Need advice/assurances

Hello Dr.,

I am a 22 year old British male who has been diagnosed with a heart murmur and with a small (.4mm) hole in a valve close to the top of my heart. I have known this since birth. I have been a heavy cigarette and marijiuana smoker since I was 15, I quit cigarettes a year ago and I quit marijuana about a week ago. I quit because for the last 6 months I had been suffering panic attacks when I smoked, having gone to the hospital several times as I thought they were heart attacks. They did an ecg, and ultrasound, and a chest x-ray, which turned out ok (although I still have to see the doctor about the ultrasound-the meeting is in august). The reason I am submitting a question is because from time to time I get a fluttering, caving in sensation in the left side of my chest, which I got when I smoked, and now that I quit it occurs after i have been laughing or have been very animated. I also have no tolerance for exercise ( I can only manage 10 mins on a treadmill, and then I feel extremely faint), and suffer from palpitations almost every day, even when I am just sitting down. Sometimes these are accompanied by a dull pain right on the spot where my heart is, and I feel fatigue and light headed, also with this impending sense of doom. I also have a gastrointestinal problem at the moment, but haven't always, and still suffered from these symptoms. I would also add I am a very angry person sometimes, with a short temper, and find it hard to relax.What worries me the most are these fluttering sensations, which make me feel like my heart is about to stop beating and I'm about to die. I will not be able to see a doctor for about a month as I am on holiday in belize with my family, and am worried that something might be seriously wrong with me. Any advice would be greatly appreciated.

Bruce

[Michael J. McWilliams, M.D.]

Bruce,
With normal EKG and heart ultrasound, it is very unlikely that anything is seriously wrong.  It sounds like you have symptomatic palpitations.  When I see someone like yourself in clinic, I order a monitor to confirm what the heart rhythm is during the palpitations.  It is usually premature ventricular contractions or premature atrial contractions -- this is not dangerous when you have  a normal heart on ultrasound and a normal EKG.  I think you will have to wait to see your doctor to get the real answers, but the short answer is -- normal EKG, normal echocardiogram (ultrasound) is associated with a very good long term prognosis.

I hope this helps.