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Suggest Remedy For Anxiety When Diagnosed With CHF
Question: Hello-
If I have spoken to you before- hello again. I am suffering from extreme anxiety (ocd and ptsd) after I was told in October 2014 that I was in CHF, had dilated cardiomyopathy, and would likely have a short life, and sudden death. It turned out I was having 65,000 pvcs a day so it was pvc-induced cardiomyopathy, and after successful ablation in December 2015, my heart function and size returned to normal by January 2015.
Now 7 months later, I am so terrified of recurrence that I cannot function. I am particularly focused on water retention because one of my doctors told me I would always be in danger of going back into CHF. I constantly monitor water intake and output and am terrified, always, that I may not be urinating enough. It is paralyzing me. My cardiologist just tells me I'm cured and being crazy but I feel some clinical explanation of why this is not possible would be helpful because I am so scared.
Specifically- is it possible with normal heart, kidney, and liver function to retain water and quickly go into CHF?
I had my last echo two weeks ago and am so scared that my heart has weakened even in this short time. Is that possible?
My echo 6 weeks ago showed EF of 55-60, and two weeks ago echo showed 65-70. Does this mean EF could be going up or can a different tech/machine make this much difference? Couldn't EF go down that quickly too then, to 45-50? I am trying to not be so focused on numbers but when I had EF of 25-30, I had no symptoms so I feel like the only reassurance I get is through tests.
Also- 6 weeks ago echo showed PASP of 24 and two weeks ago it was 34. My doctor says both numbers are normal and to just stop worrying. Is it normal for PASP to change that much so quickly?
Thank you so much. I am trying to calm
Down so I can be happy and get my life back. It is so hard to believe I'm normal again after being told I would die very soon. How do I start to really believe it when I had no symptoms other than PVCs?
Thank you.
If I have spoken to you before- hello again. I am suffering from extreme anxiety (ocd and ptsd) after I was told in October 2014 that I was in CHF, had dilated cardiomyopathy, and would likely have a short life, and sudden death. It turned out I was having 65,000 pvcs a day so it was pvc-induced cardiomyopathy, and after successful ablation in December 2015, my heart function and size returned to normal by January 2015.
Now 7 months later, I am so terrified of recurrence that I cannot function. I am particularly focused on water retention because one of my doctors told me I would always be in danger of going back into CHF. I constantly monitor water intake and output and am terrified, always, that I may not be urinating enough. It is paralyzing me. My cardiologist just tells me I'm cured and being crazy but I feel some clinical explanation of why this is not possible would be helpful because I am so scared.
Specifically- is it possible with normal heart, kidney, and liver function to retain water and quickly go into CHF?
I had my last echo two weeks ago and am so scared that my heart has weakened even in this short time. Is that possible?
My echo 6 weeks ago showed EF of 55-60, and two weeks ago echo showed 65-70. Does this mean EF could be going up or can a different tech/machine make this much difference? Couldn't EF go down that quickly too then, to 45-50? I am trying to not be so focused on numbers but when I had EF of 25-30, I had no symptoms so I feel like the only reassurance I get is through tests.
Also- 6 weeks ago echo showed PASP of 24 and two weeks ago it was 34. My doctor says both numbers are normal and to just stop worrying. Is it normal for PASP to change that much so quickly?
Thank you so much. I am trying to calm
Down so I can be happy and get my life back. It is so hard to believe I'm normal again after being told I would die very soon. How do I start to really believe it when I had no symptoms other than PVCs?
Thank you.
Brief Answer:
Nothing wrong is happening with your heart.
Detailed Answer:
Hello XXXXX!
IIt's nice to hear from you again!
I am sorry for your persistent anxiety on these cardiac issues.
But, I would be glad helping you to relieve such an unpleasant feeling on possible cardiac disorders.
I would like to explain that water retention is an expression of heart, liver, or renal dysfunction. So, it is quite impossible for that to happen, as all the above mentioned organs are functioning perfectly well. So relax!
