Left Ventricular Hypertrophy + Lightheadedness, Pain,

[vercimber]

Okay. I will try to make this as short as possible. I am a 27 yr. old male, 190 lbs. Last summer I had an "episode" in which the right side of my face and the inside of my mouth became numb. My heart rate increased to ~200 bpm, then depersonalization, chest pain, sweating, severe confusion, and both arms "shook." Afterward, I was so tired that I fell asleep immediately. The episode lasted about 5-10 min. When I woke, I went to ER and checked for infarction w/ neg. results. Went to a physician and was diagnosed with panic attacks. Now, for my concern: I began reasonable exercise regimen at the beginning of this year, and noticed, on more than one occasion, that I become extremely lightheaded, the world "dims," and my heartrate increases to 200 (no anxiety, though). I went to my physician and he placed a stethoscope over my left carotid and heard a "murmur" and said, "We need to get you to a cardiologist." Echo revealed "prominent" LVH with normal systolic diameter and good ejection fraction. After visiting with cardiologist, he said "LVH--don't worry about it," and prescribed Toprol XL: "Only take if your Holter monitor comes back with anamolies." Holter was fine. Doc says don't worry; other general physician is very worried about my "serious" pathologies and doesn't want me to exercise. I have two doctors in conflict about my problem. I am unsure what happened in the summer-- transient ischemic attack (mini-stroke) or just a panic attack? Does this all connect, and should I seek other medical opinions, given that, when I exercise, I feel like something's wrong?

[tickertock]

I also have mild LVH, 14mm of the IVS(interventricular septum), all other dimensions are within the normal limits Ef of 55%, saw a one the most respected cardiologist in Florida, told me just to keep my BP under control I used to have borderline/ mild hypertension since I was about 25, I'm now 42 apparently that is the cause, now my Bp usually averages around 110/70, On meds, atenolol, cozaar and HCTZ  even prolonged mild hypertension is not good and can cause LVH. I was  assured not worry and no restrictions whatsoever, I also posted a ? to the CCF heart forum and was basically given  the same answer. If I were you , I would make sure Hypertrophic Cardiomyopathy was ruled out, treat HTN if you have it exercise moderately.I also have connective tissue disease and suffer from dizziness and chest pain because of compressed nerves , not cardiac related at all. Good luck, hope you feel better soon.

[dmil241]

This is just my personal opinion but if I am dealing with my heart it is my cardiologist that I listen to. I do not listen to my regular GP in this area. In fact if my regular GP says something to contradict or change something that the cardiologist has done or said, I call my cardiologist and ask his office about it. When it comes to my heart, I leave it in the cardiologist's hands. That is his area of specialty. My GP is just that-a general practitioner, NO SPECIALTY.

[dmil241]

Sorry-but one more comment here. Ask your cardiologist point blank about exercise!!!!! I would be very surprised if he told you not to do it!

[Al Dente]

My advice is to gather your test data and get to a good cardiac facility.  Sometimes it is tough for some docs to understand what happens with exercise & the heart, especially with valvular or electrical issues.  The docs don't have the data from when you're having the event--so how can they diagnose it?

Some use anxiety as an excuse waaaaaay to quickly.  Not everyone's having them--and I doubt during exercise you're going through an anxiety attack.  Cardiologists will vary on their opinions--each on has one like a car has a muffler--and not all are created equal.

[vercimber]

Thank you for your input. This particular cardiologist is laconic and does not seem to care about my symptoms. And when I call, of course I have to talk to a nurse, not him. I don't want to be seen as a hyperchondriac by the doctor, but I ask him these questions and he seems not to acknowledge them. He will not tell me what the source of my hypertrophy is nor whether my exercise will exacerbate it. As for the lightheadness and the very peculiar depersonalization (like a piece of gauze over my eyes), he reponds: "Hm."

I should have mentioned that the echo and carotid doppler revealed no stenosis. Anyone have any ideas about the summer episode I mentioned and whether it corresponds somehow. Should I visit a neurologist to see if a transcranial doppler  or other test is necessary?

Thanks for all the time and help.