Tachycardia & Fatigue

[uniqueldy]

I went to my PC in March complaining of fatigue, tachycardia & chest pain. I was given a referral to a cardiologist. He ordered a echo. The echo conclusions were; Mild left ventricular hypertrophy; mild diffused hypokinesis of left ventricle; normal right & left ventricular systolic function; no evidence of mitral valve prolapse; mild tricuspid regurgitation with normal pulmonary pressures; aortic sclerosis; atrial septal aneurysm; sinus rhythm during study. The LV ejection fraction is 45%, mitral valve leaflets appear thickened. He then ordered a cath which didn't show any blockage. He then said my chest pain wasn't cardiac in nature, and gave me Rx's for Toprol XL 100 mg. 1 time a day & Verapamil 180 mg 2 times a day to slow my heart rate & said to return in 6 months. I am still tired all the time and a week ago for the 1st time ever my ankles/feet became swollen & still are, my BP and pulse became lower (100-118/56-68 & P. 62-76) and I think I may have bronchitics. Since I was told my symptoms aren't cardiac in nature what could be going on with me?

[uniqueldy]

I had a rough night (laying down caused coughing & hard to get breath & moderate chest pain) soon after posting my question.  I continued to feel rough & called and spoke to my cardiologist's nurse in the afternoon. She said to come in the following morning. I live alone and still felt rotten so I took a friend with me to my appt. We both were flabbergasted at the reaction I received after explaining my new symptoms. AGAIN I was told my cath was normal and my symptoms weren't cardiac in nature. He added my symptoms could be stress due to the constant pain of my workers comp shoulder injury. I told him I thought I recalled the cath was normal except for stating the LV function was low. He said I do not appear to believe him and if I wanted he would give me a name of another doctor or I could return to him in a year. I came right home and found my cath report which read: Pressure mmHg sys/Diast EDP (MEAN): aortic root 114/58(81); left Ventricle 114/4,17; LV Post angiogram 114/1,17 (arrow down); Pullback (arrow down); Aorta 114/62(83); Pulmonary artery wedge 16/22(13); pulmonary artery 33/16(23); right ventricle 31/4,12; reight atrium 13/12(10). Left ventriculogram: lower limits of normal with EF of 50%.  Coronary Arteries: all were normal.  Impression:1. LV function lower limits of normal; 2. normal right sided pressures are noted; 3. no obstructive cad noted. Recommendation: Medical treatment.
My 1st. concern was after my echo how concerned he was and after the cath it was all gone. I have no trust.  I appreciate your speedy responce and concern. The very next time I have chest pain that last, am dizzy or can't lay down without trouble breathing I am going to the nearest ER and take both the ech & cath with me and let them tell me my symptoms aren't cardiac. What do you think?

[Forum-M.D.-bkj]

Unique,

By your echocardiogram you have LV dysfunction which is not normal. While your chest pains aren't from coronary blockages, it is concerning that you are continuing to have symptoms. The most concerning thing however is the decrease in your LV function. I would look into seeking evaluation from a heart failure specialist. They would look into other causes of your cardiac dysfunction and also look into making sure you are on the proper medications to optimize your cardiac fucntion.

Good luck