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Cause of fatigue and Low BP - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Hypertension and Heart Disease
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1773 Questions
User :   Hi. I am 24 years old girl. i had undergone a medical check up 3 and half years back as a mandatory requirement of my profession. my ECG reports showed some problem so i was referred to a cardiologist. he advised Echo. my report showed MILD AR and Trivial MR. other parameters were LA 2.6 cm, LV 4.4 x 2.4 cm , LVPW = 0.9 cm PBF= 0.9M/SEC ABF=2.0M/SEC MVF= E=87 A=77 AVG: PPG = 15mmhg MPG = 7mmhg
conclusions were normal sized chambers, mild AR (? rheumatic)
trivial MR, good LV and RV function
i was given No objection certificate by doc and advised IE prophylaxes.
this test was done when i was away from my parents so some 7 months after this my parents insisted on another test when i met them.
so another reputed hospital gave me these reports
LV ED 42 mm ES 28 mm
IVS ES 13 mm ED 10 mm
LVPW ES 13mm ED 9mm
aortic valve 32 mm LA 33 mm
EF 60%
findings: Bicuspid aortic valve with fused right and non coronary cusps with raphe.
mild AR and no AS
NO LV RWMA global LVEF 60%
no intracardiac clot or mass
no pericardial pathology.
again doc gave me NOC and advised IE Prophylaxis.
i was told to inform my doc before undergoing any medical surgery.
as i belong to non medical background i ws happy enough to get NOC and move ahead. i hadnt shown my previous report to the second doctor. i am just curious to know why there is a difference in the report's parameters???
my BP was fount normal in both the findings but for past 14 or 15 months i am facing a constant low BP and and im having fatigue most of the times. a local physician said that it is because of my low BP which was low in 90s/ 60s.
i have been experiencing a funny heart beat irregularity all of a sudden,some or the other time, which i ruled out as a gastric problem. i get mild fever every now and then specially after physical exertion but again local doc said its because of low BP and fatigue. i was told to do the same
User :   test again every year or in two years.. i have not been telling this to my parents but now as im back home i want to know whether there is anything to b alarmed of?
i had undergone a very minor surgery in JAN this year.
Doctor :   hi
Doctor :   Dr.xx here.
User :   hello Doc xxx
Doctor :   please give me few moments to read what you have typed
User :   sure sir
Doctor :   what was the surgery done for?
Doctor :   did you take the IE prophylaxis both the times?
Doctor :   did you inform your cardiologist before the surgery?
User :   no sir the surgery was done on my nose
User :   it was beacause a small heat boil near my nose had developed pus and the site of the heat boil was under my lips
User :   my whole face was swollen
User :   and because of the pain
Doctor :   the change in readings especially the ejection fraction is suggestive of ongoing problems and that the problems are slowly going on to moderate severity.
User :   doc had to operate
User :   n take out pus
User :   ok
Doctor :   your symptoms at present of fatigue and low BP can be attributed to your heart condition
User :   and i did not take IE
User :   ok
User :   so what should i do next?
Doctor :   the Ar diagnosed results in back flow of blood back into heart when heart attempts to pump it, hence the blood pressure itself falls
User :   i mean i have not been telling all this to anyone
User :   ok
Doctor :   go back ahead with repeat check to see for current status of AR. avoid strenous activities.
User :   ok
Doctor :   if the problem is detected to be moderate or severe, consider getting operated for early and permanent treatment.
User :   ok
Doctor :   and please follow your cardiologist instruction
Doctor :   for taking IE prophylaxis
User :   ya doctor
Doctor :   it prevents you from getting any infection affecting heart and making situations worse
User :   is the difference in those parameters any concern????
Doctor :   the change in readings could be due to infection or increase in severity due to lack of prophylaxis
Doctor :   which later got worse with the surgery without the prophylaxis
User :   these test were done within 7 months of each other
User :   ok
User :   and ya doc lately
Doctor :   yes, the difference is of concern. earlier your EF was 87, later it became 60, if it falls below 40, even surgery will be of less use.
Doctor :   be in regular folow up with cardiologist
User :   ok sir
User :   lately i have finding my heart beating really hard and fast for some 5 to 10 sec and then again going normal
User :   this is after i climb up stairs fast
User :   or run and or may b when i get anxious
User :   but then everything goes normal and i forget
User :   i dont have same
User :   energy
Doctor :   yes it will be exaggerated in your case, avoid activities that give you these symptoms, you are putting extra load on your already extra working heart
User :   left
User :   ok
User :   thanx doc
Doctor :   did you follow what I have said?
User :   yes sir
User :   i would be going for a test in a day or two
Doctor :   do not ignore your heart condition. mild forms are not a contraindication for work
User :   first i have to sit and talk to my parents
Doctor :   but if not taken care, it will affect life severely
User :   and then i would take these reports also
Doctor :   take both reports together
User :   ok
Doctor :   is there anything else you would like to ask me?
User :   no sir tahnx
Doctor :   thanks for consulting me. bye for now.
User :   bye doctor
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