lost 65lbs. Not only did I eat well, but I began daily exercise. I was fine until about 6 weeks ago, when I suddenly had extreme shortness of breath, even on 1 flight of stairs. I am also terribly fatigued, but my whole life I've felt like I've had less energy than others. Since I was young, I've told my Mom that I had palpitations. Unfortunately, these never show up on any test or for the doctor. He does hear my murmur. Even with this significant wt.loss, my energy level stayed the same. I've had an echo, TEE, EKG, PFT, chest x-ray and stress test. I also had bloodwork to check my thyroid, iron, and rule out infection and maybe some other stuff.  My doctor said that the VSD is small and it is a purely coincidental finding. My PFT shows there is something "not quite right" with the small breathing tubes in my lungs, but other than that I did super great. (I teach step aerobics, so my lung capacity is huge!) My doctor told me to go back to all the things I was doing. I asked about my symptoms. He said OH. Do you want an inhaler? I am wondering if it is safe for me to keep exercising. I take strength training classes 2-3 days/week and do 45 min. cardio workouts 5 or more days/week. I keep pushing myself since my tests came out fine and I'm desperate to stay in shape and keep my weight off. But I am finding that I have less and less tolerance for my exercise. I am wondering if my doctor and the cardiologist who reviewed the echo and administered the TEE just don't understand CHD in adults. Do I wait it out and keep exercising? I had a blood clot in my arm when I was 27 that no one could explain. It came about as a result of a blood donation...but no one would believe me then [at first] that something was wrong. I just knew...

[ICURN]

A related discussion, Had symptoms and MDs found a PFO was started.

[tjw01]

Thank you for posting.  No one mentioned left ventricular dilation, but I have not seen my actual reports from my tests.  My doctor simply stated that because I'm 42 and never knew I had this before, it can't be a problem.  I do know that that is not necessarily true - I just don't know if mine is actually the problem or the cause of my sumptoms.  I know of 2 people in their 60's, recently diagnosed, who's doctor's recommended that theirs be closed.  My doctor has never even talked to me.  I just wish he would communicate.  When I go back in early August, I will probably have a better idea of what to ask.  

I'm fine with waiting until August.  As I continue to exercise, I'm trying to figure out if there is any rhyme or reason to my symptoms.  All I know for sure is that I do not have the stamina I had before this started...and the fatigue is frustrating.

[EchoTech]

Adult cardiologists do understand VSDs ( and PFOs and ASDs) since that is something that is more common than you think.  Other congenital abnormalities no, they wouldn't get it.  A small VSD isn't going to really affect you.  If it was affecting your heart, it would have shown up as left ventricular dilation, of which you did not mention that you have.  The echo would have picked this up.  I would lean towards finding other causes of decreased performanc and zip. The only other possible scenario that I could imagine is diastolic dsyfuction, but many millions of people have it and do just fine.

Good night and good luck.

[tjw01]

Thanks, Fiona, for your input.  No, my adrenal function was not checked.  I go back to my internist in early August and he said we'll see what to do next if I am still experiencing the shortness of breath and extreme fatigue.  I did NOT take any weight-loss supplements, though.  Does that change your thinking?

[finetilthree]

Hi.  I understand you are not a doctor, but I would like to ask your opinion on something.  My doc found a small PFO (atrial) when doing some testing to try and find out why I was having postpartum arrhythmias.  I had a couple short episodes of atrial fibrillation and now I have PACs.  Is it possible that my pfo is causing me to have pac's?  I have read that pfo's can cause atrial arrhythmias, but I never had any until I was postpartum.  My theory is that the pushing during childbirth re-opened my pfo which had probably sealed over previously.  Does my theory make any sense?  Thanks for your opinion.  

[Fionajnz]

Did they check your adrenal function at all during your work up?  It would probably have been a morning cortisol level.  Changes with adrenal function can cause an incredible amount of fatigue to occur.  This is especially important to check if you have been using weight loss supplements.

Just an idea.  Hope you find an answer soon.

Fiona

[Forum-M.D.-bkj]

tjw,

A small VSD will generally not cause significant symptoms.  An exercise echo could show if there is any change during exercise, but from what you post, I would consider it unlikely.

It is impossible for me to make recommendations about exercise without personally examining you.  Lack of energy can be from a large number of things. If you are not comfortable with your care plan you should discuss it with your physician or seek a second opinion. Dr Richard Krasuski at the Cleveland Clinic specializes in congenital heart disease and would be a great second opinion resource.

good luck