What Does My Ultrasound Scan Report Indicate?

Question : Hello, I am a healthy 40 year old female who does not smoke or drink. Almost 3 weeks ago I began to get heart palpitations. My doctor had me do the 24 hour Holter Monitor and it found I was having PVCs but considered nothing to worry about. Over the next few days I began to get fatigued and had shortness of breath when doing things like climbing the stairs. I went to the ER that week as it felt like the shortness of breath was getting worse. I was short of breath doing any kind of task such as brushing my teeth or washing my hands. In the ER I was hooked up to a monitor for several hours. They did a regular ecg and an ecg strip (I think that is what it was called), a lot of blood work, a chest X-ray and they had me walk around with the monitor on. All of the tests came back negative and they said my blood was getting enough oxygen as I walked with the monitor on so they sent me home. They made an appointment with a cardiologist for me for this Tuesday for an ultrasound of my heart and a consult.

The only time I would feel normal was sitting or laying down.

Over the week I began to notice that the fatigue was improving and I have not been as tired.

However, a few days ago I noticed that when I sat or laid down my legs would feel achy, like I had been standing on them all day, but I had barely done any movement. I went to the doctor yesterday. He said the only blood tests they did not run in the ER were a CK test and an hs-crp test so we did those yesterday. The results are not back yet.

In the last 2 days I still get shortness of breath climbing stairs but it has become better when doing other activities which has been nice.

Today I began to notice that my legs were feeling funny - sometimes a little numb, sometimes like they have pins and needles, but the aching feeling was gone. My legs and feet also felt cold and it is summer here. I put my slippers on but it didn't help much.

I kind of got scared this evening and looked it up on Google - maybe I should not do that as I should not diagnose myself, but I saw that leg angina had similar symptoms.

I realize I don't have an actual diagnosis yet, but I am concerned about my legs. Do I need to be seen by my doctor about my legs later today (office is closed now) or can I wait until Tuesday to discuss with the cardiologist?
Is there anything that should send me to the ER?
I am feeling rather anxious about all of this. I have 2 young kids to care for.

Hello,
Thank you for getting back to me. I am a very anxious person and have been VERY stressed about this whole situation.

The ER doctor had scared me quite a bit. She seemed quite concerned about my heart. She advised that I not be alone for lengthy periods of time, I not drive or take a shower or bath in case of fainting. On the other hand when I saw my family doctor after the ER visit, he said he thinks the cardiologist will find nothing wrong with my heart on Tuesday, but he will still send me to see him anyway.

When this feeling in my legs started I did not know what to think.

I have uploaded the reports that have been given to me. The blood work is from a clinic on Aug. 2 and not from my visit to the ER. They did not provide me with the report of the blood work there.

It is interesting that you mention a neurological problem. I have no idea if this is related and I have not mentioned it to any of the doctors as I dismissed it. Two years ago I banged my head and had a mild concussion that took me at least a month or more to heal from. It caused much pressure in my head and face, and sensitivity to light. On July 10 of this year, I banged my head again, but not quite as hard as 2 years ago. However, I experienced all of the same pressure in my head and face as the last time and the sensitivity to light. This caused me a lot of anxiety again as well. This went on for two weeks. Then 2 days before my PVCs started (and a few days later the fatigue, shortness of breath, etc started) the pressure in my head was quite bad. Once the PVCs and my other symptoms started up, I kind of forgot about me head. Could banging my head have caused any of my symptoms?

Today my legs still feel prickly or tingly and cold. I have noticed my left arm feels a little numb and even my tongue feels tingly.

Is it alright for me to wait until tomorrow or later today to see my doctor about this before I go to the cardiologist?

I have been so worried about my heart. The ER doctor frightened me a lot!
Thank you for your help.

Hello Dr. Iliri,
Thank you very much for your detailed replies. I have so many questions in my head!

Are my symptoms typical of angina or is that part of cardiac ischemia? Is coronary artery disease different than cardiac ischemia?

My family doctor has known me for 14 years and is very familiar with my health. I have suffered from anxiety my whole life. It comes and goes over the years, but the last 5 years it has been bad. Over the last several months it has been worse. Before all of these symptoms started I was stressed and worried about a few things. Once the PVCs started, my anxiety has been even higher. Then my symptoms got worse - the fatigue and shortness of breath. Going to the ER made it even worse as the doctor scared me very bad. So now I cannot stop thinking and worrying about it. I am terrified that I will have a heart attack or worse, sudden death. I can hardly sleep.

The other day my doctor sat me down to say that he knows my anxiety has become very bad. He put me on Wellbutrin as that has helped my mom over the years with anxiety. He said to me that he knows me very well and he believes there is nothing wrong with my heart. He said he thinks I am suffering physical symptoms from stress and anxiety. He wants me to see the cardiologist on Tuesday as he feels it will help my anxiety to see a specialist.

I know stress and anxiety can do many things to your body. I do believe that some of my symptoms could certainly be anxiety related. For instance the tingly feeling on my tongue and possibly the feelings in my legs. Sometimes when my mind focuses and worries too much about a part of my body it will feel numb or weird. As soon as my legs started to feel achy the other night while resting I Googled my symptoms (I need to stop doing that, too!) and I was convinced I have leg angina. Since then I have focused a lot of my worry on that and my legs now have pins and needles, numbness and yesterday had that cold feeling. Even as I write this I can feel them getting numb in spots!

I am just confused about the shortness of breath. I don't see how anxiety could cause that. It is the type of shortness of breath you experience when climbing stairs or running a race. You breath harder, your heart beats faster and you get that jelly feeling in your legs. That is how I feel when doing such things as climbing the stairs (but worse than I would normally have) and when I do other activities that I would normally not be short of breath doing.

Anyway, I am trying my best not to worry so much, but it is tough.
Thank you very much for your help.

Hi Dr. Iliri,
Thank you so very much for that detailed explanation. I really appreciate it. This will definitely help me calm my nerves as I was a little unclear of how all of those processes in your body work. When the doctor said he belives most or all of my symptoms are due to anxiety, he didn't explain what anxiety does to each part of your body. I just couldn't understand how that all worked!

Thank you so much for taking the time to explain that to me more clearly. I will definitely see the cardiologist and return to my doctor to follow up so we can have all of the proper testing done, but I feel better having spoken with you as it is calming my nerves.

Given how much anxiety I have had over all of this, believe me when I say it makes me feel much better that I have spoken with you. Thank you!