Regarding your echo parameters concern, I would repeatedly assure you that all those EF fluctuations are due to interobserver variability, and not to any ongoing pathological process.
This conclusion is supported even by your PASP values. As a general rule, when EF decreases, PASP increases. But it is not the case with your last echos: EF and PASP are increased on the samd direction, confirming tgat this is just an examinations variability, and has nothing to do with a deteriorating heart function.
Hope to have been helpful to you!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
Nothing wrong is happening with your heart.
Detailed Answer:
Hello XXXXX!
IIt's nice to hear from you again!
I am sorry for your persistent anxiety on these cardiac issues.
But, I would be glad helping you to relieve such an unpleasant feeling on possible cardiac disorders.
I would like to explain that water retention is an expression of heart, liver, or renal dysfunction. So, it is quite impossible for that to happen, as all the above mentioned organs are functioning perfectly well. So relax!
Regarding your echo parameters concern, I would repeatedly assure you that all those EF fluctuations are due to interobserver variability, and not to any ongoing pathological process.
This conclusion is supported even by your PASP values. As a general rule, when EF decreases, PASP increases. But it is not the case with your last echos: EF and PASP are increased on the samd direction, confirming tgat this is just an examinations variability, and has nothing to do with a deteriorating heart function.
Hope to have been helpful to you!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr Iliri,
I am quite embarrassed by needing so much reassurance but I cannot relax and always always feel that I am dying, and that my heart is failing again. I cannot forget that I was told that I wouldn't see my baby grow up.
I am in therapy to address the anxiety, and taking anti-anxiety medications but nothing is working very quickly.
Is it not possible for EF to fall in the same way it seemed to go up? You said to go by my clinical condition, but even at EF 25/30, I felt fine. It worries me so much that I can't know for sure that my heart is still ok without an echo. I went to three clinics for drug allergy and none of them found cardiomyopathy. It wasn't found until I saw a cardiologist for my PVCs which I had, on and off for many years and was always told that no number of PVCs could hurt me.
So I have so much trouble trusting what doctors have told me and I have such incredible fear of drinking because I think that the liquid will just get stuck in my body and I will be in CHF.
Can I truly forget about monitoring fluids and just live my life normally? I know I should just be grateful for my recovery but I am so scared to believe I'm normal in case I were to get sick again.
Thank you, Dr. Iliri, I'm sorry to take so much of your time. I wish I could just believe I am normal again but it is so hard for me to let go and trust.
I am quite embarrassed by needing so much reassurance but I cannot relax and always always feel that I am dying, and that my heart is failing again. I cannot forget that I was told that I wouldn't see my baby grow up.
I am in therapy to address the anxiety, and taking anti-anxiety medications but nothing is working very quickly.
Is it not possible for EF to fall in the same way it seemed to go up? You said to go by my clinical condition, but even at EF 25/30, I felt fine. It worries me so much that I can't know for sure that my heart is still ok without an echo. I went to three clinics for drug allergy and none of them found cardiomyopathy. It wasn't found until I saw a cardiologist for my PVCs which I had, on and off for many years and was always told that no number of PVCs could hurt me.
So I have so much trouble trusting what doctors have told me and I have such incredible fear of drinking because I think that the liquid will just get stuck in my body and I will be in CHF.
Can I truly forget about monitoring fluids and just live my life normally? I know I should just be grateful for my recovery but I am so scared to believe I'm normal in case I were to get sick again.
Thank you, Dr. Iliri, I'm sorry to take so much of your time. I wish I could just believe I am normal again but it is so hard for me to let go and trust.
Brief Answer:
I would be glad to be helpful for you!
Detailed Answer:
Hi again dear XXXX!
I know, it is so hard to face with anxiety disorders, But that's why we are here; just to help and support you.
So never feel embarrassed to discuss your fears and uncertainties!
This is a reasonable way to manage your anxiety, and if coupled with a good cognitive behavioral therapy, I think your fears will definitely vanish.
