Dr. Sapkal Ganeshrao Patilba
Cardiology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am a 20-year-old man weighing 330 pounds and a height of 5 feet and 10 inches. I experience shortness of breath, lightheadedness, dizziness, confusion, chest pain, headaches, and fatigue. I have had pectus excavatum my whole life and have always suffered from chest pain, shortness of breath, headaches, dizziness, lightheadedness, confusion, etc. I was always very athletic growing up and played soccer religiously. The symptoms worsened when I started to play in college; since then, I have stopped playing. I underwent investigations like CPET, Holter test, stress echocardiogram, TTE, and EKG. I am taking Adderall 20 mg twice, Lamotrigine 150 mg once, Mirtazipine 30 mg once, Trazadone 50 mg once, Wellbutrin 150 mg once, and Hydroxyzine 25 mg twice. Kindly help. Thank you.
Hello,
Welcome to icliniq.com.
I went through the details you provided (attachment removed to protect the patient's identity). The CPET (cardiopulmonary exercise testing) shows mechanical problems causing symptoms, and stress echocardiography is normal. The symptoms are likely to be related to a chest wall deformity. What is your hemoglobin level? You may get benefits by doing graded exercises to increase your lung capacity. Thank you.
Patient's Query
Hello doctor,
The last time I had my HbA1c checked, it was a 4.9. Diabetes and high cholesterol run on both sides of my family, and a couple of family members have had strokes. The stress echocardiography showed that my heart's left side was a little smaller than it should be. My left ventricle was hyperdynamic, and my pulmonary vein was diastolic dominant. The tests were done through the hospital, so I can not go through the results which brought me here. But my sister works in a hospital, and she was a little concerned about those things I mentioned above. Kindly help. Thank you.
Hello,
Welcome back to icliniq.com.
I asked about hemoglobin and not HbA1c. Though they have mentioned decreased left ventricular cavity size and wall thickness, it will not cause your symptoms. Pulmonary vein flow is diastolic dominant, but there is no increase in left ventricular filling pressures. Hyperdynamic response of the left ventricle is also not considered abnormal. Check your pressure for postural hypotension by measuring both supine and standing blood pressure. Thank you.
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Cardiology
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