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Dr. Andrew Rynne

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Should you trust your gut instincts over your physicians diagnosis?

I am 24 years old and as an infant I was diagnosed with a hole in my heart. My doctor told my parents that surgery wasn t necessary and that eventually the hole in my heart would close on its own which it eventually did. However I have had a slight murmur ever since. It is something that has never caused me any problems. I am very athletic, don t drink or smoke and eat healthy and at my last full physical was told that my health was good. Things changed about two weeks ago. I was lying down and suddenly I felt this sharp stabbing between my breast that lasted for a few seconds before disappearing. Afterwards, I had this strange heavy feeling in my chest that last for at least ten minutes. It was scary but I thought maybe I had gas or something and shrugged it off as nothing to worry about. Then two days later it happened again, only this time once the heavy feeling subsided, I had a feeling I could only describe as strange followed by this very hard forceful heartbeat. At this point I was scared. I made an appointment with a cardiologist when my scary experience turned terrifying. On the morning of my appointment all the same symptoms described above returned only when it was all said and done my heart was beating so fast I thought I was having a heart attack . My boyfriend rushed me to the ER where the cardiologist I made my appointment with worked. After several hours and diagnositc tests he told me that my heart murmur was just aggravated and that sometimes it happens due to overexcersion of excersize and other physical activities. He told me to rest and that I would be fine. However I don t feel fine. In fact I feel awful and I feel as if my doctor missed something. Although I haven t had any incidents since that day I feel tired all the time and my heart is beating slow yet forceful. A friend of mine who is a medical student frightened me the other day when he said it sounded like it was taking all the strength my heart had to keep beating. I m scared about it and unsure what to do. I mean I want to trust my doctor because he is a professional and he knows what he s doing, however I just can t shake the feeling that something is very wrong. Should I seek a second opinion or is it my fear over the original incident causing me to panic over something that I shouldn t be?
Tue, 15 Dec 2009
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  User's Response
I would trust your Physician's diagnosis. The information he obtained would have come from different machines run by different technicians, who would have all been checking for the same types of issues. Medical care is not the result of one Doctor looking at your symptoms and guessing. It is a collaborative effort of all healthcare practitioners and corresponding diagnostic tests. The circulatory system is 1 of the most straight forward systems in the body, and operate very mechanically. An EKG or ECG (electrocardiogram) will show the electrical impulses around your heart. The paths that these impulses take will indicate if other conditions (not related to the electrical path directly) exist as well. Another valued diagnostic test is an echo or echocardiogram. This is an ultrasound of your heart, and will show the heart visually in real time, as well as obtain velocity values of the blood flow throughout the heart. It will determine the cause and quantify the severity of your murmur. There are other tests you could have as well, but these two would be the most relevant given your circumstances. Was the shunt (hole) in your heart an ASD (atrial septal defect) or a VSD (ventricular septal defect)? Both of these would be seen on an echo. It is more likely that your symptoms stem from anxiety from your perceived condition after it was aggravated as your doctor said. If you continue having anxiety (which often presents as cardiac symptoms, among other things) you may speak to your doctor about medication to treat the anxiety (A benzodiazepine for example) or practice breathing exercises, yoga, meditation, etc.) Hope this helps. Good luck and all the best.
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
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