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Excessive fatigue, loss of appetitie, Concerned of a heart failure - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: General Health
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3632 Questions
User :   I have been battling a fatique and lack of appetite problem for a couple weeks now. I have been checked in an ER 4 times in the last month and all test are coming back normal. I recently started seeing a cardiologist and got an echo done and kidney arteries sonogramed. I am ready to check into a phych hospital tomorrow and was wondering if the ER's could pick up if I am in beggining stages of heart failure?
Doctor :   Hi
Doctor :   Please give me a couple of mins to read your query
Doctor :   i just read your query
Doctor :   may i know if your 2D ECHO was normal?
User :   yes
Doctor :   ok
User :   is that the echo done in the cardio's office?
Doctor :   yes
User :   yes
Doctor :   may i know if an ECG was done ?
User :   yes, normal
Doctor :   ok
Doctor :   may i knkow how is your blood pressure ?
User :   140's over 80
Doctor :   ok
Doctor :   did they check your blood sugars ?
User :   ER did
Doctor :   ok
Doctor :   was it normal ?
User :   yes
Doctor :   may i know your age ?
User :   44
Doctor :   ok
Doctor :   may i know if you smoke or consume alcohol?
User :   no
Doctor :   may i know your height and weight ?
User :   5'11 230 lbs
Doctor :   ok
Doctor :   did they test your lipid profile ?
User :   what are some of the early symptoms?
User :   not sure
Doctor :   may i ask you a few more questions ?
User :   yes
Doctor :   apart from fatigue and lack of appetite may i know if you have shortness of breath , palpitations ,excessive seating , chest pain , etc ?
User :   no
Doctor :   ok
Doctor :   since they have done an examination and an echo as well, a heart failure would not be missed
Doctor :   fatigue and lack of appetite could be due to many reasons
User :   so they would of picked up on the exam at hospital
Doctor :   yes
User :   I have severe depression
Doctor :   a heart failure would mean an exitence of the symptoms i mentioned above
Doctor :   ok
Doctor :   since when are you having depression ?
User :   for years
Doctor :   ok
Doctor :   may i know if you are on any medicines?
User :   cymbalta 60mg and xanax3 mg at hs
Doctor :   ok
Doctor :   apart from these are you on any medicines for any other problem?
User :   prilosec
Doctor :   ok
Doctor :   there can be many causes as i mentioned before
Doctor :   i would want to advice on a blood test and a thyroid test too
Doctor :   depression itself could be a likely cause
User :   But all of the checkups and the echo would of picked up heart failure?
Doctor :   yes , heart failure can be picked up in an ECHO
Doctor :   even an ecg can be suggestive
User :   Tyroid was done also
Doctor :   along with a clinical examination
User :   I have been checked 4 times
Doctor :   ok
Doctor :   may i know how is your diet
Doctor :   since your appetite is low , i would want to know about your present diet
User :   is there anything in a blood panel that can indicate heart failure?
User :   I don't eat much
Doctor :   a heart failure is best detected by ecg , echo and an examination
Doctor :   blood tests would not be of much help
User :   ecg?
Doctor :   ECG ids the base line investigation
Doctor :   it will detect changes of a heart failure
User :   ekg?
Doctor :   yes
User :   Had 4 of them
Doctor :   OK
Doctor :   since the doctors have not diagnosed it to be a heart failure you need to worry about the heart failure
User :   ?
User :   not to worry you mean
Doctor :   i meant you need not worry
Doctor :   the possibility of a heart failure is very unlikely
Doctor :   you do not have the symptoms which i mentioned earlier and your reports too are not indicative of it
Doctor :   i suggest you review the reports with a general physician
User :   Why am I so fatigued then
Doctor :   and if everything is normal, review your medicines form the psychiatrist
Doctor :   is your hemoglobin level normal?
User :   i believe so. is that part of a normal panel?
Doctor :   yes it is
User :   Everything normal
Doctor :   anemia is a common cause of fatigue and loss of appetite
Doctor :   if everything is normal , i would attribute this to your depression
User :   ok
Doctor :   i feel a review must be taken on your condition and medicines may be altered
User :   ok
Doctor :   if you were to have symptoms and changes in any of the reports i would have thought of other causes
User :   like
Doctor :   like thyroid , anemia, infection
User :   ok
Doctor :   heart problems like valve disorders, heart failure , diabetes , etc
User :   Is it also true that your HR gets rapid with heart failure
User :   legs swell up
Doctor :   yes , it is possible during the initial stages for the heart rate to pace up
Doctor :   swelling of legs could happen in heart failure, anemia, kidney and thyroid abnormalities
User :   It was 75 ealier this evening
Doctor :   a heart rate of 75 bpm is not worrying , its normal
User :   ok thnks
Doctor :   so do not worry about it
Doctor :   i would suggest you to eat on time
Doctor :   and drink lots of fluids
User :   just when I don't something will be wrong
Doctor :   small frequent meals at regular intervals will be helpful
Doctor :   it will slowly increase your appetite
User :   force feed?
Doctor :   no , i meant frequent small meals
Doctor :   may i know if you exercise daily ?
Doctor :   how is your physical activity ?
User :   I get hunger pains but have no desire to eat
Doctor :   ok
Doctor :   prilosec will be helpful
Doctor :   as your on Prilosec , continue it
User :   Last summer I walked 3 to 4 miles a day
Doctor :   ok
Doctor :   what about your exercise now ?
User :   no
Doctor :   i suggest you walk for 30 mins at least daily
User :   ok
Doctor :   this would be really helpful for depression nd the other symptoms of fatigue as well
Doctor :   may i know if you get good sleep ?
User :   no
Doctor :   for how many hours do you usually sleep
User :   don't sleep well at all
User :   6
Doctor :   that may be one of the reason for lack of appetite and fatigue
Doctor :   you must sleep for 8 hrs
Doctor :   the body and mind needs enough rest to get fresh the next day
User :   ok
Doctor :   else one would feel fatigued
Doctor :   express this to your psychiatrist at your next consultation
Doctor :   so that the medicines would take care of this too
User :   you really helped out tonight
Doctor :   pleasure here
User :   I have obsessive/compulsion disorder with my health
Doctor :   hope i was of some help
Doctor :   i understand your worry
Doctor :   OCD can be stressful
Doctor :   do not think a lot in terms of heart and other things since you say your reports are normal
User :   always taking my BP
Doctor :   there is no need to worry for now
User :   ok
Doctor :   hope i answered all your queries
Doctor :   thanks for consulting me
User :   yes
Doctor :   wish you good health
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