I am very worried about heart failure, please help..

[munkiman]

First off, I have been on the drug Accutane for severe cystic acne from the beginning of February to the beginning of June. During this time, I had been hospitalized after about a month of taking the drug because I could not catch my breath, basically I felt like I was not breathing properly. I suffer from asthma and this did not feel like an asthma attack. In the hospital, I had an x-ray conducted on my heart and lungs, an ECG done on my heart, an ultrasound, and a CT scan conducted on me to see if I had a blood clot on my lungs. These tests came out fine and the doctor said I was fine and couldn't see a problem.

He gave me ventolin and an orange inhaler (I forgot the name of this but it was a stronger medication for asthma). My breathing then gradually improved for about a month then it hit me again after I smoked marijuana twice in April.

This is when the breathing problem started to persist and never go away. I have had this breathing problem for almost 6 months now and it has worried me ever since. I have had a physical exam because of this in July, and also another x-ray, all the tests showed that I was perfectly healthy (I had a stress test on a treadmill, another x-ray on my heart and lungs, basically checked up my whole body). I also had a lung function test and the doctor said it was above average which confused me a great deal.

I then moved to Calgary (Canada) in August and have experienced a bit of a difference in my breathing issues. This includes running out of breath more easily e.g. when I run up the stairs I run out of breath when I usually don't an when I crouch down or kneel over to clean my car or whatnot. I also have had aching, tingling and pressure on the left side of my chest and on my left arm, this comes and goes and it frightens me.  I know that the altitude in Calgary is above 3000 ft, which is high, and that people need to adjust to the altitude. But I have a hard time linking my out-of-breath-ness with  the altitude because I have been having it for about 2 months. Does it usually take that long to adjust to high altitudes? I have seen a doctor here about it and he ran through my physical exam as I showed him the booklet containing all my results, he also said there shouldn't be any problem with me and that I seemed perfectly healthy.

I'm now worried I might have heart failure. If I had it, would the stress test be able to detect it? Are the symptoms I described an indication of heart failure or anything else? Is accutane the cause of what I'm experiencing? Is it the marijuana? I need help and a second opinion, there's a lack of doctors accepting new patients here in Calgary and it takes awhile to get an appointment with a specialist... thank you so much for your help.

[kenkeith]

An individual should adjust within several hours to an altitude change.  Was the ultrasound an echocardiogram?  That would be the best test to see if there is any heart failure as an echo sees the heart wall movement in realtime.  If there is heart failure, the heart wall movement would be impaired and heart contractions would be weak.

An ECG is not a very good source to detect heart failure or heart muscle damage.  However, the tests indicate you don't have cardiovascular disease that could block the blood flow, and that would be the result of the stress test.  If there is heart failure, it would be due to heart muscle damage and can be due to infection, medication, drugs, alchohol, etc.  Shortness of breath can be a heart or respiratory problem, and because you have a known respiratory problem it is most probable your symptoms is due to your asthma.

Lung function tests (also called pulmonary function tests, or PFTs) evaluate how well your lungs work. The tests determine how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood. The tests can diagnose lung diseases, measure the severity of lung problems, and check to see how well treatment for a lung disease is working.  If your doctor said "it is above normal" it must pertain to a good outcome of how well your lungs work described by the functions shown above.