SOB and light headed together with certain activity

[purpleurkle]

SOB and lightheadedness together

I'm a 28 yr old male,  Last yr for unknown reason I shot from 220 lbs to 250 lbs in just acouple months.  I have had this situation for at least the past 2 years but worse in the last several months.   There are specific activities that cause me to go SOB and get lightheaded at the same time.     I do 30 minutes to an hour of cardiovascular exercise daily despite my weight I have fairly good tolerance underneath the fat.    

What do I mean by specific activity?   It isn't so much sustained cardio that does it to me, But rather when I exercise the muscles or do any straining..  Climbing stairs, standing up, and especially lifting weights (even a light set of curls, or especially leg work)  will usually cause my heart to beat very forcefully (but NOT fast) and when this happens my vision starts to fade and I am short on breath.  I am very calm when this happens, but it's a highly abnormal experience.   This all happens together...The forceful heartbeat, SOB and lightheadedness.  Then, it will all pass after 15 seconds if I stop my activity.   I also have bilateral pitting peripheral edema in my ankles that is not too bad, but it shouldn't be there.

I've had a nuclear stress, cardiac CT, BNP, echo, Liver test, and all the standard blood tests like CBC.  Echo just showed mild pulmonic and mitral regurgitation and my EF is 59.    

Since this all started, I have also been having many isolated palpitations (they called them early beats),  that I had never had before.

So basically, with the normal heart tests, I've been left to think that although my heart is working right, it hates it's job.    Sometimes It just feels like I have a weight in the center of my chest that just sits there and pulls at my heart making me feel sweaty and weak,  but I don't experience fatigue per se.
   What do you think about this?

[National Jewish Health]

There is a physiologic event, called a Valsalva maneuver.  It attempts to forcefully trying to empty the lungs, exhale, while at the same time, blocking airflow in the larynx with a closed glottis.  It is often performed while lifting, especially while lifting a heavy weight, to stabilize the abdominal muscles and results in decreased blood flow to the brain, often leading to lightheadedness or even to syncope, commonly called fainting.  Many individuals do this unconsciously.  Heart rate may also slow.  You should mention this to your doctor and perhaps simulate the experience of lifting in his/her office.

The weight gain may be a reflection of fluid retention and your doctor should seek the cause of that.

Good luck.