dizzyness/lightheaded/panick

[jared12]

Hi-
I am 41 years old, exercise frequently, slightly overweight due to muscle mass. I went running last week in 95 degree weather, got my heart rate up to 195. the next day I became extremely dizzy and experienced chest pain along with pressure in left caroid artery. it felt like a panick attack and I thought i was having a heart attack. went to the emergency room, had stress test and echocardiogram with doppler. Doctor said I was fine, all negative test results. I experienced 3 more dizzy, panick, tightness in the chest episodes so i had a 64 slice ct scan. results showed no calcium/ no blockage but my left ventricle had increased substantially since me my last CT of 2 years ago and my lv ejection fract had gone from 58% to 88% since last ct. further, resting systol had gone down to 12%. The radiologist was concerned and believed that I had signs of IHSS. its worth mentioning that at the hospital my Ejection fraction in the echo showed 58% but study read "technically difficult study". Based on the radiologist's comments, I went to a cardiologist and was told "your heart is fine, dont worry, your LV has enlarged because you exercise and the lv ejection of 88% is a good sign. you dont have IHSS because everything else looks fine". yesterday, after 40 minutes on treadmill at 140BPM, as I was coming down, the symptoms occured again. i.e. dizzyness, chest pressure, pallor and slight shaking. Today at my office, i had several minor episodes of dizzyness/foggyness tightness.

Am I having panick attacks or is something going on with my heart that I should look into? I have never had a pannick attack before in my life and have no added stress now that would explain pannick disorder.

why would my lv enlarge substantially in 2 years?, why the difference in EF? is the CT as relaible as he echo?

Thanks for your input and sorry to write such a long question.

Jake

[rockcityaudiouk]

Hi Jared,better to wait to jog when the suns gone down then.
I don't think that these forums will really help you that much.you seem like a no-nonsense kind of guy and you certainly new what tests to go for,after you I think you have had the best.
I think to second what the other poster said,you really need a good second opinion.
one that you can trust,because obviously you don't feel quite right,however obviously your BP is quite raised after work,so obviously if your under stress at work and or home that will not help at all.In answer to your question as long as the 64 slice CT has the latest software and a good operator,then its about the same.
please see this link.Hope this helps and hope you have some rest.
john.
http://bjr.birjournals.org/cgi/content/abstract/81/966/450

[jared12]

Thanks for the post. I live in Florida, its always 95 degrees in the summer (LOL). resting HR upon waking is 58 to 62, BP 117/78. After a day at the office, 78 resting HR 135/90 BP.

I dont take any supplements. I was questioning the veracity of the 64 CT which showed EJ Fr. of 88% at rest, compared to ECG after stress test which showed EF of 55%.

I know the CT is excellent for CAD but is it reliable for EF?

Thanks and take care.

[kevk]

Hi Jared,
I have IHSS / Hypertrophic obstructive cardiomyopathy, I have the same symptoms you have. It does not mean we have the same thing but HCM can be very tricky to diagnose, The average cardio doctor may miss it. If I were you I would want a second opinion just to make sure.
I could not picture running at all, let alone in 95 degree heat.  High blood pressure in your heart can cause Left ventricle hypertrophy without HCM .

[rockcityaudiouk]

PS No-one repeat no-one should be running in 95 degree weather!,
unless your in the Army and training under medical supervision. (and even then its crazy)(many soldiers die  from this)every year!.there is no benefit from this for fat loss either as you will only lose water.(for a short while).electrolyte imbalance can KILL!.so be warned.
take care buddy,
John.

[rockcityaudiouk]

Hi Jared,Im concerned to hear that your having so many CT scans,the radiation factor you should not overlook.Your EF is quite high for an average person but it sounds to me you may be very very fit normally?and you have a lot of muscle mass.so that may be a reason.(this is normally seen in athletes for example.
so a clue would be your resting heart rate,please post it.
two things concern me here.
1.are you lifting very heavy weights to support that muscle?,if you are, then be very cautious until your heart is checked out by a second cardiologist.
2.are you taking any supplements,steroids/or any powders even if you have been taking them for a long time you can develop an allergy.
In any case your cardiologist should have totally reassured you and it appears that they did not.

If you have a cardiologist that your unsure of or even if your unsure you should pursue the best qualified cardiologist that you can afford or your insurance will pay for.
If you had 62 slice CT angiography I can assure you that there is not better diagnostic tool available in the right hands.you should be able to get copy's of your scans and then give them to your new cardiologist.
Failing that they may want to do a myocardial profusion scan on you,however with the CT you had in the right hands,I don't see why they would.
obviously a stress test under medical observation is needed and should be done as yourblood work should be done as well including a C-reactive protein (CRP)

Arterial damage is thought to result from inflammation due to chemical insults. CRP is a general marker for inflammation and infection, so it can be used as a very rough proxy for heart disease risk. Since many things can cause elevated CRP, this is not a very specific prognostic indicator.[5] Nevertheless, a level above 2.4 mg/l has been associated with a doubled risk of a coronary event compared to levels below 1 mg/

best wishes,John. PS post your resting heart rate.(important.)

[BionicBabe]

I'd get a second opinion from another cardiologist. I don't know if you're having panic attacks or not, but I think you would know. If there is a concern of IHSS (is that the same thing as HCM?) then you should get this checked out until you are satisfied.