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Had weakness, excessive sweating and loss of breath. Has pacemaker in heart. Had pneumonia. Suggest

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My husband has had a problem with weakness, excessive sweating and with just minor exertion has a hard time getting his breath. This has been going on now for at least 9 months he has a pacemaker we have seen his heart dr.he sent him to have I think it was called a crystal test to see if he had a blockage, he had pneaunomia and was hospitalized for 3 weeks 2 years ago and had to have surgery to remove the fluid from his lungs. He has seen a pulmonary Dr. & he said his lungs are functioning properly. We have seen his family dr.and he did blood work and sent him to see if he had a blockage in his neck ..he had a small one but not up to 50% we now have another appointment tomorrow to see his family Dr. again because he says he is so week he can hardly go, to see if there is something else he can test him for. My husband says he feels just like he did when he had pneaumonia and was so week he couldn't go. Do you have any insite for us?
Posted Sun, 23 Jun 2013 in General Health
Answered by Dr. Jorge Brenes-Salazar 14 minutes later
Dear patient

thanks for your health concerns. Given the history, the main thing that needs to be ruled out is cardiac disease as the pulmonologist indicates that pulmonary function tests are normal. The function of the pacemaker needs to be checked as sometimes inadequate settings can create what we call pacemaker syndrome with a weak heart muscle. Since the symptoms are exertional, the best course would be to reproduce them with exercise, on a treadmill or recumbent bike, and take a look at the heart with echocardiogram(ultrasound of the heart) to see how it reacts with stress

hope this brings some initial insight wish you the best

Dr Brenes Salazar MD
Mayo Clinic MN
Above answer was peer-reviewed by
Follow-up: Had weakness, excessive sweating and loss of breath. Has pacemaker in heart. Had pneumonia. Suggest 36 minutes later
He had an ultra sound test done when he had the other heart test done that I mention and they said everything looked ok nd as I mentioned early on in my request to you he has seen his pacemaker Dr. and everything is ok according to them that is why I don't know what my next plan of action should be. Is there any kind of test I should ask his GP to send him for? When we explain to the GP his issues they don't seem to be taken serioulsly. Bear in my my husband is 66 he works everyday, he drives an 18 wheeler and unloads the trucks all day long and it is all he can do to get through the day. Up to 9 months ago he didn't have a problem doing this, now just getting up in the morning and dressing and getting out the door he is exhausted and I have to take a towel and wipe down his face neck, arms and chest because he is soaking wet and exhausted from that little exertion, something is not right and we are at our wits end trying to figure it out.
Does any of this info give you insite into his situation?
Answered by Dr. Jorge Brenes-Salazar 45 minutes later
thank you for the additionsl information. there would be a couple of steps that we could have in mind for patients with similar concerns. If the heart ultrasound was performed at rest, it has very little value since we want to look for the changes with exercise. then, as i said an exercise stress echocardiogram would be in order. Another test that would be quite useful is a cardiopulmonary oxygen consumption test in which the patient exercises and you can see both the heart and lung response. If none of that workup is revealing the ultimate test is doing a right heart catheterization to check pressures and oxygen levels of the heart and lungs; even more, those same pressures can br measured as he exercises on a recumbent bike. Exercise induced pulmonary hypertension, exercise induced diastolic dysfunction are very incapacitating entities that only give subtle hints on badic testing and can be unmasked this way

hope that brings further guidance, yours truly
Above answer was peer-reviewed by
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