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Forum Name: Valvular Heart Diseases

Question: Arrhythmia + low blood pressure + fatigue + fainting


 asdfasdf - Wed May 26, 2010 12:26 am

I have had a serious of symptoms, but I am not sure if any/all are related, so I will just say them chronologically. I have had sharp chest pain, usually below my left breast, and difficulty breathing deeply for about ten years. The difficulty breathing deeply is always, while the sharp chest pain is constantly changing in frequency over the years, anything from once a month to twice a day. I have fainted about four times in the last few years, and am constantly lightheaded. I also had a seizure last year while doctors were taking blood. (I have no idea why...) I have low blood pressure: 90/60 is normal, not sure what it is when I feel lightheaded, and I am ALWAYS tired. I am constantly fatigued. Standing makes me tired, moving makes me tired, not doing anything, I am still tired. And now recently I have started feeling arrhythmia. It feels like it is skipping a beat usually, though lying down it feels more like a very uncomfortable quiver. I have felt arrhythmia for about six months, but not very frequently. It may not occur for a week and then I may have four in one day. I had a doctor give me a 24 hour holter, but I did not feel arrhythmia during that time, and the test of course didn't show it either. I did confirm though my feeling of arrhythmia in my chest with me actually feeling my pulse and feeling the arrhythmia in my hand. Anyway, hat I am most interested is in the title: arrhythmia, low blood pressure, fatigue. Listing all of this has actually made me a bit more worried, but hopefully someone can give me some kind of answer, at least as a guide. I really really would like an opinion as to what steps to take or any possibility of what it may be. Also, the doctor that gave me the holter, initially gave me an EKG, and from that said I have a heart murmur, but continued on as if it were nothing. Not sure what he based it on nor what a heart murmur is, if its serious, or has anything to do with my symptoms. Anything from you guys would help. Thanks!
 Faye Lang, RN, MSW - Thu Jul 01, 2010 7:18 pm

Hello, asdfasdf,

It is totally understandable that you would be worried about all of your symptoms. To reassure you a litte, I'll point out that having the chest pain episodes for 10 years without having the episodes advance to a more serious situation is a good sign! I do not mean to minimize the discomfort you feel, but to say that it does not appear to be life-threatening. An irregularly-occuring arrhythmia is very difficult to diagnose. You might consider discussing it again with your doctor in regard to a 48 or 72 hour holter monitor, and to discuss the possibility of a complete cardiac workup, including a stress test, echocardiogram, and any other test the doctor feels might be helpful. It might help you to know that all of us experience arrhythmias at times; it's the frequency and the type of arrhythmia that determines how serious it is. The impulse for the heart to beat can arise in different locations in the heart muscle; normally, it's in what is called the sinus node, located in the upper portion of the heart. Thus, a "sinus arrhythmia" is one that starts from the correct spot, but misfires occasionally, and that can be entirely normal or acceptable. Monitoring it by taking your pulse will not tell you what type of arrythmia it might be.

When was the last time you had a complete physical? Your symptoms could be related to things other than a heart condition. It sounds like you have become deconditioned physically. If your physical examination reveals no serious problems, perhaps you could discuss a reconditioning program with your doctor. It would generally consist of mild exercises, increasing over time. This type of approach strengthens the heart muscle, as well as benefits the oxygenation of all the muscles in your body, which would help you feel more alert. Do not do this without your doctor's supervision, however. Have your doctor determine your body index; sometimes something like a weight-loss program can help tremendously. Your blood pressure actually is quite good, barring any unknown condition. It's on the low side, but within a normal range.

I hope this information helps you proceed in establishing your best state of health. Good luck to you.

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