Split s1

[farmmax]

I supposedly have a fixed split S1 (wide).  Also have arrythmia problems. (Generally mild). I walk around on the flat OK, but not so good on the hills.  Have severe problems with squeezing, lifting, pushing, pulling type exercise. This causes SOB, nausea, bad pressure in the chest.

The trouble is, when with a doctor I become a mindless idiot(because I don't like being there), and don't seem to be able to ask questions I should. Would you be able to answer some now that I've had time to think of them?

I know why S2 splits, but what are the mechanics that cause the fixed S1 split? I can't find much information about it on the net. What type of conditions can lead to a fixed S1 split.

Why can I walk around so well, but not do well with other forms of exercise? Isn't all exercise the same?

I am supposed to go back to the doctor, but haven't got around to it yet.

Thanks

[farmmax]

Tried that!

What a failure!  The doctor seemed greatly insulted (don't know why), looked down his nose at me and said he didn't do things that way.  He wouldn't even read the notes I had made. No wonder I have a problem with doctors!  Needless to say I've changed doctors, but I'm no more confident with the one I'm seeing now.  Trouble is, the community I live in is very small and the range of doctors is equally as small.

Envy all of you that seem to be able to have frank and informed discussions with your doctor.  It doesn't seem to be encouraged where I live.

[hbp702]

Write out a list of your symptoms and concerns and bring it with
you to your doctor's appointment.

[CCF-M.D.-KE]

Dear farmmax,

Sorry to hear about your exercise intolerance. 2 general causes of a fixed split S1 are a right bundle branch block (RBBB) and a condition called Ebstein's anomaly. However,  a systolic ejection click may resemble a fixed split S1. Conditions which may cause a systolic ejection click include aortic or pulmonic valve abnormalities and some congenital abnormalities.  This is relatively abbreviated discussion of the S1 but highlights some key issues. However, if you are experiencing exertional symptoms I would recommend having a stress test and an echocardiogram. Discuss your symptoms with your doctor so that he or she may further evaluate your symptoms.

Thanks for your question,


CCF-MD-KE