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Suggest Treatment For Fatigue, Low BP, Dizziness And Breathlessness
Question: I have a complex history. It goes back as far as to the time I was around sixteen. That was the first time I felt something was "off" with my heart. I had extrasystoles, which doctors said was not dangerous. I also had a partial blockade something, which also was not dangerous. But I became full of anxiety from this, and it made my life a living hell. Everything revolved around my heart. It was not only extrysystoles I felt- after workouts, it was just no normal rythm I felt. And I was admitted to many hospitals during my early life, but noone ever found any problems. Still- at age 40, I have the same things. But the things that bothers me, is that I get winded easily, and my muscles are drained from just walking stairs. I also suffer from relatively low bloodpressure, and get a drop in bloodpressure sometimes just from adrenalin (dentist, driving very fast, etc) or working out, seeing blood, and pain (needle shots etc). I have so many symptoms that its easier to name the diagnoses than the complete list. Cronic fatigue (ME), high metabolism, mercury poisoning, borrelia, b12 low, low D-vitamin status is all diagnoses I can recognize MANY of my symptoms. Also heart "failure". In Norway its called hjertesvikt. Its not that the heart stops, or cardiac arrest, or a heart attack I mean- but what can follow a heart attack when the heart is unable to pump 100 percent.
Now. The weird thing, is that my daughter suffers from the same thing, I am sorry to say. She has no energy, low bloodpressure, during gym class at school, she has faintet many times when she is too active. Also get VERY dizzy, especially on hot days, if I work and get heartrate up. Must sit down. Some times I do get high heartrate sitting still, and fell I cant breath. Can we have a dialog with someone to tell us what we might help our doctors with, to find out whats wrong with us? PS I never discussed my problems with my daughter. PS. I also have a bit elevated bloodprocent (bloodcount) In Norway it supposed to be under 17, and I am a bit over.
Sorry for the bad English. Very hard to describe everything in another language. Please ask questions, so I can answer and maybe have a dialog. This is very fruystrating. So scared of the bloodpressure drop and all other things, that when I suffered appendicitis, I refused to operate and they treated it with antibiotics instead. Might be to some degree anxiety, but the anxiety comes from the physical problems- not the other way around.
Now. The weird thing, is that my daughter suffers from the same thing, I am sorry to say. She has no energy, low bloodpressure, during gym class at school, she has faintet many times when she is too active. Also get VERY dizzy, especially on hot days, if I work and get heartrate up. Must sit down. Some times I do get high heartrate sitting still, and fell I cant breath. Can we have a dialog with someone to tell us what we might help our doctors with, to find out whats wrong with us? PS I never discussed my problems with my daughter. PS. I also have a bit elevated bloodprocent (bloodcount) In Norway it supposed to be under 17, and I am a bit over.
Sorry for the bad English. Very hard to describe everything in another language. Please ask questions, so I can answer and maybe have a dialog. This is very fruystrating. So scared of the bloodpressure drop and all other things, that when I suffered appendicitis, I refused to operate and they treated it with antibiotics instead. Might be to some degree anxiety, but the anxiety comes from the physical problems- not the other way around.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome back on HCM!
I carefully read your question and reassure you that your symptoms are not related to any cardiac disorder.
If I were your doctor, I would recommend you not to trust too much on every thing you read on the internet. The information is very wide and everyone can find himself complaining of symptoms present in different disorders. This is a common phenomena ind students of medicine in their first years.
But this also happens to anxious persons, who try to find a connection between their symptoms and any possible disorder.
Anxiety seems to be a big contributor to your symptomatology.
A chronic anemia and orthostatic intolerance could also be related to your problems.
The fact that your daughter has the same symptoms could indicate an orthostatic intolerance (probably genetic) and a low blood pressure. Hereditary chronic anemia should also be taken into consideration.
Your elevated erythrosedimentation (I suppose you are calling it bloodcount), could be related to chronic anemia or inflammation. Anyway, it can be higher in different disorders (even dehydratation).
I recommend performing a Head Up tilt test to rule in/out possible orthostatic intolerance, tests for chronic anemia (complete blood count, ferritene and hemosiderine levels).
I would also advise you to closely monitor your blood pressure and refer the values to your doctor.
