Hi. My daughters heart rate mid Feb 2008 at night was 40 and irregular BP 120/70 repeated with no change. She is 18 yo. If we were not awake together due to a new puppy this would have been missed till she truly became symptomatic or worse... Anyway went to ER. HR was anywhere from 40-150 with many PACs. She has h/o SOB during sports for at least 2 years and was thought to have exercise induced asthma. Looking at her you would not think she was in respiratory distress. PFTs were all normal. No one thought that SOB might be cardiac related. She has always done sports. Lungs are clear BL during episodes of SOB, no pedal edema, no CP, no JVD. able to sleep flat. DC'd from ER with follow-up with cardiologist. She had an echo which showed mild diffuse left ventricular hypokinesis, left ventricular EF mildly decreased (no% given?), mitral insuff is absent, RA and RV are nl in size, no pericardial effusion, trace regurg of tricuspid and mild regurg of pulmonic valve, no murmurs auscultated that I have been told. Halter monitor showed rate from 40-154, no ventricular ectopy, 10 episodes of 3 or 4 sec pauses, sinus arrthymia. Cardiopulmonary stress test showed VO2Max 31. Awaiting second echo results and final report on cardiopulmonary stress test. Since she is still being worked up and in NAD-asymptomatic no one has started her on meds or has suggested she needs meds at this point. I understand there is aprox 1/3 chance of this reversing on its own. I started her on CoQ10-100mg and L-Carnitine-500mg. I feel there is nothing to lose to start this now while we continue with work-up. Her work-up is now in the hands of a heart failure specialist at Columbia Presbyterean in NY. Are second opinions needed or is there a protocol that is followed and if so what physician/treatment center in the country has the most success with management for cardiomyopathy? Since she describes sxs I assume she is NYHA stage II? Will she be put on meds based on what info I have given? Thanks