[34F] Evaluation of cardiac and respiratory symptoms with history of congenital heart defect

Question

Should I ask my doctor for a cardiac mri or wait to c a pediatric cardiologist in September

Patient Description

A 34-year-old female with a significant medical history of being born prematurely at six months and undergoing open heart surgery for a congenital heart defect presents with ongoing cardiac and respiratory symptoms. Recent investigations include a CT scan indicating possible left ventricular dysfunction, and an EKG showing sinus tachycardia with non-specific ST-T wave abnormalities suggestive of ischemia. Previous cardiac evaluations in January revealed left and right ventricular enlargement, with no tricuspid regurgitation and EKG changes indicating potential ischemia. The patient also reports obesity, with a height of 4'11" and weight of 159 pounds, exacerbating her symptoms. Physical exertion, such as walking up five flights of stairs, leads to significant breathlessness, chest pain, and exhaustion, necessitating the use of an inhaler. These symptoms and findings suggest a complex interplay of cardiac and possibly pulmonary issues, warranting a comprehensive evaluation to assess for ischemic heart disease, cardiomyopathy, or other complications stemming from her congenital heart disease and lifestyle factors.

Show More

Arora's Assessment

What might be happening

Based on the information provided, you may be experiencing a combination of conditions that are contributing to your symptoms:

  • Congenital Heart Disease Complications: Given your history of being born prematurely and requiring open-heart surgery for a congenital heart defect, it's possible that you're experiencing long-term complications from this condition. Your previous echocardiogram showed left and right ventricular enlargement, which could indicate that your heart is working harder than normal. This could be due to residual effects from your congenital heart disease or surgery, or new heart issues that have developed over time.

  • Obesity: Being overweight can put additional strain on your heart and lungs, making physical activities more challenging and potentially contributing to your shortness of breath and exhaustion.

  • Possible Asthma or other Respiratory Condition: The fact that you use an inhaler and experience shortness of breath with exertion could suggest a respiratory condition like asthma. However, it's also possible that these symptoms are related to your heart condition or obesity.

  • Possible Ischemic Heart Disease: Your EKG showing non-specific ST-T wave changes suggestive of ischemia raises concern for reduced blood flow to your heart muscle, which could be a sign of coronary artery disease.

What you can do

  1. Follow up with your doctor: Given your complex medical history and current symptoms, it's important to continue regular follow-ups with your doctor. They can monitor your condition, adjust your treatment as needed, and order additional tests if necessary.

  2. Lifestyle changes: If you're not already doing so, consider adopting a heart-healthy lifestyle. This includes eating a balanced diet, getting regular exercise (as tolerated and recommended by your doctor), maintaining a healthy weight, and avoiding smoking.

  3. Medication adherence: If you're on any medications for your heart condition, asthma, or other health issues, make sure to take them as directed by your doctor.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Chest pain or discomfort that doesn't go away with rest
  • Severe shortness of breath or difficulty breathing
  • Fainting or loss of consciousness
  • Rapid or irregular heartbeat

Remember, while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare professional.

Show More

5
 Hugs
2
 Comments

Save

7 mo ago

People Also Ask

What are the potential long-term complications of congenital heart disease?

Long-term complications of congenital heart disease can include heart failure, arrhythmias, pulmonary hypertension, and increased risk of stroke. These complications arise because the heart may have to work harder to pump blood, leading to structural changes over time.

How does obesity affect heart and lung function?

Obesity can lead to increased workload on the heart, higher blood pressure, and elevated cholesterol levels, which can contribute to heart disease. It can also reduce lung capacity and lead to conditions like sleep apnea, making breathing more difficult.

What are the symptoms of ischemic heart disease?

Symptoms of ischemic heart disease include chest pain or discomfort (angina), shortness of breath, fatigue, and in some cases, heart attack. These symptoms occur due to reduced blood flow to the heart muscle.

How can asthma or respiratory conditions be distinguished from heart-related symptoms?

Asthma or respiratory conditions typically present with wheezing, coughing, and shortness of breath that may improve with inhalers. Heart-related symptoms often include chest pain, palpitations, and shortness of breath that may not improve with respiratory treatments. A healthcare provider can perform tests to differentiate between these conditions.

2 Comments

Diane#14250

7 mo ago

Your current findings don't seem particularly worrisome, as breathlessness after 5 flights of stairs is relatively normal for a lot for many people and could be explained by a combination of obesity and exercise-induced asthma.

Regarding your question, you could establish care with either a pediatric heart specialist (because they are more used to congenital heart diseases, often times even in adults) or probably more appropriately an adult cardiologist who specializes in congenital disease. For example, a friend is a cardiologist at Boston Children's Hospital but basically only sees adult patient

1
 Hugs
Reply

Billy#7

7 mo ago

The next step would be a cardiac ultrasound (echocardiogram), not an MRI. You want to see the heart function not a still image of the heart. I think you'd want this before September, and it's also a very quick and pretty cheap test

1
 Hugs
Reply

Share your feedback

All Stories

Experiencing symptoms?

Our AI will conduct a medical interview and assess what might be happening. You can also make a post afterwards.

Share your feedback