Meanwhile, I would recommend you and your daughter to take plenty of fluids to avoid dehydration, avoid prolonged standing up position, straining physical activity, staying in hot places or with high humidity, as it seems that you are sensitive persons to extreme environmental conditions.
Thyroid hormone levels are needed to exclude possible thyroid dysfunction in both of you. Some thyroid disorders can be hereditary.
Hope you will find this answer helpful!
Wishing all the best for this New Year!
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome back on HCM!
I carefully read your question and reassure you that your symptoms are not related to any cardiac disorder.
If I were your doctor, I would recommend you not to trust too much on every thing you read on the internet. The information is very wide and everyone can find himself complaining of symptoms present in different disorders. This is a common phenomena ind students of medicine in their first years.
But this also happens to anxious persons, who try to find a connection between their symptoms and any possible disorder.
Anxiety seems to be a big contributor to your symptomatology.
A chronic anemia and orthostatic intolerance could also be related to your problems.
The fact that your daughter has the same symptoms could indicate an orthostatic intolerance (probably genetic) and a low blood pressure. Hereditary chronic anemia should also be taken into consideration.
Your elevated erythrosedimentation (I suppose you are calling it bloodcount), could be related to chronic anemia or inflammation. Anyway, it can be higher in different disorders (even dehydratation).
I recommend performing a Head Up tilt test to rule in/out possible orthostatic intolerance, tests for chronic anemia (complete blood count, ferritene and hemosiderine levels).
I would also advise you to closely monitor your blood pressure and refer the values to your doctor.
Meanwhile, I would recommend you and your daughter to take plenty of fluids to avoid dehydration, avoid prolonged standing up position, straining physical activity, staying in hot places or with high humidity, as it seems that you are sensitive persons to extreme environmental conditions.
Thyroid hormone levels are needed to exclude possible thyroid dysfunction in both of you. Some thyroid disorders can be hereditary.
Hope you will find this answer helpful!
Wishing all the best for this New Year!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I don't know if you got my follow-up question or not. So I write again.
Thank you for answering .
In your opinion there is nothing wrong with my heart, based on the all-clear from resting ECG, 24 hrs ECG and ultrasound?
Even with symptoms like low bloodpressure, heavy arms when winded or active, the muscles that runs out of power after very short stairs or running, dizziness when I get active like with housepainting or other work? Can it be related to something else- that makes it feel like the heart?
You mention Thyroid. My mother had problems with that, and had a operation. A month later she had a big heart attack, but survived. Out of the blue. Slim, non-smoker in her 60s.
I understand anxiety can play a part. But I can seperate the two. The anxiety is where I wont go on planes, do operations, do fun stuff that gives me adrenalin, because it all may result in bloodpressure drop- and I avoid it for everything in the world.
It has to be something- since my daughter that never knew of my problems, has the exact same issues. Heritage?
Is there any thing we can do about it, or just live life like this?
Also wondered. I have pain in my jaw. Especially when its cold outside which it is now in Norway. I heard that can be related to certain things like Angina. I also am familiar with chestpain, and pain in left arm, but it might be muscular or something. My bloodcirculation is bad too. Always cold feet, and they tend to be moist.
I need to be assured the heart and cardio veins are okay, can I trust the tests? The Calcium Score? Its hard to live like this- the physical symptoms. The anxiety too, but that is managable- its the bloodpressure drops, the various pains I link to heartdesease, and the total lack of fitness or capability to do physical stuff like running etc without getting unwell.
I thank you for responding.
Thank you for answering .
In your opinion there is nothing wrong with my heart, based on the all-clear from resting ECG, 24 hrs ECG and ultrasound?
Even with symptoms like low bloodpressure, heavy arms when winded or active, the muscles that runs out of power after very short stairs or running, dizziness when I get active like with housepainting or other work? Can it be related to something else- that makes it feel like the heart?
You mention Thyroid. My mother had problems with that, and had a operation. A month later she had a big heart attack, but survived. Out of the blue. Slim, non-smoker in her 60s.
I understand anxiety can play a part. But I can seperate the two. The anxiety is where I wont go on planes, do operations, do fun stuff that gives me adrenalin, because it all may result in bloodpressure drop- and I avoid it for everything in the world.
