edema

[help30439]

I am trying very hard to trust the medical profession right now, and hope you can aleviate some of my questions.  About 6-8 months ago I started having unusal fatigue, weakness, near syncope and shortness of breath walking up stairs, and general lightheadedness alot.    

I went to a cardiology clinic and had an in-house Cardiolite stress which showed some anterior ischemia, but I'm 60 pounds overweight and the Dr. attributied it to a false positive due to my weight after a very nice cardiac CTA with a calcium score of 0 and agiographically normal vessels..   I also have an echo which showed mild mitral and pulmon. regurgitation,  my EF's were 61% and 59% respectively.  
3 months after these tests, I started having bi lateral edema in both lower legs/ankles, but not so much my feet.   I went to my GP was ran CBC, CMP, Liver panel, and BNP test.   He was no longer concerned.  I then went to another cardiologist for 2nd opinion, he did another echo and again the EF was 61%.  
I then saw a 2nd GP for a fresh opinion about the edema and he wasn't concerned either, after the normal blood tests.

I've always thought edema was a bad sign of something, but now that all these doctors are not worrying, I'm no longer too worried,  but in the back of my mind I won't why I have it in conjuction with these symptoms, and even as I've been back on a good daily exercise routine and lost 10 pounds in the last 2 months, it's still there.  It's not extreme only about +1 they say, but it never goes away, it's there first thing in the morning too, and my ankles get stiff and feel swolen.
Can you help to alleviate some of my concerns, why is this of no concern to the doctors?  Is it benign, what is likely causing it?
Thanks for your time, I really apprectiate it.

[erijon]

I know I brought this up once before, but this looks like another post by the same person who has asked this question under new screen names so many times in the past month or two. If you are the same person you must really be unwilling to trust doctors as all the ones you've seen and all the doctors that have responded to you on all the different forums here that this question has been asked on have all given you the same answer.

Again, reach out to the members in the heart disease forum, they can help you as well. Also, it seems like this is one person that keeps creating new screen names to ask this question over and over and it is keep others from getting their questions answered as well, which is not fair to them either.

If this is not the same person, please forgive my error. If it is however, please come to the heart disease forum and get some dialog going with the members of that community, they can be a real help as well.

Jon

[Cleveland Clinic]

Having a completely normal echo pretty much rules out cardiogenic edema in most patients.  there are some cases such as constrictive pericarditis where more sophisticated echo testing has to be performed to rule out this condition. The absence of HTN, significant valvular disease and the lack of certain commmon findings on blood tests rule out diastolic dysfuction of the Left ventrilce, a very common cause of LE edema.  Well, if it isn't the heart that causing the swelling in the legs, than what is it.  Another very common cause for LE swelling is obstructive sleep apnea which occurs in obese patients and is typically diagnosed with a sleep study.  Patients with this condition are typically very tired even after a long night sleep, they are frequently sleepy, fall asleep at work or while driving, complain of fatigue and headaches.  Of course kidney and liver disease have to be ruled out with simple blood tests and occasioanlly we rule out LE clots with an ultrasound especially when the swelling is asymetric.  Some of the other common causes of LE swelling are venous insufficiency which is also very common in the obese population.  US of the lower extremity might reveal that.  Finally, standing upright for long period of time has also been linked with lower extremity edema.  In the latter case, the lower extremity usually goes away overnight and gets worse as the day goes on.  Your doctors and myself aren't concerned about your heart as being the cause of the edema.  I think that at this point, depending on your current weight, you might consider pursuing ruling out obstructive sleep apnea.  Otherwise, i would recommend wearing special Compression Stalking that have been shown to help.  You have to be fitted for those by your doctor.  

[Pulseman]

You really need to see a cardiologist ASAP. Edema is a tell tale sign of heart failure. My mother died of heart failure and her only symptom before diagnosis was edema in her legs,

[Me967]

Hi.  I hope you can get some answers to your questions concerning "unusal fatigue, weakness, near syncope and shortness of breath walking up stairs, and general lightheadedness".  Do you also get leg cramps?  Do you notice hot or cold intolerance?  Are your feet, hands or arms and legs normal color?  
I noticed most of focus on test are heart related.  Have they checked out your calcium, iron, B, thyroid, PTA, hsCRP etc. levels?  You might want to ask your doctor.  

Take care and good luck.

[help30439]

PS-  Also, I have been at this weight before and I have never had edema in my life until after I had these symptoms.  Which is why I'm concerned.