Numerous symptoms in 17 year old which appear to point to heart problem

[wanttohelpafriend]

I am a mentor to a 17 year old boy whom I believe has a heart problem.  I have taken him for a free screening for Hypertrophic Cardiomyopathy and the tests were negative.  I have taken his blood pressure and it is normal.  He comes from a poor family who have no health insurance so he has never seen a cardiologist.  I would appreciate any advice you have in terms of what the symptoms I am about to describe could be pointing to.  If there is a specific thing these point to I may be able to pay for him to go to a cardiologist for investigation of that issue.

I am listing the symptoms in what I guess to be most significant/relevant to least significant/relevant.

When he runs really fast he always gets a burning sensation in his heart which does not stop until about 5 minutes after he stops running.  This happens every time he runs really fast, without exception.

Sometimes when he is just sitting down and inactive he suddenly feels short of breath even though he has been in a resting state and not exercising at all.

His left arm frequently suddenly turns red and the veins in his arm pop out noticeably and this is always immediately preceded by a feeling of pressure in his forearm that feels like the blood is trying to get into his arm but it is not able to do so for some reasons.  After about 30 seconds it goes away.  This mainly happens when he is standing up but not exerting himself.

Sometimes when he is walking he suddenly gets dizzy for no apparent reason.

Sometimes his entire torso suddenly feels very hot for no apparent reason. This happens when he is not exerting himself or exercising.

His pupils tend to be more dilated than other people even in a well-lit room.

He has been hospitalized twice for anemia, once when he was 6 and again at age 10, and he is very thin but still very strong for his size.  He is about 5 feet 9 inches tall and weighs about 120.

Thank you for any suggestions you are able to offer.

[wanttohelpafriend]

Thank you very much.

[Darcy Green Conaway, MD]

Hearing your concern about the arm pain and venous swelling makes me think about clots occuring in the veins,impeding flow from the arm to the heart. There is a syndrome called Paget-Schroetter that might be a possibility-- it involves having a deep venous thrombosis (clot) in an upper extremity vein,such as the axillary or subclavian vein. I would think an ultrasound of the extremity would be helpful. These clots can sometimes cause long-term sequelae so I would not blow this off. Pupil dilation can also be seen with clots in the head-- I think he needs to be evaluated immediately as he may have a clotting disorder.