It has to be something- since my daughter that never knew of my problems, has the exact same issues. Heritage?
Is there any thing we can do about it, or just live life like this?
Also wondered. I have pain in my jaw. Especially when its cold outside which it is now in Norway. I heard that can be related to certain things like Angina. I also am familiar with chestpain, and pain in left arm, but it might be muscular or something. My bloodcirculation is bad too. Always cold feet, and they tend to be moist.
I need to be assured the heart and cardio veins are okay, can I trust the tests? The Calcium Score? Its hard to live like this- the physical symptoms. The anxiety too, but that is managable- its the bloodpressure drops, the various pains I link to heartdesease, and the total lack of fitness or capability to do physical stuff like running etc without getting unwell.
I thank you for responding.
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello again!
Thank you for the additional information!
I would like to explain that I just said that your symptoms are not related to cardiac ischemia.
Nevertheless, an orthostatic intolerance (including POTS) should be excluded. A head up tilt test would be needed to rule out/ in this disorder.
Regarding your mother's medical history, I would explain that thyroid problems can be treated with drugs first, before considering any interventions. From the other hand, her death may be related to different disorders (like heart attack, lifethreatening cardiac arrhythmi). But you should know that it is important diagnosing as early as possible thyroid problems and treating them properly to avoid possible complications (like heart failure or cardiac arrhythmia). So I strongly recommend you to perform thyroid hormone levels.
Regarding the pain on your jaw, I recommend consulting your your dentist for a careful physical examination of your temporo-mandibulary junction. It may be related to changes of temperature or atmospheric pressure, when you go out in the cold weather. But it doesn't seem related to myocardial ischemia. I agree with you that this is a common symptoms in ischemic cardiac disease, but all your performed tests have excluded this possibility.
As you have no cardiac risk factors and no suspicions of cardiac ischemic disease are raised, a coronary CTA (including total coronary calcium score) would not be the first test of choice to be done in your clinical situation.
Instead, I would recommend an exercise cardiac stress test.
If there is a sufficient suspicion for inducible cardiac ischemia during the stress test, than further clinical investigations would be helpful.
Coming to this point, one of the following tests would be necessary:
a-cardiac stress echo
b-coronary angio CT (including total coronary calcium score)
c-nuclear perfusional cardiac stress test
Nevertheless, I still insist that your symptoms are not related to cardiac ischemia.
So relax! You have nothing to worry about!
Hope you will find this answer helpful!
If you have any other uncertainties you can ask me directly at any time at the link below:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765
Greetings!
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello again!
Thank you for the additional information!
I would like to explain that I just said that your symptoms are not related to cardiac ischemia.
Nevertheless, an orthostatic intolerance (including POTS) should be excluded. A head up tilt test would be needed to rule out/ in this disorder.
Regarding your mother's medical history, I would explain that thyroid problems can be treated with drugs first, before considering any interventions. From the other hand, her death may be related to different disorders (like heart attack, lifethreatening cardiac arrhythmi). But you should know that it is important diagnosing as early as possible thyroid problems and treating them properly to avoid possible complications (like heart failure or cardiac arrhythmia). So I strongly recommend you to perform thyroid hormone levels.
Regarding the pain on your jaw, I recommend consulting your your dentist for a careful physical examination of your temporo-mandibulary junction. It may be related to changes of temperature or atmospheric pressure, when you go out in the cold weather. But it doesn't seem related to myocardial ischemia. I agree with you that this is a common symptoms in ischemic cardiac disease, but all your performed tests have excluded this possibility.
As you have no cardiac risk factors and no suspicions of cardiac ischemic disease are raised, a coronary CTA (including total coronary calcium score) would not be the first test of choice to be done in your clinical situation.
Instead, I would recommend an exercise cardiac stress test.
If there is a sufficient suspicion for inducible cardiac ischemia during the stress test, than further clinical investigations would be helpful.
Coming to this point, one of the following tests would be necessary:
a-cardiac stress echo
b-coronary angio CT (including total coronary calcium score)
c-nuclear perfusional cardiac stress test
Nevertheless, I still insist that your symptoms are not related to cardiac ischemia.
So relax! You have nothing to worry about!
Hope you will find this answer helpful!