I would like to firmly assure you again about your opportunity to follow a quite normal and healthy life-style and diet without any substantial water retention.
It is my professional conviction and the most reasonable conclusion, to declare you all my above mentioned opinions.
You can keep performing periodically scheduled cardiac ultrasounds, just to be in touch with you current clinical conditions.
Meanwhile, what I stated above regarding LV EF is quite important to remember time after time, as it may help to avoid new uncertainties to perturb your mind.
My best wishes,
Dr. Iliri
I would be glad to be helpful for you!
Detailed Answer:
Hi again dear XXXX!
I know, it is so hard to face with anxiety disorders, But that's why we are here; just to help and support you.
So never feel embarrassed to discuss your fears and uncertainties!
This is a reasonable way to manage your anxiety, and if coupled with a good cognitive behavioral therapy, I think your fears will definitely vanish.
I would like to firmly assure you again about your opportunity to follow a quite normal and healthy life-style and diet without any substantial water retention.
It is my professional conviction and the most reasonable conclusion, to declare you all my above mentioned opinions.
You can keep performing periodically scheduled cardiac ultrasounds, just to be in touch with you current clinical conditions.
Meanwhile, what I stated above regarding LV EF is quite important to remember time after time, as it may help to avoid new uncertainties to perturb your mind.
My best wishes,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr Iliri,
You are so kind and patient, thank you.
I had such a bad panic attack today that I went to ER. Chest xray and echo looked good and all bloodwork was normal but creatinine went from .7 to .8 ans proBNP went from 67 to 71. Do you think these are normal variations or could there be a trend towards bad numbers and worsening kidney and heart function?
Thank you so much.
You are so kind and patient, thank you.
I had such a bad panic attack today that I went to ER. Chest xray and echo looked good and all bloodwork was normal but creatinine went from .7 to .8 ans proBNP went from 67 to 71. Do you think these are normal variations or could there be a trend towards bad numbers and worsening kidney and heart function?
Thank you so much.
Brief Answer:
You are in perfectly normal conditions.
Detailed Answer:
Dear XXXX!
Those lab tests results are perfectly normal; just tiny variations related to a normal body physiology.
If you have further uncertainties, do not hesitate to contact me!
Regards,
Dr. Iliri
You are in perfectly normal conditions.
Detailed Answer:
Dear XXXX!
Those lab tests results are perfectly normal; just tiny variations related to a normal body physiology.
If you have further uncertainties, do not hesitate to contact me!
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much, Dr Iliri. When I had blood tests yesterday, it was late in the afternoon and I hadn't had anything to eat or drink since early morning. Other times I usually have had blood drawn in the morning, shortly after breakfast. Could this account for slight increase in creatinine? I am worried (of course I am) because creatinine was .6 in May, .7 in XXXXXXX and July, and then .8 yesterday so it seems like upward trend. Do I need to keep testing frequently or just let it go as it is all normal range? I don't have any risk factors for kidney disease but as you know I am very very afraid of fluid imbalance.
Thank you!
Thank you!
Brief Answer:
Everything seems to be normal.
Detailed Answer:
Hi XXXX!
All the above values are within normal ranges, so nothing to worry about.
Creatinine level may be influenced by several factors, like diet profile (the amount of meat consumed), physical activity performed prior to blood sample provision, hormonal balance, possible muscle injury, etc.
Because of so many interfering factors, two blood creatinine levels could be hardly the same.
I don't think you should check more frequently creatinine level. Just perform the routine medical check up, as usually scheduled.
Regards,
Dr. Iliri
Everything seems to be normal.
Detailed Answer:
Hi XXXX!
All the above values are within normal ranges, so nothing to worry about.
Creatinine level may be influenced by several factors, like diet profile (the amount of meat consumed), physical activity performed prior to blood sample provision, hormonal balance, possible muscle injury, etc.
Because of so many interfering factors, two blood creatinine levels could be hardly the same.
I don't think you should check more frequently creatinine level. Just perform the routine medical check up, as usually scheduled.
Regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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