Question on Diastolic Dysfunction

[julid]

I'm a 41 yr old female, 5'3", 130lbs and recently had a abnormal echo stress test.  I then had a left catherization done and was diagnosed with "hypertensive heart disease with diastolic dysfunction".  I am on Lisinopril/Hydrochlorothiazide meds of which I take 1/2 tablet of a 12.5 mg tablet daily.  My cardiologist stated that the diastolic dysfunction is caused by untreated high blood pressure, but I've been on blood pressure meds (hydrochloritiazide) for over 3 years prior to getting this latest diagnosis.  

My question is whether or not there are any other possible causes of diastolic dysfunction.  I've had other symptoms over the last few years (fatigue, weakness/loss of strength, numbness in hands/feet, dizziness, foggy memory, slight carpal tunnel in both wrists per EMG test) and have undergone a few tests (checking for Rheumatoid Arth., Lupus, EMG test) all of which came back normal.  My blood pressure has always been low, in fact too low (81/48 lately) since I've been on the blood pressure meds.  I'm just trying to find out if there may be another root cause of why I'm not feeling well.  I have two young kids (4yrs and 9yrs) and have actually had a doctor tell me "you feel tired all the time because of the kids".  Well, I'm not buying it.  Please help me solve this mystery once and for all if possible.  

Thank you in advance for any insight you may provide.  I look forward to your response.

[kenkeith]

Anemia can cause fatigue. Without sufficient iron, your blood can't carry enough oxygen to the cells in your body. The result: fatigue, weakness, faintness, and dizziness.

Then there can be iron overload. Some individual inherit a tendency to accumulate iron in the blood and fatigue is a common symptom.

The only way to know if you have this condition is to have one of two tests: a transferrin saturation blood test or a serum ferritin test. These tests are not the same as the one used to check for anemia and doctors do not routinely perform them. (Ironically, you can have both anemia and iron overload at the same time.) If you test positive for iron overload, your doctor will draw out units of your blood once or twice a week until the excess iron is removed. After that, simply giving blood three to five times a year is usually enough to keep your iron at normal levels as long as you aren't taking iron supplements.

Chronic fatigue syndrome (CFS).  According to some of your posted symptoms and failure to dx, and if you're so exhausted that you're having trouble going about your usual activities, and your fatigue has been going on for more than six months, and your doctor can't find any other medical reason to explain it, CFS may be the culprit. Unfortunately, no one knows what causes this mysterious malady, but symptoms can last for months or years. In addition to overwhelming fatigue, people with CFS have at least four of the following symptoms: Do you have at least 4 of the following? Difficulty concentrating, forgetfulness, sore throat, tender lymph nodes, muscle pain, joint pain, headaches, fatigue on waking up, and feelings of illness and exhaustion after even light exertion.

Because so little is known about CFS, no definitive treatment plan has been established. Most experts recommend living as healthfully as possible: Exercise regularly, eat a balanced diet, get enough rest, learn to pace yourself,  don't smoke, and cut back on alcohol and caffeine, if so consumed.

There can be a thyroid problem.  Hypothroidism can produce a slow heart rate and fatigue.Your thyroid gland produces hormones that tell your cells how fast to work. If it's not producing enough, everything slows down, etc

[andydandy]

I will be 70 late this year.  Last June, 07, I had an echo and found I had diastolic dysfunction with a 60% output.  I had been diagnosed with mycoplasma pneumoniae the January before and was sick with that off and on until I ended up in the hospital in June.  For those previous six months I was off and on serious antibiotics and Prednisone, a steroid to help breathing.
So I have learned from the response to your questions...possibly mine came from steroids and infection.  They did not suggest a catherization in my case.  I have also been very tired.  I was also placed on lisinopril as my ankles were swelling...20mg.  I too have had verey low blood pressure most of my life.  My last prescription I forgot to have filled on time...several days later I checked my blood pressure...below 130 so I began th think I did not need.  So have not been taking!  But last night and tonight my ankles are swelling so your questions pointed out that maybe the lisinopril

[julid]

Thanks for your info.  According to my angiogram, my arteries are clear and I'm not in danger of a heart attack for at least 5 years according to my cardiologist.

You mentioned the body's metabolic needs not being met and that could cause fatigue.  I've had several blood tests over the last couple of years, some of which were abnormal (low potassium, high c-reactive protein and many others).  Do you have any suggestions of blood tests that I could recommend to my PCP that may help further investigate the symptoms I'm experiencing.  Also, I've heard there's been a connection between people with Amyloidosis (sp?) and diastolic dysfunction of the heart.  Have you heard of this before or know anything about Amyloidosis?

Thanks again....I really appreciate you taking the time to respond.

[kenkeith]

Hypertension and cardiac ischemia (occluded coronary arteries) are the most common causes of diastolic heart failure. Common precipitating factors are tachycardia; exercise; hypertension; ischemia; systemic stressors (e.g., anemia, fever, infection, thyrotoxicosis); arrhythmia (e.g., atrial fibrillation, atrioventricular nodal block); increased salt intake; and use of nonsteroidal anti-inflammatory drugs.

With diastolic dysfunction, the heart is unable to meet the body's metabolic needs, whether at rest or during exercise.  That will cause fatique.