If you have any other uncertainties you can ask me directly at any time at the link below:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765
Greetings!
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Doctor.
But:
As I wrote, my mother did not die- she survived the heart attack.
You say:The fact that your daughter has the same symptoms could indicate an orthostatic intolerance (probably genetic) and a low blood pressure. Hereditary chronic anemia should also be taken into consideration.
But doesn't Anemia mean a LOW bloodpercent? I wrote that I do have a elevated (high) bloodpercent.
Am I misunderstanding something?
But:
As I wrote, my mother did not die- she survived the heart attack.
You say:The fact that your daughter has the same symptoms could indicate an orthostatic intolerance (probably genetic) and a low blood pressure. Hereditary chronic anemia should also be taken into consideration.
But doesn't Anemia mean a LOW bloodpercent? I wrote that I do have a elevated (high) bloodpercent.
Am I misunderstanding something?
Brief Answer:
My opinion as follows:
Detailed Answer:
Hi again!
I am sorry for the misunderstanding!
I asked what do you mean by blood count, as the value you refered is a little strange. Do you mean erythrosedimentation rate or Hemoglobin?
If it is Hemoglobin, you are right: this would indicate polyglobulia (the opposite of anemia) and in such case further investigations should be done for possible causes of secondary or primary polyglobulia (living in the high altitude, pulmonary disease, etc.).
I still insist in performing a Head Up Tilt test to exclude orthostatic intolerance and thyroid hormone levels.
Kind regards,
Dr. Iliri
My opinion as follows:
Detailed Answer:
Hi again!
I am sorry for the misunderstanding!
I asked what do you mean by blood count, as the value you refered is a little strange. Do you mean erythrosedimentation rate or Hemoglobin?
If it is Hemoglobin, you are right: this would indicate polyglobulia (the opposite of anemia) and in such case further investigations should be done for possible causes of secondary or primary polyglobulia (living in the high altitude, pulmonary disease, etc.).
I still insist in performing a Head Up Tilt test to exclude orthostatic intolerance and thyroid hormone levels.
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Okay, no its easy to misunderstand. Yes it is Hemoglobin. Its a bit high, my doctor says its not high enough to be alarming. I am a smoker so might be the reason?
But pulmonary? Is that lunge problems? I do have some trouble breathing at times, especially when active. Kind of strangeling feeling and a "noise" from my throat. But lunges are very fine they say at hospital. I did a test where I breath as hard as I can into some machine, and it was good they said.
I will ask my doc about the orthostatic intolerance. Might something be done to make that better?
And thyroid testing too.
Hope this will help!
Thank you for a magnificent service.
But pulmonary? Is that lunge problems? I do have some trouble breathing at times, especially when active. Kind of strangeling feeling and a "noise" from my throat. But lunges are very fine they say at hospital. I did a test where I breath as hard as I can into some machine, and it was good they said.
I will ask my doc about the orthostatic intolerance. Might something be done to make that better?
And thyroid testing too.
Hope this will help!
Thank you for a magnificent service.
Brief Answer:
There are different treatment for these disorders.
Detailed Answer:
Hi again!
Yes, the fact that you are a chronic smoker could explain a higher Hemoglobin. From the other hand if you live in a higher altitude, this would be another explanation.
But I would exclude a pulmonary disorder, based on your performed respiratory function tests, which have shown a normal respiratory function and normal lungs.
Regarding orthostatic intolerance there are different ways to be treated (pharmacological and non pharmacological). Performing a lot of physical activity (aerobics, etc.) and increasing salt and caffeine intake would be helpful.
Thyroid dysfunction, if detected in your tests, could be treated too (there are different medication, based on the type of thyroid dysfunction).
Hope to have fulfilled all your expectations!
If you have any other uncertainties, you can ask me directly at any time at the link below:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765
Best wishes,
Dr. Iliri
There are different treatment for these disorders.
Detailed Answer:
Hi again!
Yes, the fact that you are a chronic smoker could explain a higher Hemoglobin. From the other hand if you live in a higher altitude, this would be another explanation.
But I would exclude a pulmonary disorder, based on your performed respiratory function tests, which have shown a normal respiratory function and normal lungs.
