heart problem

  I had a cardiac cath. performed in March of this year, the results were thought to be an ASD. I was referred to a surgeon whom then had ordered a TEE the results of that were thought to be SPFO. I was then referred back to my original Dr.  Which decided to do another cardiac cath, in May he performed the right side cardiac cath in which he stated I have a PFO. I was placed on inderal 10mg bid. I returned to the doctor due to persistant problems which brought me to the hospital in the first place in March. chest pain, dizziness, always short of breath, wheezing (whisteling sound)Mostly at night, and recently numbness in the arm and shoulder. When I went to the doctor they did an EKG after he read the EKG he acted alarmed and wanted to put me in the hospital.  I pleaded and asked if I could just go home and if I did not feel better I would then go in the hosp. he allowed me to go home and saw me back in the office 2 days later. At that time he decided to do a 24 hour holter monitor test which said I had a tachy run of 160 BPM for several hours. I asked why he was alarmed with my EKG the last time I had been in. the doctor stated he was more alarmed with my extremely low blood pressure in combination with the results of the EKG in which he said the ST beat started diminished till gone. that is what he was more concerned with. Now I had been back to the doctor the other day due to more severe chest pain, now my blood pressure was high and the EKG was the same. The doctor said now he wants to send me to a clinic in Minn.(Mayo). I have been under alot of stress lately and do notice when stressful situations arise I notice the chest pain to be worse. I feel now I should not bother him with this pain as for I feel it is stress related. My family is as concerned as I am. We lost a brother at the age of 43 and our father at 62, whom had CHF. I am concerned but get stressed when family harps on me. My doctor at this point feels I confuse him, although he said it in different words. Although at first the doctor thought I had and ASD he felt that my Asthma like symptoms were due to the lungs overfilling with blood, But now he is not sure of what it is and cant explain why I am having problems, he states my arteries are NOT BLOCKED, therefore I am kinda looking for advise as to what to do. He said that if he sends me to mayo that they will just do the same tests all over again, Meaning the cardiac cath, the stress echo, the monitor, TEE, and all the rest of the tests so they can tell him what is wrong or what would even be better is if someone can get to the bottom of this problem. I am kinda at a loss and dont know what else to do, any info would be helpful.

[CCF Cardio MD - MTR]

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Dear Mary, thank you for your question.  I don't think that I'll be able to provide you with specific answers to your questions, but I'll try to provide some information.  An ASD is an atrial septal defect that is a persistent hole between the right and left atria of the heart.  A PFO is a patent foramen ovale which is a common finding in up to 25% of the population.  During fetal development, the foramen ovale is open to allow oxygenated blood from the placenta to enter the left side of the heart from the right atrium.  Since the fetal lungs are not exchanging air, oxygenated blood needs to traverse the right side of the heart through the foramen ovale to the left side of the heart so that the fetus will receive adequate oxygenated blood.  When the baby is born, the foramen ovale usually closes but can remain open.  Normally, a patent foramen ovale is not a problem and causes no symptoms.  From the description of your symptoms, I doubt that a PFO is the root of the problem.  However, with normal coronary arteries, I can surmise that your chest pain is not caused by coronary blockages.  Thus, I agree that you need a comprehensive reevaluation.  If you would like to be evaluated here at the Cleveland Clinic, then follow the instructions listed below.  We have numerous expert cardiologists who would be happy to see you and I'm confident we could give you some answers.  However, if the Mayo Clinic is more convenient for you, they also have excellent cardiologists.  
I hope this information is useful. Information provided in the heart forum is for general purposes only.  Only your physician can provided specific diagnoses and therapies.  Feel free to write back with further questions. Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.