Hi, and thank you for being here for my question. Basic info: I'm 45, 5'4", 201 lbs. I had an appointment with my internist today and told her about some recent heart symptoms I have been having, and she dismissed them, saying I was "intellectualizing" them. This is what I told her, and what I have been feeling: Three to four times per week, when I lie down to sleep, my heart feels like the blood inside is gurgling, and it makes me think of the health shows I've seeon on TV where they show the blood regurgitating back inside an atria, etc., depending on the location of the blood flow. It just doesn't feel like the blood inside my heart is flowing efficiently, like it's sluggish and gurgling. My heartbeat seems sluggish and slow at the same time, too. She said that people can't feel the blood flow inside their hearts, and that I was intellectualizing, and she couldn't do anything with my description. I think that the words "sluggish," "gurgling" (blood sensation), and "sluggish" and "slow" heartbeat were very telling. Maybe I'm not feeling the actual path of blood flow through my heart, but I'm certainly feeling something, and I don't think it's healthy, and it shouldn't be swept under the rug. Also, I have been EXTREMELY fatigued, sometimes to the point that I have to stop after climbing 4 or 5 stairs and rest for a couple of minutes (this has NEVER happened). Throw this into the mix: 3-4 times per week my cheeks and neck flush, usually at night, and they are so hot that the first couple of times I thought I had a fever (started a couple of weeks ago). One strange thing about my temp is that it's usually in the 97's and continued to be during the flushes. FYI, in my mid-twenties, my doctor said he could barely hear a mitral valve prolapse, but if I lived a healthy life, it shouldn't be a problem. I haven't lived a very healthy life (no drug abuse, just haven't eaten very well, and have had Major Depression since early 30s and it's taken it's toll). So since my internist won't help, even to rule trouble out, I now have only the internet to turn to. I'm SO glad there's the Cleveland Clinic here! Can you help? In my Google travels, I've run across mitral valve regurgitations, etc., but no information as to if one can feel them, and what a gurgling blood feeling might be. By the way, I'm lying on my back when this happens, I was just diagnosed with diabetes (borderline) today, and about 6 weeks ago, had a bad chest cold to the point where my lungs weren't just wheezing, they were singing!! -- my sternum even hurt (lasted about a week) (didn't go to the doctor). Minor symptoms have dragged on ever since up to last week (nose, ears, throat), but they seem to be gone now. I thought the heart and flushing symptoms might be related to the cold (since it dragged on, though minor, for the last 7 weeks), but my internist today didn't let me get that in edgewise. I'm not overly frightened, but definitely concerned. Hope you can help! I don't know where else to turn. If you need more info, please let me know. I am so very thankful, Julie
Just to clarify, I trained at the Cleveland Clinic but am now in private practice in North Carolina. The Heart forum questions are answered by people currently at the Cleveland Clinic.
I am not sure what to think about the gurgling either --- that is more likely to be GI related. You can't feel blood flow in the heart.
If you saw a cardiologist with the symptoms of shortness of breath that you describe, an echocardiogram would probably be ordered and answer the question of if the heart function is normal and if the valves leak.
I cannot think of one unifying diagnosis to explain all the symptoms you describe, but heart problems could explain the shortness of breath. An echocardiogram would answer the question. You will have to check to see if your insurance allows you to refer yourself to a cardiologist or if you need your primary care doctor.
The flushing feeling you have may be the hot flashes of perimenopause. I had them for years before I finally finished my cycles. Very interesting sensation. I'm not thrilled about your doctor's response. Perhaps you could go for a second opinion, someone that doesn't have a history with you, hasn't formed any biases. Maybe the gurgling feeling is stomach related. When you lie down the organs could be pushing upward and putting pressure on your stomach and esophagus. Extra weight (not nagging here) will do that. I'm glad your bad cold cleared up on its own. The doctor will have some good answers for you.
Hi ireneo, Thanks for commenting. I'm on estrogen already (since last Nov) because of having been CONSTANTLY hot, not just flashes. I grew up near Palm Springs, so I know what 130 degrees feels like, and it felt like that ALL of the time during November in San Francisco. It's taken the strongest Vivelle Dot transdermal patch, 0.1, plus 1mg of Estrace to quell the heat. The weight came on with the estrogen, as did hideous acne. The acne turned out to be because of sky-high testosterone, 103 when the high range was 45. I was put on a med that blocked the testosterone, which worked for the acne, and have been waiting to get in to see a endocrinologist. The rapid weight gain (50 lbs over 2 months, no change in diet), + testosterone is acting like polycystic ovary syndrome (PCOS), but I'm too old for it to actually be that, and no one has so far been able to figure it out. Hopefully this repro endocrine guru I've been waiting for can. In the meantime, my testosterone has come back down to normal (why, no one knows) and I'm going to go off of the med for that issue. Thanks for the input. -- And by the way, the dr. I saw was not my normal doctor. I'm looking for a new one and this one was applying for a position in the office I went to. Hopefully, with a bedside manner like hers, she won't get hired and be able to upset, at the least, and damage, at the worst, other people. Thanks again :)
I don't know if I'm allowed to respond -- don't know where to find the Forum Rules for this. If not, please excuse the following.
What came to mind when I read your response is that there is something wrong with the rhythm of my heart when this is going on, and I think that that should be addressed along with the shortness of breath -- it's more like extreme fatigue, absolutely can't move another inch after 4 stairs (haven't had a chance to run out of breath). The gurgling definitely doesn't feel like GI, it's exactly where I feel my heart beating. The gurgling sensation could be a combination of the heartbeats being sluggish and not on rhythm, and I'm just grasping at straws for a description.
With the above, do you come to the same conclusion, an echo?
I have Medicare, and I think they don't care about referrals, it's more the cardiologist who cares about the referral here in San Francisco.
Thanks again (if you are able to answer a second time),
I just posted about 10 minutes ago, but something just occurred to me. I take Inderal LA, 80mg for essential tremor. It puts my blood pressure on the low side, 105/55 - ish. Once in a while it will be even lower, and on those days I can feel really tired (however, I've always been able to get up the stairs!). The sluggish, etc. symptoms I have described all occur when I've just started relaxing to go to sleep, and am on my back. Could this (at least the symptoms at night while lying down) be a low blood pressure issue?
Again, thank you so much for your time and expertise, and have a wonderful holiday!
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