Regarding orthostatic intolerance there are different ways to be treated (pharmacological and non pharmacological). Performing a lot of physical activity (aerobics, etc.) and increasing salt and caffeine intake would be helpful.
Thyroid dysfunction, if detected in your tests, could be treated too (there are different medication, based on the type of thyroid dysfunction).
Hope to have fulfilled all your expectations!
If you have any other uncertainties, you can ask me directly at any time at the link below:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765
Best wishes,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much.
I also wonder what to ask my doctor about, when it comes to respitory problems.
As I said, I have been breathing in to a device, I think its called spirometry. It was good results- but when testing, I didnt feel any trouble breathing.
The feeling I get, is that it is narrowing around the XXXXXXX apple, kind of squeezing and tight feeling. It makes it harder to breath IN, but out is fairly easy although there is a small hissing noise. Not really noise from chest, but from throat.
If I try to swallow the mucus, it feels like it goes a bit down but stops, and comes a bit back up haha. It is really hard to explain. But my throat definately gets tight, and it does affect my breathing. Since I have so many symptoms from the heart, and nervous system, I have not dared to try my mothers asthma medicin (she has asthma).
My doctor never looked into my throat, but just thought it could be acid from the stomac leaking up, and then some reaction in the throat.
I have been thinking allergy, of course heart failure, and asthma- maybe the form one gets only when active? But i thought asthma was trouble breathing OUT?
It can resemble beeing choked.
Thank you
I also wonder what to ask my doctor about, when it comes to respitory problems.
As I said, I have been breathing in to a device, I think its called spirometry. It was good results- but when testing, I didnt feel any trouble breathing.
The feeling I get, is that it is narrowing around the XXXXXXX apple, kind of squeezing and tight feeling. It makes it harder to breath IN, but out is fairly easy although there is a small hissing noise. Not really noise from chest, but from throat.
If I try to swallow the mucus, it feels like it goes a bit down but stops, and comes a bit back up haha. It is really hard to explain. But my throat definately gets tight, and it does affect my breathing. Since I have so many symptoms from the heart, and nervous system, I have not dared to try my mothers asthma medicin (she has asthma).
My doctor never looked into my throat, but just thought it could be acid from the stomac leaking up, and then some reaction in the throat.
I have been thinking allergy, of course heart failure, and asthma- maybe the form one gets only when active? But i thought asthma was trouble breathing OUT?
It can resemble beeing choked.
Thank you
Brief Answer:
Your symptoms are not related to asthma or heart failure.
Detailed Answer:
Hello again!
As I already explained before as your respiratory function tests (spirometry) have resulted normal, any pulmonary disorders (including asthma) has been excluded.
In case you suffered from asthma, this test would have resulted abnormal, compatible with asthma pattern of respiratory dysfunction. But this didn't happen in your case.
So relax!
Your symptoms seem to be related to anxiety or to esophageal spasms. These disorders could explain the sensation of chocking and tightness in your chest.
I would exclude any possible allergic reaction or heart failure. Allergy is associated to other signs like itching, running nose, etc. While heart failure has been exluded by all your performed cardiac tests.
I would recommend trying alprazolam 0.5mg if this sensation occurs. It is a benzodiazepine which is very helpful against anxiety, but as they have a low myorelaxant effect, it can help relax muscular contractions too.
Hope you will find this answer helpful!
Greetings!
Dr. Iliri
Your symptoms are not related to asthma or heart failure.
Detailed Answer:
Hello again!
As I already explained before as your respiratory function tests (spirometry) have resulted normal, any pulmonary disorders (including asthma) has been excluded.
In case you suffered from asthma, this test would have resulted abnormal, compatible with asthma pattern of respiratory dysfunction. But this didn't happen in your case.
So relax!
Your symptoms seem to be related to anxiety or to esophageal spasms. These disorders could explain the sensation of chocking and tightness in your chest.
I would exclude any possible allergic reaction or heart failure. Allergy is associated to other signs like itching, running nose, etc. While heart failure has been exluded by all your performed cardiac tests.
I would recommend trying alprazolam 0.5mg if this sensation occurs. It is a benzodiazepine which is very helpful against anxiety, but as they have a low myorelaxant effect, it can help relax muscular contractions too.
Hope you will find this answer helpful!
Greetings!
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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