When to seek cardiololgist w/ newly diagnosed LVH

[stac90]

I am 36 yr old female w/ history of hypertension, hypothyroid, DVT & PE (3 yrs ago). I am overweight and have been trying to lose, but so far have had little success. (still working on it!) Normal check up was 3 wk ago when MD found cause to order ECG which was abnormal. Ordered echo. Findings showed left side enlarged, MD had nurse phone to tell me & to continue Lisinopril & Metoprolol & lose weight w/ follow-up echo in 1 yr. I am concerned b/c of the onset of symptoms that I conveyed to MD prior to testing that may/may not be related. ie fatigue, can't sleep for more than 1 hr. in bed laying down b/c of coughing & shortness of breath and/or frequent indigestion/bloated feeling in chest (that isn't always dependent on laying down), I have a wheezy "smokers cough" when I laugh that has developed over past yr or so & I am not in great shape, but the shortness of breath w/ exertion seems to have increased for me. A couple of times I've had episodes where I have gotten very lightheaded & dizzy & my vision has blacked out partially. Echo results are: RV 2.0cm, LVd 4.5, LVs 2.8, IVS 1.2, LVPW 1.1, FS 38, EF 63, AO 2.6, LA 4.3, LVOT peak velocity 104.3, AV peak vel 122.1, MV peak vel 100.0, PV peak vel 107.6, TV peak vel 59.1, PAP 15.0. Are these symptoms related to this problem, and are the echo results w/ in only slightly over normal? I'm wondering if I should seek a followup w/ cardiologist? My MD has left me w/ a lot of questions that I don't know if I need a specialist to answer or to just try to see her, which will be in 3 mos. Thank you for this service and any help!

[Nikki23]

stac,

You might want to check to see if you are having a reaction to the Lisinopril.  My husband, who has no heart problems, had visual blackouts (and then real ones after a year) - especially after lunch.  Don't ask me why - but it turned out to be the medication and once the doctor tapered him off, he was fine again.  I wish we had known from the beginning that he was sensitive to ACE inhibitors.  Just another thing to recheck.

[stac90]

Thanks for the responses! I appreciate this forum and the advice that people are able to receive! It's so helpful to get some advice from people who are not so close to the situation. The partial black-outs are episodes hard to describe, I get disoriented, feel like I need to grab a wall. There's a black 'fog' that drifts over and I black out momentarily. Not really a dizzy 'spinning' effect, but I lose my balance. People have told me I look flushed or like I've just worked out after it happens. It seems to accompany busy days when I do a lot of activity. Stress? I'm trying to journal symptoms and note a pattern and if they 'cluster' together or if they are random. Don't know what good that will do, but put my mind at ease!

[hbp702]

Get a referral to a cardiologist. Shortness of breath with exertion, shortness of breath and coughing when lying down, dizzyness, lightheadedness and partial vision black outs are very worrisome. If it were me, I would personally be extremely worried about the possibility of CHF and arrythmias which reduce circulation to the brain and/or eyes (vision blackouts).

Sometimes a specialist is what you need.

Just the fact you feel you need to ask whether to see a specialist is good reason to do so.

[~*CaMeO*~]

Would you explain what happens when you have the partial vision blackouts?

[Cleveland Clinic]

stac,

My recommnedations will are not based on the echo numbers you report.  It really is very difficult to interpret isolated numbers on an echo without looking at the study.  

Your symptoms are worrisome but somewhat nonspecific. They really could be from any of your medical problems (persistant hypothyroidism, recurrent PE or HTN) or a combination of all nor none of them in addition to your obesity and deconditioning.

Your best course should be a supervised cardio-fitness and weight loss program with a careful evaluation of your overall medical health by a skilled physician.  It is just as likely that one of your non cardiac health issues is contributing to your symptoms and my best advice would be to find a skilled internist to evaluate these issues carfully.  From what you report, an internist should be able to evaluate you and refer you if they deem necessary.


good luck