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Get chest pain. Feel anemic and fainting. Stress test, Echo normal but Doppler flow suggests impaired lv relaxation. Guide?

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Ok im getting Angina like chest pain for a few months that worsens with stress or exertion. But the doctors dont seem to think anything is wrong with my heart. Im waiting on iron study results and hormone testing to come back. As well as a 48 hr holter result and im wearing a loop recorder for two weeks and i see cardiologist Oct 11.
Yesterday i had a skipped beat feeling which i have always all throughout the day but this time i almost fainted. I was sitting at the table when it happened. My heart wasnt racing or anything. My heart rate speeds up alot at times. A simple walk up the stairs can bring my rate uptp 140-150 sometimes and at average moving around the house its at 125. I just found out im slighly anemic but not sure that can cause my symptoms. Nearly fainting scared me!! If i were to faint would i wake up again? Would they be able to see something life threatening in tests? The following tests ive had are...
Stress test x2 both normal
Echo normal but doppler flow suggests impaired lv relaxation.
Ecg normal
Cta chest normal
Xray normal
Posted Mon, 23 Sep 2013 in Hypertension and Heart Disease
 
 
Answered by Dr. Jorge Brenes-Salazar 25 hours later
Brief Answer:
Unlikely to be blocked arteries

Detailed Answer:
Dear XXXXXXX

Thanks for your query. If both stress tests have been good quality in terms of your physical effort and negative, it is certainly less likely that the symptoms are coming from blocked arteries; such quick increase in heart rate after starting exercise may represent deconditioning, which is a common, probably most common, cause of shortness of breath in clinical practice; furthermore, the relaxation of your heart is not totally normal and this could make symptoms worse. The loop recorder results will be important to rule out an arrhythmia contributing to the symptoms. Good control of your blood pressure and regular exercise are important to recover cardiovascular conditioning; if your body mass index is over 30, weight loss will be quite important as well.

If all the testing from the heart are normal, then exploring other systems that can cause chest pain, such as the lungs, GI tract and structures from the chest wall would be in order. This, in by itself, would be great news.


Yours truly,

Dr Brenes-Salazar MD
Cardiology
Mayo Clinic MN
Above answer was peer-reviewed by
 
Follow-up: Get chest pain. Feel anemic and fainting. Stress test, Echo normal but Doppler flow suggests impaired lv relaxation. Guide? 46 minutes later
My phospates are on the low norm side and rdw high mch low hemoglobin low too. Something seems wrong.
Can impaired lv relaxation be temporary? A mistake? What would cause that?
 
 
Answered by Dr. Jorge Brenes-Salazar 5 minutes later
Brief Answer:
Abnormal extracardiac tests

Detailed Answer:
Dear XXXXXXX

Phosphates usually come from diet, if your diet is normal and we see low phosphates, then we have to think about endocrine (gland) problems such as elevated Para Thyroid Hormone, which can increase calcium levels and lower phosphate levels; also Vitamin D deficiency needs to be entertained. Left Ventricular relaxation abnormalities indeed can change over time, for example, if your blood pressure is high, if you have anemia, etc.

The part of the anemia is definitely not normal; the pattern that you describe is microcytic hypochromic, most consistent with iron deficiency. If confirmed, then a source for the iron deficiency must be pursued. And it can be easily corrected with iron supplementation and elimination of the cause for such deficiency.


Yours truly,

Dr Brenes-Salazar MD
Cardiology
Mayo Clinic MN
Above answer was peer-reviewed by
 
Follow-up: Get chest pain. Feel anemic and fainting. Stress test, Echo normal but Doppler flow suggests impaired lv relaxation. Guide? 21 minutes later
Hi, sorry im female , 40 yes old :-)
My husband is XXXXXXX
Iron studies being done and blood pressure is perfect. I have had so many tests on my heart but noone can find anything other than what i said.
Vit b12 is is 294 would that cause symtoms?
 
 
Answered by Dr. Jorge Brenes-Salazar 4 minutes later
Brief Answer:
Potentially, test methylmalonic acid

Detailed Answer:
Dear Mrs XXXXXXX XXXXXXX

Thanks for clarifying. Indeed, most of the workup of your heart has been reassuring, and we need to think also of "non-cardiac" causes of your symptoms. The best test to rule out a B12 deficiency are methylmalonic acid levels in blood or urine; if normal, the likelihood of functional B12 deficiency is very low; that being said, b12 deficiency indeed can give a sensory neuropathy, and other atypical Symptoms,

Your truly,

Dr B
Above answer was peer-reviewed by
 
Follow-up: Get chest pain. Feel anemic and fainting. Stress test, Echo normal but Doppler flow suggests impaired lv relaxation. Guide? 21 minutes later
Folate?
 
 
Answered by Dr. Jorge Brenes-Salazar 2 minutes later
Brief Answer:
Usually not

Detailed Answer:

Folate deficiency is extremely rare with a normal diet, and does not cause neuropathy but can cause anemia.

Hope this answers your query.

Regards,
Above answer was peer-reviewed by
 
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