Is this anything to worry about?

[dldaisy]

I got my echo stress report a few days ago.  It said I had sclerosis of the aortic and mitral valves with "some" and "mild" regurgitation respectively.  My left ventricle is slightly enlarged.  I have an incomplete right bundle block.  I have supraventricular tachycardia.  I also had some PVCs.  

My current symptoms are feeling short of breath when lying down, feeling the arrythmias at times, and swelling of my feet and legs.  Sometimes I think my chest is swelling also, because the band of my bra is very tight by day's end.  I am also falling asleep trying to drive to work in the mornings.  As of the past 2 days, the fatigue has begun to last the entire day in various amounts.  I sleep with a CPAP and had a sleep test in October.  My CPAP is new and has been checked to make sure it is operating correctly.  

My cardiologist appt. is the 20th.  I don't know whether to be concerned in the meantime or not.  It seems that some of the problems I've been diagnosed with have been discussed in this forum and are insignificant.  I'd like to exercise (walk), but I get very SOB and my heart becomes tachy and I feel great pressure in my chest and back.  So, do I try again before going to the cardiologist?  Or wait?

What are some good questions to ask the cardiologist?  (This is my first visit to one.)

  

[dldaisy]

I am 53.  I was diagnosed with sleep apnea 6 years ago and had my last sleep study in October.  They tell me this is not sleep apnea.  I have a new CPAP which I had checked to make sure it was operating correctly.  Prior to the first of the year, my CPAP seemed to be controlling all symptoms I thought attributable to sleep apnea.  I had no fatigue, headaches, etc.

Most of my symptoms have developed since around Christmas.  I had a colonoscopy on the 23 and ended up in the ER on Christmas Eve with severe dizziness, nausea and a headache.  I didn't know if I was having another TIA or what.  I had one following a surgery in 2005.   The ER dr decided my symptoms were Benign Positional Vertigo.  The dizziness lasted about 10 days.  It was then I noticed the other symptoms beginning.  Jan. 5 I went to the ER with the worst chest pain I've ever had.  The only thing I've had that was worse, marginally, was kidney stones.  They said I hadn't had a heart attack and sent me home.  My PCP ordered and Upper GI, ultrasound, and echo stress test.  Only the stress test showed any abnormalities.  Since the first week of Jan I've developed the edema in my legs and feet.  Sometimes I think my chest is also swelling as my bra fits comfortably in the morning, but cuts into me by evening.  The shortness of breath upon lying down has developed since the first of the year also.  So has the morning sleepiness.  Until 2 days ago, I would "get my second wind" after getting to work and was able to get through the day without unusual tiredness.  But, for the past 2 days I've been tired throughout the day.  I went to bed at 7 last night.  
     My PCP doesn't seem to want to treat this.  Hence the referral to various specialists.  My pulmonary appt is Monday.  I have asthma and my peak flow now stays 60 points below what used to be my normal prior to the first of the year.  However, I'm not wheezing and my albuterol does nothing but cause tachycardia.  So, I'm not certain if any of my symptoms are related to the asthma.  Hopefully, I'll know that Monday.
     I tend to be conservative regarding salt.  I cook without salt, with exception of one or two foods which I seldom cook.  My major sodium intake is the Soup at Hand I eat for lunch 2-3 times a week.  I don't (seldom) eat processed meats and use fresh or frozen vegetables.  I drink 2-3 cans of soda a week and sometimes not that.  I have noticed that the caffeine sometimes aggravates the arrythmias.  But not always, which I find strange.  
     My EF was good at 65%,  I'm wondering if this is consistent or varies throughout the day???  

[KimberlyRN]

May I ask your age? How long have you been having episodes of SOB, swelling, etc? I would assume that the fatigue prompted the CPAP, as this is a common symptom for people suffering from sleep apnea, also may be a causative factor in the left venticle enlargement, RBBB, edema, etc. I am not a doctor, just a cardiac nurse. I would not recommend exercise until you have seen your cardiologist.

When my husband starting using his CPAP he immediately started to feel more energized not the opposite as you have described. This is something to report to the cardiologist as the lungs and heart directly effect one another.

Have you noticed increased swelling of your hands and feet? If so call the cardiologist and report worsening symptoms and they will direct you further. do you have a history of high blood pressure? Diabetes? High Cholesterol?

You should start watching your sodium intake closely, the cardiologist will likely recommend a low sodium diet, usually 2 grams a day. Read labels closely, you might be really surprised at the amount of sodium you are currently taking in.

Questions to ask the doctor? With the information you already have just make sure they explain all of this to you. You will likely get so much information at your first visit that you may feel overwhelmed. I guess i would ask if the cardilolgist feels a heart catheterization is necessary. Do you have a copy of your Echo? sounds like you do. What did it say about your Ejection Fraction?