Re: CHF

Posted By CCF CARDIO MD - MTR on March 20, 1998 at 13:56:24:

In Reply to: CHF posted by Al on March 19, 1998 at 15:33:38:







: I am a 37 year old, mostly ex-smoker (I cheat sometimes - alot lately) and have had asthma since I was 11.  Recently I've had pain in my chest on the left side and at the breastbone.  ANY exertion causes difficulty breathing and my feet swell at night.  Throughout my life I have experienced strange temporary severe pain in my chest when I tried to take a breath.  Usually ti subsides when I take a lot of short breaths but sometimes it lasts for 20 minutes.  I am forced then to anly take shallow breaths.  I am concerned because I feel an increasing (and more often) pain in the left side of my chest.  It has sometimes extended to my arm pit.  I also occasionally feel numbness in my left had and arm.  I also get lightheaded and dizzy sometimes.  I am not overweight and hate going to the doctor nut sometimes I think I'm having a mild heart attack.
Exertion is causing more and more difficulty in breathing but it's very unpredictable.  While sometimes, just getting ready for work causes me to have problems, other times I can walk for five minutes without a problem.  I have an allergy to dust, could it be as simple as my house being to dusty?  Or could I have CHF?
Thank you






________
Dear Al, thank you for your question.  Your symptoms sound like they could be angina but
with your history of asthma, it's harder to determine.  Asthma can cause exertional
shortness of breath like you're having and certainly would be worsened by cigarette
smoking.  So, first of all, I'd strongly advise you to quit smoking. Your chest pain
could also be angina from reduced blood flow to the heart muscle and angina is sometimes seen
along with exertional shortness of breath.  
    Congestive heart failure (CHF) is caused by reduced pumping strength of the left
ventricle (the main pumping chamber of the heart) and is first noticed when patients
develop shortness of breath and ankle swelling like you have.  These symptoms occur
because blood backs up into the lungs and the venous system when it can't be pumped through
the heart efficiently.
     In your case, I would suggest that you see your physician about your symptoms.
A number of tests can be done to look into this problem for you.  A stress test could
be done to look for reduced blood flow to the heart.  In a stress test, you walk on a
treadmill with an ECG attached until you can't go any farther.  Images of the heart
are obtained before and after the stress test to localize any potential areas of
reduced blood flow to the heart.  An echocardiogram uses an ultrasound probe to generate
images of the heart structures.  An echo can evaluate the pumping function of the left
ventricle and the function of the four heart valves.  Additionally, pulmonary function
tests could be done to look into how severe your asthma is.
  Certainly, you need a thorough medical evaluation for your symptoms and I hope this
information is helpful to you in that regard.  Good luck quitting smoking!
Information provided in the heart forum is for general purposes only.  Specific diagnoses
and therapies can only be provided by your physician.