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Lightheaded, short of breath, rapid pulse (96-120), very weak, hear pai...
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Lightheaded, short of breath, rapid pulse (96-120), very weak, hear pain.

I am writing regarding my 26 year old daughter.  She is currently having her second episode of the following symptons (the first was 3 months ago):

Lightheaded, short of breath, rapid pulse (96-120), very weak, hear pain.

Tests performed 3 months ago:  EKG, Echocardiogram, thyroid test (then a more in depth one), anemia…pretty much everything, and everything came back normal.  She was put on Toporol to slow down her heart rate.

The cardiologist figured she had a virus that settled in her heart and told her to wean off the Toporol after 3 weeks which she did, and has been symptom free for the last three months.  Now it’s happening again.  Her GP stated that maybe she is having another episode with the virus and has her monitoring her pulse this weekend but we (her parents) are very concerned about her heart being damaged from whatever virus this is.

My question is:  are there any tests that will determine what the virus is and is there a way to treat it & get it out of her heart,  what damage can occur and how serious is all of this.  Should she be seeing the cardiologist again?

Any suggestions would be appreciated.

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In addition to the Heart Rate, it would probably be prudent to measure her Blood Pressure. They sell Blood Pressure Monitors at many Pharmacies. Discuss it with the Pharmacist to determine what model would be most reliable. It's quite easy to take the Blood Pressure the old way as well, with the cuff and stethoscope, perhaps if they have this option they can instruct you on its use. Record the values and correlate them to her symptoms (lightheadedness or otherwise) and provide the results to her Doctor.

Ask her Doctor if she should be fitted with a Holter Monitor, so that they can see the how her heart is functioning over a 24 hour period, or alternately be given a 30 Day Event Monitor (Loop or otherwise).

I would think that the diagnosis is rather non-descript, (in other words, it may not be a virus in her heart), and push for an actual cause. Suspecting is not the same as knowing. Did they, in the course of the testing that you described, detect a dysfunction with the heart that indicates that a virus may be the cause? (one site mentions temporary ECG changes or an incidental echocardiographic diagnosis of ventricular wall motion dysfunction pointing to a myocardial pathology in otherwise barely affected patients.)

In English, I believe that they are saying that, in patients that show little symptoms, EKG Changes or Peculiar Ventricular Wall Motion observed during an Echocardiograms may indicate that something is wrong. Since your Daughter’s symptoms are more significant, did they find anything during your Daughter's test?

From a medical site: "In the majority of cases myocarditis develops after a systemic pulmonary or gastrointestinal viral infection." Was this the case, was your daughter afflicted with systemic lung or stomach type virus before she developed her heart related symptoms?

From the same medical site: "In rare cases, virus induced myocarditis may develop within a few days and be accompanied by life threatening arrhythmias or rapid progression of myocardial dysfunction. The majority of patients with acute myocarditis, however, have a clinically inapparent course and cardiovascular symptoms may be minimal. Frequently, only temporary ECG changes or an incidental echocardiographic diagnosis of ventricular wall motion dysfunction point to a myocardial pathology in otherwise barely affected patients. In this setting, myocarditis may easily be overlooked. Often, the pathologic findings recede completely within a few days or weeks. If global or regional wall motion abnormalities or clinical complaints such as fatigue, angina, dyspnea or arrhythmias persist over a period of several weeks or months without improvement, a chronic inflammatory process or a persistent viral infection must be suspected."

Notice it says in Rare Cases does the problem become serious. They continue by stating if the fatigue, pain, problems breathing, and arrhythmias persist for several weeks or months without getting better, a chronic inflammatory process (i.e. I believe they are inferring it may not be viral related in this case) or a persistent viral infection MUST be suspected.

Here they name some of the viruses that may be responsible: "Apart from enteroviruses, analysis of endomyocardial biopsies employing molecular biology techniques has also identified, with varying degrees of frequency, adenoviruses, parvovirus B19, human herpesvirus type 6, adenoviruses, cytomegalovirus (CMV), herpes simplex type 2 virus and hepatitis C virus in the myocardium."

They also differentiate these three scenarios:
1. Acute viruses (as mentioned above, perhaps the remnants of an infection elsewhere) and hopefully self limiting and requiring no therapy.
2. Autoimmune Inflammatory Disorders of the heart, requiring immunosuppression.
3. Viral Heart Disease, requiring Anti-Viral Therapy.

Another site mentions the Coxsackie B virus as being a possible cause.

If you are seeing a Cardiologist, consider seeing an Internist or other qualified Doctor for a second opinion. Sometimes problems are attributed to the wrong cause.

Hope this is of some help. Please keep in touch with your Doctor, and visit the Hospital Emergency Room if things seem to worsen.

I just wanted to make clear that the Doctors don't respond on this forum. Most of the posters to this forum are people that have had problems with Heart Rhythm over the years, or have loved ones that do. The level of experience for all of us depends on how much we personally have witnessed and experienced problems over the years, and how much we have researched. Others are medical professionals (Nurses, EMTs, etc.) that have an interest in the Forum and Topic.

There is a link at this site that requires a fee to ask a question to the Doctors, but it is not on this forum.

I just want you to be aware of this. If your Daughter's condition worsens, please consult her Doctor or visit the Emergency Room of your Local Hospital.

Best Regards.

My wife suggested that Pericarditis may also be a possibility. Rather than the heart muscle itself having an infection, the Pericardium is the "thin sac-like membrane that surrounds your heart. Pericarditis often causes chest pain and sometimes other symptoms."

From an online site: "Signs and symptoms: If you have acute pericarditis, the most common symptom is sharp, stabbing chest pain behind the breastbone or in the left side of your chest. However, some people with acute pericarditis describe their chest pain as dull, achy or pressure-like instead, and of varying intensity. The sharp pain may travel into your left shoulder and neck. It often intensifies when you lie down or inhale deeply. Sitting up and leaning forward can often ease the pain. At times, it may be difficult to distinguish pericardial pain from the pain that occurs with a heart attack.

Other signs and symptoms, from an online site, often associated with Pericarditis include: "Shortness of breath when reclining, Low-grade fever, An overall sense of weakness, fatigue or feeling sick, Dry cough, Abdominal or leg swelling."

In any case, be sure that your daughter keeps in touch with her Doctor, and consider encouraging her to get a second opinion on the situation if you do not believe that she is being treated aggressively enough.

Best to you and her.
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