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    Suggest treatment for pressure in chest and palpitations while treating low testosterone levels

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Posted on Sat, 28 May 2016 in Hypertension and Heart Disease
Question: I am 36 yr old male having an issue with left chest pressure and some palpitations. my legs also feel weak frequently. I do have Testosterone on the low side and nervous about taking injections based on my research. I recently went to ER and was admitted for one day. they ran the basic blood work, ekg, echo, and a treadmill test. they said they did not test for heart failure on the blood work. I am a little nervous still. would heart failure have shown on the echo or any other test they ran? also should I have this test done?
doctor
Answered by Dr. Ilir Sharka 2 hours later
Brief Answer:
I would explain as follows :

Detailed Answer:
Hello!

Welcome on HCM!

Regarding your concern, I would explain that heart failure is a clinical syndrome and its main complain is shortness of breathing.

It is true that, besides a carefully l physical examination and medical test (chest X ray, cardiac ultrasound,etc.) an impoetant role in HF diagnosis plays also dosing of NT proBNP level.

When it results high, heart failure is much likely to be present.

But even without BNP test, physical exam and especially cardiac ultrasound may be able to detect heart failure.

Your clinical symptomatology is not likely to be related to HF. Probably caused by low testosterone or other alternative reasons.

Nevertheless, I would like to directly review your cardiac ultrasound report, if available (please ulloade it here).

Hope to have been helpful to you!

Feel free to ask me whenever you need!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 18 hours later
thank you for getting back to me quickly. Here is the one I have. Let me know your thoughts.
doctor
Answered by Dr. Ilir Sharka 11 hours later
Brief Answer:
Opinion as follows:

Detailed Answer:
Hello again, dear XXXXXXX

I carefully reviewed your uploaded cardiac ultrasound report and would explain as follows:

Left ventricle is normal (function and dimensions). Left ventricular filling pressures are within normal ranges, so there is no reason that heart failure symptomatology be caused by left heart failure.

Regarding the moderate mitral regurgitation; to further investigate the exact severity degree and potential implication on elevated pulmonary pressures, it could be recommended a trans-esophageal cardiac ultrasound.

From the other side, there is a mild elevation of systolic pulmonary artery pressure (around 38 mmHg) and mild dilation of right ventricle, which raises suspicions on a pulmonary vascular disorder.

Coming to this point, I would recommend performing some additional tests:

- arterial blood gas test,
- pulmonary angio CT,
- pulmonary function test,

to further investigate a pulmonary disorder, which could be implicated in the actual echo report findings and your current clinical symptomatology.

You need to discuss with your attending physician on the above mentioned issues.

I remain at your disposal for any further explanations, in case of further uncertainties.

Feel free to ask me again whenever you need!

Kind regards,

Dr.Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 7433 Questions

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