Pediatric Heart Expert Forum
unusual symptoms
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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unusual symptoms

Hello,
My 15 year old son had a very bad cold 9 months ago that lasted a month.  The acute symptoms clear up but what remains is a constant sensation of a "lump or frog" in his throat, nasal congestion and severe burning in his throat and chest when he breaths hard and gets his heart rate up.  He was a competitive cyclist and can no longer ride or even participate in high school PE.
We have had complete workups by a pulmonologist (no asthma), allergist (no allegies), GI did endoscopy with PH monitor (some acid but not GERD), MRI, CT scan of nasal passages, 2 chest xrays all showed nothing unusual. All blood work normal but low end for WBC (4 - 4.9), ENT did culture of throat and found serratia marcescens and is treating w Levoquin but my pediatrician did culture and found nothing so thinks it's not pathological. Other than a tendency to catch colds on top of these constant symptoms he appears healthy and has normal energy level.  Is a checkup with a cardiologist warranted with these symptoms?  Perhaps the original cold caused a viral infection in the heart?
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Myocarditis is an inflammation of the heart muscle usually related to a viral infection.  In the acute phase, the patient would have symptoms of congestive heart failure and low cardiac output.  It does not sound like your son ever had that.  There can be a chronic component to this, where the heart muscle weakens as a result of the prior infection.  In that situation, there could be a component of exercise intolerance.  It sounds like your son has had a number of doctors evaluate him, and as such I would assume there are no pathologic pmurmurs of a valve leakage.  Also if he has had a couple of chest xrays (CXR) that are normal, it does not sound like there is any heart enlargement (which you would expect if the heart had become weakened).  A simple way to assess your son's cardiac status would be to have your primary doctor order an electrocardiogram (ECG).  if that is normal, as well as a CXR and his cardiac exam, it makes it highly unlikely that he has a cardiac issue.  If abnormal, then he needs to see a cardiologist and have an echocardiogram (ultrasound of the heart).  If his symptoms are primarily exercise related, the pulmonologist could order a stress test. Hope this helps.
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The Children’s Hospital of Philadelphia
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