Know How iCliniq's Doctor Helped a Woman With Heart Symptoms and Autoimmune Disorders

A 34-year-old female experiencing shortness of breath and increased heart rates for the past year consulted a cardiologist on iCliniq.com. She also had palpitations and had been feeling extremely tired. She was diagnosed with Hashimoto's thyroiditis, and treatment helped bring her thyroid levels back to the normal range. The local doctor asked her to get an echocardiogram, which showed mild mitral prolapse. The ECG (electrocardiogram) showed a right bundle branch block, which was diagnosed many years back. The 24-hour Holter showed an increased heart rate. She also got a chest CT to rule out any problems with her lungs. As the CT showed some pericardial effusion, she was put on steroids. The patient felt a little better after completing the steroid therapy. But after a week, her symptoms gradually worsened. She could hear her heartbeat in the form of clicks and squeaks easily without a stethoscope, and it was louder through her mouth. She recorded these sounds by holding her phone next to her mouth and sent it to our doctor. She also informed him that her blood pressure had significantly decreased since these symptoms started. After reading the patient's complaint and hearing the attached audio, our doctor explained that her initial symptoms of shortness of breath, palpitations, and tiredness were likely related to thyroid disease. Pericardial effusion could have multiple causes, but as the patient was young and had thyroid disease, he suggested testing for connective tissue disorders. He also said that any other condition causing hyperdynamic circulation, such as anemia, vitamin B deficiency, and thyroid disease, could cause such symptoms. He suggested she repeat the echocardiography and thyroid test and start beta-blockers under her doctor's supervision. If her thyroid and connective tissue disorder reports came back normal, then these symptoms could be correlated with mitral valve prolapse. The patient was grateful for the doctor's detailed answer. She attached her stress echo result and wanted the doctor to comment on it. As her next appointment with her cardiologist was after a month, she wanted our doctor to help her with the next steps. She also asked if she could have sarcoidosis or some other autoimmune disease, as she was already diagnosed with Hashimoto's thyroiditis and alopecia. The doctor did believe that mitral valve prolapse in the echo test was the cause of her shortness of breath and fatigue. He also thought that sarcoidosis could be the cause. He asked the patient to do a Thallium stress test to reconfirm the abnormalities and a CT coronary angiography and revert with the reports. With autoimmune disorders and some rare diseases often misdiagnosed, the patient was surprised by our doctor's knowledge. She thanked him for his time, and for his helpful and to-the-point answers. She promised the doctor that she would follow-up with the reports.