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Date of last update: 10/20/2017.

Forum Name: Cardiology Symptoms

Question: SOB, fatigue, chest pain upon exertion

 30yrsUnDxd - Sat Aug 11, 2007 8:45 pm

I'm a 54 y-o female, with obesity due to severe, long term (30 years), under treated Hashimoto's Thyroiditis. I was initially dx'd in September 2003. The doctor never gave me enough Synthroid and my condition slowly worsened until April 2007 when I started having cardiac symptoms. My complications stemming from severe under treated hypothyroidism are bradycardia, stage II hypertension, mild cardiomegaly, sleep apnea, and minimal endometrial hyperplasia.

I'm currently taking Synthroid, Progestin (for abnormal uterine bleeding due to side effect of Triamterene/HCTZ), and B12 1000mcg plus daily vitamins.

There's no family history of heart problems in my family. My father did have hypertension for a while and it was quickly corrected with dietary change, exercise, and short term medication with no recurrences. My mother has Hashimoto's, Addison's, and Type 1 Diabetes. My father and all three siblings have Ankylosing Spondylitis. I don't have AS or the genetic marker for it.

The cardiac symptoms were SOB, chest pain, dry cough, and fatigue upon exertion. When I started taking the diuretic the symptoms mostly subsided. However, 2 weeks ago they started worsening again. At that time I was on Triamterene/HCTZ for my hypertension. And I started having post-menopausal bleeding again (the hyperplasia) which had stopped.

The diuretic has been discontinued due to the bleeding. The SOB and fatigue is worse than 2 weeks ago and feels like I can't catch my breath. And my dry cough has returned. And I have more symptoms. Feels as though I'm breathing through a straw in a hot, humid room. The SOB, fatigue and dry cough occur after I exert myself such as fixing a meal. I sit down for a while and that relieves it.

Now if I do laundry or mop the floor or vacuum, I have fatigue, dry cough, and SOB afterwards and the SOB during the exertion. However, about 30 to 60 minutes (or more) later I start having the symptoms again. The SOB starts again followed by chest pain, fatigue, and dry coughing. Two days ago I had an episode after doing laundry and mopping the floor where I felt as if I was suffocating. I had to go outside to breathe. Slightly bending over my deck railing seem to help me breathe. Then I got chest pain, stabbing upper back pain, and shoulder pain. I took some pain medication that night and called my primary doctor the next day. I'm being referred to a cardiologist.

Also I have all over swelling with fluid, especially upper abdomen. And my feet and hands are cooler than normal especially after moderate exertion.

My primary doctor says I should be getting better by now since I've been on my new dose of Synthroid for over 6 weeks. She told me I shouldn't be having problems with exertion. My pulse ox was 98 sitting and after less than 3 minutes walking in her office with a pulse oximeter it was 92 and I had SOB. And she said I don't have heart failure.

Is that possible? Or is it cardiomyopathy? Or pericarditis? Or myocarditis?
 30yrsUnDxd - Sun Aug 19, 2007 10:38 pm

The cardiologist said my symptoms are caused by my sleep apnea. He did a rule out pharmaceutical stress test and my heart looked fine.
 30yrsUnDxd - Tue Oct 23, 2007 3:39 am

I got diagnosed with perimyocarditis on the 17th of October after spending my third time in the CCU following an intial diagnosis of pericarditis with pericardial effusion and atrial fibrillation on September 27th.

So much for it being Obstructive Sleep Apnea.

What is the prognosis for perimyocarditis? I can't be treated with anticoagulants due to bleeding easily from my vagina with an unknown cause. I've had extensive testing for bleeding and clotting disorders: all negative. I'm on Tamborcet and Digoxin for the A Fib, Ibuprofen and Colchicine for the inflammation, and other supplementary medications for my other conditions/diseases.
 John Kenyon, CNA - Wed Jul 23, 2008 11:31 pm

User avatar Hello -

Well now you know what was going on at least. The prognosis for perimyocarditis is generally good, although it is helpful to find the underlying cause. Meanwhile the treatment seems to be extremely appropriate and should be helping by now. Whether or not this problem becomes chronic depends upon whether it has a known cause or if it is primary and of unknown cause. Sometimes it just resolves after treatment with anti-inflammatories. It is also worth noting it is sometimes seen in conjunction with thyroid disease, but the connection is not clear.

I hope by now the problem has improved greatly. Please keep in touch here and let us know how you're doing.

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