Question: Hello Dr. Shehu:

You have answered my questions previously.

Just got back from a short vacation south. After a few days during this vacation I got sunburn on my feet and then developed some pitting edema.
Since I have been having some unresolved issues for while....I did not like what I was seeing.

As soon as I got back to Toronto, I saw my family physician and he suspected a mild form of congestive heart failure. So he ordered some blood work and an echocardiogram. This of course frightened me but three different cardiologists so far had told me that I was not going though congestive heart failure...although I am using multiple pillows during sleep after a viral infection about two years ago.

My family doctor gave me water pills for one week and so far I have taken 6. The pitting edema has resolved. I am able to go on the treadmill for a fast walk for about 50 minutes with no issues( I just choose to exercise for this length of time).

I am seeing my doctor for the blood work and echo results on Monday....however the echo technician hinted that my echo was normal (ie. above 60 ejection fraction etc.). My question is...could one have a normal ejection fraction and still be going through heart failure? If all blood work is normal....what could be the cause of pitting edema and water retention?(I dropped about 7 lbs with the water pills) Could it be simply salt? obesity? or something else?

Thank you,
XXXX
Toronto-Canada

Hello Dr. XXXXXXX

Thank you for your response.

What about heart failure with normal ejection fraction(HFNEF)? How is this dignosed? My understanding this is when one of the ventricles is stiff and can not fill up properly with the right amount of blood?...but the ejection fraction is normal? Can the echo detectect this type of heart failure? If this was the case...would there be more symptoms evident?

I don't mean to "exhaust the issue"...i am hoping for good results... but i need to know all possibilities in the worst case.


Thank you,
XXXX

Thank you for making things clear...i will see my doctor tomorrow and get the results...i will keep you posted.

Best regards XXXXXXX

Hello Dr. Shehu:

I just got back from my family doctor...he got blood results for liver and kidneys but no results for echo yet. Liver and kidneys are fine. So i hope in the next day or two to get results for echo and hope that will be fine too.

Thank you...talk soon.

Hello Dr. Shehu:

I just got the echo and its basically normal from what i was told. I am so glad
there seem to be no chf issues.

I dont know how to load the reportit so you can see it...is there an email where i can scan it and send it to you?

Anyway...here are the coomments at bottom of report:

1. Left ventricle is normal in size and function.
2. The left atrium is normal.
3. Mitral valve shows no prolapse or stenosis.
4. Aortic valve is trileaflet and normal in function. Tricupdid and pulmonic valves are
Normal.
5. Right ventricle is normal. No pericardial effusion.
6. Colour Doppler study done shows trace mitral and tricupsid regurgitation. Normal
inflow is across other valves. No evidence of shunt.

IMPRESSION:

Normal ventricular function. Trace mitral and tricupsid regurgitation within normal limits. No evidence of shunt.


Dr. Shehu...can this regurgintion worsen with age? Is there something i can be doing now to prevent or strengthen the valves? Would more exercise help this issue in any way? Any other suggestions/recommendations?

Thank you,
XXXX

Thank for the advice Dr. Shehu....I will follow it as best as possible.
I already eat the Mediterranean diet but i will remove starches as best as possible.

What do you think of adding some natural supplements that some people say are good for the heart like CoEnzyme Q10, Magnesium etc.?


Best wishes to you,
Faleminderit!!

XXXXX

Hi Dr. Shehu:

I am finding that i am retaining water again.

I decided to go back on the water piils.(Furosemide) I am close to 219ibs...that is 7lbs more than when i stopped the pills last Sunday...or 7 lbs within one week!! I felt it more this weekend...what could be going on? Could i be so sensitive to salt? But i dont eat very much salt...at least i dont feel that i do...this is "driving me crazy" now...

Any other suggestions/tests i should do?

Thank you,

XXXX

Thank you so much for the advice. I will do as you say and see another doctor here in Toronto to do testing..

Best Regards,
XXXX

Hello Dr. Shehu:

I dont want to become tiring about my issue but i just saw my family doctor and he told me to stop the diuretics. He said there is no reason to continue taking them since all the dangerous causes of pitting edema were eliminated(ie. Heart, liver, kidneys). He said he wants to see me live if edema surfaces again. I showed him a picture i took on Monday morning on my cell phone and told him the edema returned after i stopped taking them the first time. He told me that he is very determined to solve my issue. So as you can probably guess....i am a bit confused!
Is there any danger if i stop the diuretics in your opinion? He ordered a ultrasound/doppler? of the veins in my legs. It is scheduled for this Thursday at 1pm.

Regards,
XXXX

Hello Dr. Shehu:

Just to keep you informed and perhaps your opinion again...

I saw today Dr. Zoltan XXXXXXX MD .....a respected doctor who practices Alternative and Complementary Medicine here in Toronto. Dr. XXXXXXX wants me to see another Cardiologist for another opinion.....so we waiting for an appointment. I think he just wants to be very thorough and very catious. He told me of a similar case to mine where the patients tests were all normal and eventually he was diagnosed with 5 clogged arteries. Anyway....not to over dramatize things....my questions are:

1. Can clogged arteries manifest symptoms like pitting edema?

2. Can the echo or stress-echo and ecg....miss major heart issues?

Thank you,

XXXX