Cath. results

[Lyn2]

I had a left/right heart cath. done due to recurring bouts of edema, PND, SOB,distended neck veins, elevated pulm. pressures on echo., frequent A-fib, pacer for SSS, mod. tricuspid regurg.,PFO.

My cath. showed normal coronary art., normal pulm.pressures. Relatively high RA,SVC and IVC sats (86%) w/no step-up and cardiac output 16L/min index 11.0L/min/m2, SVR 415dynes/sec-5.
My cardio. said the C.O. is high.  Also developed wide complex tach,(rate 250)w/no caths. in place. It responded to 2 doses of lidocaine.Probable afib w/aberrancy.
Question-
I am curious about the C.O. in light of these other findings.  It doesnt seem to make sense to have high C.O. with symptoms of heart failure, does it?
My cardio has suggested a 2nd opinion to get a fresh pair of eyes looking at this. I dont want to start over, and I feel that my docs. have been very thorough.
Question-
Please help with imput.
Question-
What are some causes of high C.O.?
Question-
Is it possible that it is lone a-fib, or are there too many influencing factors?
In case you need to know, I am early 30s, 105lbs.
Thankyou so much!!!!!!!!

[heartsalive]

I have been having tightening of my chest and shortness of breath for the past two weeks, at the time this happens, I also have palpitations and lightheadedness.  I was admitted into the hospital for 6 days due to an abnormal ECG, I ended up having a cardio angiogram.  The arteries were clear, so the Doctors discharged me.  I do not feel any better, and went to the ER of my local hospital, even though I am having bradycardia (ranging 40-60bpm) and Bp's ranging 114/56,they thought I was having anxiety attacks, and prescribed xanax for me.  I feel I have been misdiagnosised.  I am a nurse, and am very aware of the signs and symptoms that I am feeling.  I don't always have the sypmtoms they come and go.  I have been doing some research and discovered that a SA block II would not show on the EKG, I have also had rheumatic fever in the past (one of the causes of blockII)  Do you think, that I am wrong for pursueing this matter so forcibly, When I have an episode my heart beat goes up to the 100's, and the BP also elevates to 138/80.  I am scared, knowing the prognosis of this illness, and feel the Doctors should be moving faster, and not drugging me so I don't complain! Pleas respond....................heartsalive

[CCF-M.D.-CRC]

Dear cn,

Question-
     I am curious about the C.O. in light of these other findings. It doesnt seem to make sense to have high C.O. with
     symptoms of heart failure, does it?
    
A: Actualy high output heart failure is a well described cause of heart failure.  If you think about it it makes sense that the heart is working so hard that it begins to fatigue.
  
    
     Question-
     What are some causes of high C.O.?

A: Causes of high cardiac output include: anemia, beri-beri (thiamine deficiency), diabetic ketoacidosis, fever, thyrotoxicosis and any left to right shunt (including PFO, AV fistula, Patent ductus arterious, and hemangioma).
    

Question-
     Is it possible that it is lone a-fib, or are there too many influencing factors?
    
A: Lone afib is a diagnosis of exclusion.  If all structural heart disease has been excluded than the diagnosis can be made.  In your case it sounds like something else is going on it is less likely to be lone afib. However, the treatment is the same.  First the underlying problem should be found and treated as needed and then the afib treated if it continues.