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Bradycardia, intermittent RBBB, fainting, myocarditis in healthy 27-yr-...
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Bradycardia, intermittent RBBB, fainting, myocarditis in healthy 27-yr-old

I'm a very healthy 27-year-old female, non-smoker. I checked into the hospital with palpitations, 2 fainting spells, dizziness, and shortness of breath. In 1 out of 5 ECGs (the only one taken immediately after I fainted), they found a Right Bundle Branch Block, which they did not find again on the other 4 ECGs they took. I also had a slightly lower-than-normal Echocardiogram (52% Ejection Quotient). Thyroid functioning, all the blood tests were normal. While in the hospital, they noticed my heart rate dropping below 40 while I slept, and I noticed it dropping below 50 quite often while I was resting and awake. Diagnosis was myocarditis and they sent me home with some pain medication for headaches and chest pains, and with very little sense of prognosis. Family history includes a couple of heart attacks and bradycardia in my father (he's had it since he was my age).

I continue to have problems (now two weeks out of the hospital). Occasionally, for no apparent reason, I get very dizzy, have trouble breathing, and feel like my heart rate is too slow, as though it is struggling to pump. This also occurs if I walk for more than about 5 minutes. I'm not sure what else might be the cause, or whether it's normal for myocarditis to have intermittent symptoms like this. I saw a whole team of Internal Medicine doctors at a prestigious university hospital, and Infection Disease specialist (due to travel history in Africa), but no cardiologist. Any advice? Does this seem accurate or like I should get this checked out further?

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Hi Jane,
I can't answer what is normal for myocarditis. If the doctors you saw did not give you any information, or suggest that you should see a cardiologist, I would call them and ask. Given your family history, I would think it would be wise to see a specialist. Better to know than to have anxiety wondering. Maybe someone else here can answer your question re myocarditis.

I hope it clears up for you and you are back to your normal self soon!

Do you have copies of the tests/bloods done?  I'd be interested to know your TSH (even though you were told thyroid is normal -- another test to tease out potential thyroid problems would be to take your basal body temperature each morning - you can find info about that in the thyroid forum on medhelp).  Myocarditis is a bit of a thorny diagnosis - in your case, if its myocarditis, its a "sub-clinical" case in the sense that your EF is not seriously depressed.  I would definitely follow up with a cardiologist - if you do have myocarditis, or damage due to myocarditis, that could be seen on a contrast cardiac MRI (although by the time an MRI could be scheduled its possible any infection would be out of your system) - in addition to allowing for diagnosis of a current cardiac infection it would also indicate previous heart attacks, scarring (a potential outcome of a viral infection), function, valves etc and would tell you your EF (a second reading would be a good idea for several reasons).  I was concerned about a viral infection over a year ago and found that it is VERY difficult to find myocarditis specialists and the typical Dr response I heard was that viruses will work themselves out given time - while I consider that advice laughable it is often true - though many people do suffer from post viral fatigue, virally induced autoimmune problems, virally induced CFS etc etc.  Definitely give the cardiologist a call (he/she will want to see a copy of your echo and the ekg showing RBBB), get copies of your tests, do your best to rest and eat well.  The good news is that if the hospital released you without any big red flags you're most likely dealing with a problem that is upsetting and difficult but not an immediate threat to your well being in the larger sense (Western medicine does tend to be strong on that point).
Best of luck
I was 22 yrs old when I first got diagnoses with Myocarditis. I was very healthy active duty Air Force. I got sudden sharp chest pains with numbness into my left arm. I had a few blood test done and had postive Triponin. I was then sent to a civlian specalits, where they performed a hearth Cath because my triponin kept climing up. The cath was normal and they doctors werent for sure what to diagnose. Until they performed a Cardiac MRI, it showed active inflamation (inflammation) of my heart. I fought with chest pains and weeknees for many months and had another cardic MRI performed 2 months later. It still showed active inflamation (inflammation) but not as bad as before. I was then refered to UCLA cardio center for a work up. They kinda just played it off like it wasnt a big deal, they did another Cardiac MRI 6 months after the inital finding and it showed the inflamtion was gone but I had scars and leasons on my heart wall. I have chest pains almost everyday still and its very diffuclt to find a good doctor. I since seperated from the military because of this illness and 2 months after seperation, 18 months after my intial diagnoses of myocardits, and healing and getting better, the infection came back, I had antoher postive triponin with severe chest pains, and I recenlty had my 4th Cardiac MRI which showed active inflamtion, there is really no way to treat this illness, The doctors have tried anti bodics, steriods, anti inflamitories. Hopefully this is some help to your case

Sorry for spelling and gramar mistakes

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