Cardio concerns

[Amber1975]

I am a 37 year old female, normal weight, history of allergic asthma, and diagnosis of mixed connective disease.  Recently I have experienced SOB and dyspnea while working out.  I had started working with a new trainer and contributed it to that, but after about 6 weeks there was no improvement, and my trainer suggested I see my Pulmonologist .  CPET was ordered.  Results mildly low CO2 at peak, decreased O2pulse at peak, and low VE max.  No EKG abnormalities.  He ordered a new ECHO and referral to cardiologist.  Last ECHO, a year ago, showed LAD of 4.2, mild diastolic dysfunction, RVSP of 33, and intra atrial septum aneurism.    Pulmonologist told me I needed to push this, given new symptoms and MCTD.  My mother really wants me to look hard for a cardiologist and inquire about a cardiac rehab program.  I am not a person who questions doctors, and am worried about looking like a hypochondriac .  Is this something I need to push?  I don 't want to ignore something that may progress into a bigger issue.  Should I be pushing for more aggressive treatment of MCTD or is that in no way related to this.  I am not sure what issues are related.  I am worried that no one is connecting the dots.

[Amber1975]

I have not received any advice concerning exercise ect.  Don't know size of aneurism.  I didn't ask for copy of ECHO report, and just know this information from my pulmonary records.  My pulmonologist is the only Dr who has monitored and ordered routine ECHO's.  I saw a cardiologist once last year when a chest CT showed a small pericardial effusion, he said no big deal, not to be concerned with ECHO findings, take baby aspirin.  SED rate is low so when I tell me rheumatologist I'm am experiencing fatigue she says I am depressed.  I am not depressed, confused and slightly aggregated, but definitely not depressed

[skydnsr]

Seeing a cardiologist after another one of your doctors has recommended that you do so will not make you look like a hypochondriac.  If your connective tissue disease is one that can affect the heart, then obviously you need to see a cardiologist when your pulmonologist tells you to.  Actually, I can't believe you're not already being followed by a cardiologist.  When you say you don't want to ignore something thay may progess into a bigger issue, that is the key point.  When you say you're not sure what issues are related, that is another key point, and the only way to find out is to investigate it by consulting the appropriate specialist(s).  Only when you have all of the evaluation data and treatment recommendations in front of you, can you make an informed decision about what treatment you do or don't want to do.  Please take care of yourself.  If you can find a cardiologist who has particular expertise in your kind of heart problems, so much the better.  You're not the usual, run-of-the-mill cardiology patient.  I'm hoping you live in a big metropolitan area or near a teaching hospital where you can find an expert for your type of heart disease.  Good luck.

[ed34]

With the test results you've had, including mild diastolic dysfunction, what advice have Doctors given? With any form of diastolic dysfunction I'm not sure that pushing with exercise is the wise thing to do, especially as there could be underlying causes. I would get some answers if you don't have them. How big is the septal atrial aneurysm? is it impeding the filling of the heart causing the diastolic dysfunction?