Hi there -
I'd say that based on your family history and the too-short-to-be-conclusive stress test you probably have reason to be concerned, although I wouldn't go beyond "concerned" at this point. I do feel you should be worked up more thoroughly, however, preferably including a stress test with nuclear scan, and an
echocardiogram.
The long Q-T on
EKG could be a separate concern, but was probably transient (and should be rechecked to be certain); T-wave abnormalities are frequently seen in healthy people for various reasons, but when coupled with symptoms such as you describe they shouldn't be brushed off. However, you're a young, otherwise healthy woman, so it's difficult for a lot of doctors to accept that there could be a cardiac cause for the symptoms. This is an ongoing problem, because odds are the symptoms aren't cardiac-related, but they are caused by something, and heart disease is too often overlooked in younger women.
Since pulmonary
hypertension seems to be ruled out I'm thinking possibly a structural abnormality of the heart's workings. It could be a thickened chamber wall, a malfunctioning valve, something like that. An
echocardiogram would very likely rule this sort of thing out -- or in.
For the time being, I'd recommend not over-exerting, and to be very aggressive in seeing that you're followed up for this. Something is causing the symptoms and they are somewhat troubling. They could be due to something fairly minor, but until it's clarified it's not safe to assume there's nothing to this. The symptoms speak for themselves.
I hope this is helpful to you. Good luck to you. Please follow up with us here as needed.
Having seen a pulmonologist was a very good idea and happily things appear to be fine there. I was thinking possible pulmonary
hypertension, but apparently not. Good.
The left atrial enlargement finding is also common and usually meaningless, but also can occur in conjunction with systemic
hypertension. Since your blood pressure did get rather high very quickly during your stress test (and I'm assuming this is why it was terminated after less than two minutes, since you were nowhere near your maximum heart rate), your symptoms may be due to some sort of blood pressure abnormality. Do you know what your normal resting BP is?
