ADVERTISEMENT

Q. I have shortness of breath, and I can hear my heart beat loud. Why?

Answered by
Dr. Sapkal Ganeshrao Patilba
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Feb 23, 2021 and last reviewed on: Mar 18, 2021

Hi doctor,

I am a 34-year-old female and have been experiencing shortness of breath and increased heart rates for the past year. I also have palpitations and have been feeling extremely tired. I own and run a farm, so I am very fit, but I have been struggling with physical work due to these problems. During this time, I was also diagnosed with Hashimoto’s thyroiditis, and I am currently taking Levoxyl (Levothyroxine sodium), which has brought all my thyroid levels back to the normal range.

I have talked to a cardiologist, but due to COVID-19, I have not seen him in person. He sent me for an echo (echocardiogram) which was totally normal, and it just showed mild mitral prolapse. The ECG (electrocardiogram) showed a right bundle branch block, which I have been aware of for many years and has never affected me. I wore a Holter monitor for ten days, and all it showed was an increased heart rate, mainly sinus rhythm, PVCs (premature ventricular contraction), and one episode of NSVT (non-sustained ventricular tachycardia).

I went to a rheumatologist a few months later, and she sent me for a chest CT just to rule out any problems with my lungs. It showed that my lungs were totally normal, but it did show some pericardial effusion. She put me on Prednisone and Colchicine. I was unable to continue the Colchicine because it was causing abdominal pain, but I did finish the Prednisone. While on the Prednisone, after about a week, I did notice a marked improvement. I also did not feel exhausted and tired as I did before. I finished the Prednisone about a week ago, and I feel a gradual worsening of my symptoms again.

My main reason for writing to you is to ask about a strange symptom:

There is always a noise of my heartbeat that can be heard easily without a stethoscope, and it is louder through my mouth. It comes in the form of clicks and squeaks, in the exact rhythm of my heartbeat. It is mainly the clicks that are heard with a slower heart rate, but as my heart rate increases, the squeaks also become louder. Is this just something I should ignore, or could it be a sign of something? I did tell the cardiologist this during our phone appointment, but he did not seem to believe me. I have recorded the noises on my phone by holding it next to my mouth. I am hoping I can send them to you. The noise seems to have worsened recently.

I also should mention that since these symptoms began, my blood pressure has significantly decreased. My blood pressure was perfect my whole life, and now it is always low, around 95/47. Not sure if that is relevant or not.

Thank you so much.

ADVERTISEMENT
#

Hi,

Welcome to icliniq.com.

I went through the details you provided. I guess you have described symptoms in chronology.

1.Initial symptoms of shortness of breath, palpitations, and tiredness likely to be related to thyroid disease.

2.Pericardial effusion can have multiple causes. But as you are a young female with thyroid disease, I suggest you do tests for connective tissue disorders.

3. Heartbeat description you provided can occur in mitral valve prolapse. Also, any condition causing hyperdynamic circulation like anemia, vitamin B deficiency, and thyroid disease can cause such symptoms. I suggest you repeat an echocardiography test, thyroid test, and start on beta-blockers under your doctor's supervision.

Thanks.

I hope this helps.

Hello doctor,

Thank you so much for your response.

My thyroid hormone levels have been consistently within normal range since I have been on Levothyroxine. The rheumatologist has done many blood tests for other autoimmune disorders which I believe includes connective tissue disorders. So far everything other than the antibodies for Hashimoto’s has been normal. For your interest here is a recording of the noise my heart makes. I recorded it by holding my phone next to my face.

Thank you again.

#

Hi,

Welcome back to icliniq.com.

I heard the audio (attachment removed to protect the patient's identity). Sounds are because of your mitral valve prolapse. If your thyroid and connective tissue disorder reports are within normal limits then these symptoms can be correlated with mitral valve prolapse.I will suggest a repeat echocardiography (to see any progression) and betablockers trial.

Thanks.

I hope this helps.

Hi doctor,

I had a stress echo performed and the results are as follows. Is it anything to be concerned about? What should be the next step? I cannot get an appointment with the doctor for another month. Could this be the cause for my shortness of breath and fatigue? I am usually a very fit person. If the hypokinesis is not caused by ischemia what might be the cause? I already have two autoimmune diseases (Hashimoto’s and alopecia). Do you think sarcoidosis might be a possibility?

Thank you so much.

#

Hi,

Welcome back to icliniq.com.

I went through the report. Yes this may be the cause for shortness of breath, fatigue. The cause of hypokinesia in your case may be because of coronary arteritis, microvascular disease in arteries, vasospasm in arteries, or metabolic abnormalities in myocardium. These are all theoretical abnormalities and are difficult to diagnose. Sarcoidosis may be the cause, but its usual presentation is with cardiac rhythm abnormalities. Next step is to do stress thallium to reconfirm the abnormalities and to do a CT coronary angiography.

Thanks.

I hope this helps.


Was this answer helpful?

 | 

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!



Related Questions:
Why are palpitations occurring even after pacemaker implantation?

.. have gone through the report that you have provided. He is having the tachycardia-bradycardia syndrome. In this case, the pacemaker avoids his bradycardia episodes only. For his tachycardia episodes, drugs can be given. Sometimes the drug contro...   Read full

What is the prognosis of hypertrophic Hashimoto's thyroiditis?

Right now, usual symptoms of hypothyroidism are present like extreme fatigue, dry hair ... From the details posted it appears as autoimmune hypothyroidism (Hashimotos) ...   Read full

I have chest tightness. Is it caused by trivial mitral valve prolapse?

Hello doctor,I have mild mitral valve prolapse for the past five years ... After echo, I was diagnosed with trivial mitral ...   Read full

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read


Monkeypox Virus - Symptoms, Diagnosis, Treatment, Complications, and Prevention
Monkeypox is a zoonotic viral disease. This virus got its name as it was first noticed in laboratory monkeys in the late...  Read more»
Tomato Fever - Causes, Symptoms, Diagnosis, Treatment, and Prevention
Tomato fever is an unidentified and fast-spreading type of viral infection seen in young children. Scroll down to know m...  Read more»
Histrionic Personality Disorder - Causes, Signs, Symptoms, Diagnosis and Treatment
Histrionic personality disorder causes variations in the thinking ability of a person. Read this article to know more.  Read more»

Ask your health query to a doctor online?

Ask a Cardiologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.