Can hemochromatosis cause cardiac conduction problems?

Question

Hello doctor,

I am a 49-year-old woman. I was diagnosed with hereditary hemochromatosis a decade ago. I have had TSAT in the 80% range since then, and this has been dismissed as irrelevant by my doctor and hospital. Their advice was to wait till I got to Ferritin 400 micrograms per liter and start venesection.

I have been complaining to my general practitioner for years about fluttering heart, left shoulder pain, and borderline high blood pressure on and off, which a cardiologist said was nothing to worry about. I was vivisected at the end of last year with Ferritin at 450 micrograms per liter; now it's down to 30 micrograms per liter.

Ferritin, 50% TSAT. This year, my issues have become worse. I got dizzy when I got out of bed recently, and my heart rate was 37 beats/minute. My diastolic blood pressure drops periodically to the early 60s and 50s, which causes deep fatigue. I cannot squat, and my knees are crunching and clicking. My hip is also bothering me.

My question is, has my condition been mismanaged? I am worried whether my heart conduction system has been damaged due to iron overload, causing bradycardia. They have recently done an ECG, stress test, and echo, and have said it is normal. I still have to get a heart CT scan done. I am confused as to why I am feeling worse this year. My menopause has started too. I woke up last night with heart flutters and slight pressure in the middle of my chest.

I have feelings of mild nausea and lightheadedness, and my hands and feet are sometimes cold to the touch.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and understand your concern. Yes, hemochromatosis may cause conductive cardiac problems. But as such, the present heart rate and blood pressure in the report (attachment removed to protect the patient's identity) you provided are normal.

Yes, sinus bradycardia or sick sinus syndrome may lead to syncopal attacks. Sometimes hypotension or cardiac arrhythmia leads to syncopal attacks. Paroxysmal atrial fibrillation is the most common arrhythmia in atrial hemochromatosis. To diagnose this, you need Holter monitoring of the heart to record the heart's rhythm.

This procedure measures the heart rhythm for 24 hours by placing chest leads. Pressure at the chest's center may also be due to acid reflux or esophageal spasm. So take proton pump inhibitors (PPI) and antacids to get relief. Electrolyte imbalance and hyperthyroidism can also present like this. So please consult your physician or cardiologist and get an ECG (electrocardiogram), thyroid profile, serum electrolyte, and Holter monitoring tests done, and then follow up with reports.

Thank you.