I am a 41 year-old male with a complex health profile, but I will be as concise as possible. My present worry is edema, including tightness and pain in my left arm and shoulder and the left side of my neck. This has present for two months, since my arm originally swelled while I was doing cardiovascular exercise on an elliptical machine. I've noticed that the left sleeves of my shirts are tighter than the right, and I can see visible swelling, including that veins in my left arm are less prominent than in the right.
Regarding heart concerns, I had an EKG and a coronary health panel blood test several months ago and these were normal. My blood pressure monitor, however, regularly notes a heart arrhythmia and a wildly fluctuating resting heart rate. In addition to the heart function blood test, I had liver and kidney panels and both the ALT and A/G ratio were slightly elevated (ALT = 53 w/ ref being 0-44; A/G was 2.3 w/ red being 1.2-2.2).
The complexities are that I have mast cell activation disorder and I frequently/usually experience various forms of inflammation, ranging from hives to flushing to gastrointestinal problems such as severe acid reflux. I treat these with H1 and H2 blockers and quercetin under my doctor's supervision. I don't take any other medications; I discontinued taking Tylenol for pain when I found my ALT level was elevated, and I rarely drink alcohol (1-2 drinks approx. 3 times per year). I have both heat and exercise sensitivities, triggered as discussed above regarding the elliptical machine, and my activity is limited primarily to walking 1.3 miles each way to work and back every day, during which I only experience adverse events on very hot days. I don't have shortness of breath or angina while walking, even briskly. I had Lyme disease and a Bartonella coinfection years ago, but I believe that these were treated successfully at this point.
I'm unsure whether or not to pursue further cardiovascular investigation because my EKG and my cardiac blood panel are normal. I also had a chest X-ray during an adverse event, probably MCAS related, about three years ago and my heart was determined to be normal at that time. As noted above, I am concerned about the edema especially in my left arm, but I suspect now that some of the weight I have gained is fluid retention. (I am about 5'11" and approximately 178 pounds, which is heavier than my former baseline--I've assumed this is due to age and reduced physical activity, but I look and feel swollen.) Around 10 years ago, I noticed that my legs retain imprints from socks for hours after I remove them, and my arms do the same when I wear tight ribbed sweaters. However, I don't seem to have pitting edema according to what I've read about it online; poking my arms and legs with my finger do not leave imprints--the flesh springs back into place immediately without any indentation.
I'm concerned about my heart because of the pain and swelling in the left arm, but also because my father over the past several years has had a triple-bypass heart surgery as well as a stent implanted in an abdominal aortic aneurysm, and I know that inheritance creates a risk for cardiovascular problems. I've never seen a cardiovascular doctor per se. I am certain that my doctor would refer me to a cardiovascular specialist, but her immediate impression is that he swelling and pain likely are the result of my mast cell disorder and that it is worth monitoring but not necessarily pursuing a specialist.
Thanks for any advice anyone can provide.