Should I be worried?

[1bigmedicalenigma]

I don't want to place a real legnthy post so here are the facts.

38 yr fem.

x smoker 20 yrs + or - 3 yrs tried to quit + 2 preg.1/2 pack/day

As a little girl I had palpitations going up my neck either while sitting or exercise/ learned to control it by holding breath.  Event. would stop

16yrs - diag. innocent heart murmur-ekg norm.  Assumed it went away

heart prob. in fathers fam. clots, irr. hbt's, high bp

freq. Migraines in 20's go away

To present still have palpitations but can't control them

migraines return freq

health conscious-run/jog/walk treadmill 2-3 mi. 3-4 x week
using weight machine 2-3 x week-Oct.'03 had to stop exercising suddenly due to breathlessness

check up in 8/03 BP slightly elev. 120/78 norm, this time 120/87
each dr. appt. shows a BP with lower number at it's highest 92

lightheaded at times

Get winded carrying laund. up & down stairs, sometimes brushing teeth, hanging something up etc.

Good chol. 90 combined 190

Thyroid test norm- cardiac stress norm - cardiac/dye pict. norm-
Pulmonary funct. norm -chest xray norm-blood gases norm

Saw pulmonary dr. had finger oxygenmeter/walking test-1st x norm reading sitting, stood up O2 level dropped, came back,sat down level went up-dr thought it was meter, sent diff. nurse/diff meter- norm sitting, stand up/walk, O2 drops- dr. can't believe it, has me laydown, stand up same thing again,he's just baffled
orders exercise stress to get better oxygen readings as oppos. to the other stress test

Have not seen an actual cardiologist - what 2 do?

Thank you!

[CCF-M.D.-RCJ]

1bigmedicalenigma,

Thanks for the post.

I would start with a good internist.  If you can't identify one in your area, then consider seeing a cardiologist.

The positional oxygen saturation changes could be related to many things, but one possibility is an intracardiac shunt (hole in the heart).  With your history of murmur, migraines, and now the positional oxygen satuation changes; a unifying diagnosis would be a Patent Foramen Ovale (PFO), a type of shunt.  This is easily diagnosed by an echocardiogram (echo).

The history of Sydenham's chorea complicates things because it implies that you had rheumatic heart disease.  Rheumatic heart disease could also explain your breathlessness and oxygen saturation changes.  An echo would be helpful for this as well.

At any rate, start with a good internist.  And best of luck.

[1bigmedicalenigma]

I also forgot to mention that I was diagnosed with Syndenham's Chorea 1 1/2 yrs ago.

[candygurl]

I suggest going to see a real cardiologist. I myself suffer from a simular problem. the symptoms were the same as yours until one day i was walking in the mall ( alone thank god my mom worked there!) and i was standing at the register paying for a shirt. all of a sudden i just dropped straight back. when i came to i didn't know what had happened.i was so scared. Later at the hospital they told me they thought i had passed out. to make a long story short i found out 3-4 months later i had 2 heart conditions!!!!!! at the age of 16!!!!!! i got diagnosed with Sinus Node Tachycardia and 1st degree AV block. Make sure if you get some information from a cardiologist to check it on the computer or books at the library don't believe everything a doctor tells you just becuase he's the dr. my cardio. told me that my AV block couldn't change and go to 2nd or 3rd degree. he lied i was doing a paper on it and got some info. on the comp. and found that it starts in 1st degree and goes through 2nd and 3rd degrees over time. they said that the av block wasn't hurting me. well i'm sorry but if your heart has even the slightest problem with it, it is important and is hurting you. i still go to the same cardio. because my parents won't let me change, but i have bad bad bad heart pains. my cardio. says it's in my head even though i've had  them since i was 5 or 7! so check up what docs. tell you.

[1bigmedicalenigma]

Thanks hun!  I really appreciate the info.  I am VERY sorry to hear about your problems.  Trust me, I KNOW how you feel.  In the past I've been misdiagnosed and have also been told that pain was in my head, when in fact there really was a medical problem.  I won't give up.  Actually the Dr. (cardio.) is a old friend, that we haven't seen in about six years, but I was too embarrassed to call him after all this time, and I am also afraid that the dr.(any other one) would say it was in my head.  After having a dream last night that I was on the heart transplant list, that convinced me to call.  Thanks again and best of luck to you!

God Bless!

Mary Ruth