unexplained heart trouble

Posted by John on April 13, 1999 at 16:32:44
I am 19 years old and untill now have lead a healthy life.  I was born with a patent arterial ductis which was surgicaly rectified when i was 7.  Over the last few months I have been feeling very faint (not just when i stand up but all the time) and have been having afew heart problems with it.  My heart keeps racing and i get chest pains every day.  About six weeks ago it got so bad i was rush into hospital,  my heart rate was 185 at rest and i had severe chest pain.  I had numerous ecg's including a 24hr ecg,  they all showed nothing out of the ordinary.  I'm now taking atenolol(50mg) each day which helps with the heart rate a bit but does nothing for the pain.  Also i keep getting headaches with it.  I've had lung scans ,ecg's ,brain scans ,heart ultrasound, and numerous blood tests but all turned out fine.   I'm now waiting to see a neurologist to see if there is something wrong with the part of my brain which controls my heart.  As i said above i have a healthy lifestyle i don't smoke, drink little, and have no stress or pressure in my life at all.  Any advice on what it could be would be very greatfully recieved and what exactly it the neurologist going to do?
Posted by CCF CARDIO MD-APS on April 16, 1999 at 10:46:09
Dear John,
It would be good to have an event monitor that captures your heart rhythm during some of your chest pain episodes, as well as when you are feeling faint.
It would also be good to have an evaluation/opinion from a congenital cardiologist (if you have not already) who best understand the long term sequelae of congenital heart disease (fixed or not.)  It is imperative that your entire heart and aorta be scanned for not only failure of the original surgery, but also for any abnormalities that were overlooked at the time of your surgery, and a regular echo will not necessarily find these things, often a TEE (transesophageal echo) or at least an echo done by a technician trained in congenital heart disease is required.
Sometimes even in congenital heart patients there are other reasons for chest pain besides the heart, and once the heart as a source of the pain has been ruled out, these (stomach, esophagus, chest wall, etc.) other systems need to be checked out.
The neurologist is likely to do a number of tests on you in an attempt to figure out your faintness; I can comment no more as I am not a neurologist and yours is not a case I know well (even if I did, this is an informational forum, not a diagnostic one.)
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.