What could cause edema of legs, shortness of breath with exertion?

[rondoo]

I am a 44 yr old female with history of AVNRT with 2 cardiac ablations in 2006.  Also diagnosed with thyroid cancer in sept. of 09 with total thyroidectomy.  Prior to thyroidectomy had been having edema of both lower extremities and had to get clearance for surgery.  Echo within normal limits (Also have MVP).  Past couple years have chronic edema of feet,ankles and calves, Shortness of breath with exertion and general fatigue.  Thyroid hormone levels normal now with replacement therapy.  I have seen pcp, cardiologist and endo and nobody can explain my symptoms.  I feel like I am 90 years old.  Also cannot tolerate heat at all and have frequent pvcs.  I was chalking it up to the thyroid hormone imbalance but not so sure now.  Also when I do any kind of physical activity, I get ringing in my ears as well as the shortness of breath and muscle weakness.  Do you have any advice? Does this sound cardiac or should I be looking at something else.  I am not satisfied with feeling this way and it has gone on too long.  Also I did have a cardiac catheterization in august of 06 which showed no blockage. I would appreciate your response.

[CCF HeartMD-1]

MVP or mitral valve prolapse is where the mitral valve leaflets prolapse backwards some into the left atrium.  It can be the reason for mitral regurgitation or "leakiness."  I seriously doubt this is the reason for your lower extremity edema unless you have severe mitral regurgitation and by your last echo you had no regurgitation.  I think you should be evaluated by a vascular medicine specialist to make sure your veins are functioning appropriately.  You may have venous insufficiency.  

[rondoo]

I am 5' 10" and 170 lbs. My blood pressure is always on the low side, usually around 100/60.  My pcp prescribed dyazide but I am not taking it.  I want to know what is causing the edema and am also afraid of the dyazide dropping my pressure.  I am going to ask about another echo but had one about a year and a half ago.  Do you know about MVP sundrome or do you think this is a possibility?

[CCF HeartMD-1]

I would definitely have thought this could be due to your thyroid issues also but if your TSH has now normalized then likely not.  Peripheral (lower extremity) edema can be due to multiple issues including venous insufficiency (leaky veins), heart failure, liver disease/cirrhosis, thyroid problems or abdominal issues.  As you can see, there are many causes.  However, in combination with shortness of breath with exertion, I would always want to rule out heart disease or issues first.  I would make sure you have had a recent echocardiogram and at the same time get an assessment of your exercise or functional capacity by making it a stress echocardiogram to evaluate your valves, rule out ischemia (low blood flow in the coronary arteries) and assess your functional status.  If you snore at night or have daytime sleepiness I would make sure you have been evaluated for sleep apnea.  I cannot necessarily explain the heat intolerance especially if your thyroid is now normal.  Do you mind me asking if your weight is within a normal range for your height and age and is your blood pressure  controlled?  If your stress echocardiogram and basic labs are all normal, then your lower extremity edema could be related to venous insufficiency.  What are your doctors doing for your edema?