Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Heaviness In Chest And Weakness Causing The Inability To Walk
Question: Dr. XXXXXXX
I talked with you a week or so ago about recent diagnosis of cardiomyopathy. Since then I have been in the hospital... Cardiac unit. My husband and I went to a movie, (calm situation with lay back chairs) at end of it, I started to not be able to catch my breath, and my heart was in my throat, and a heavy feeling in my chest, and as if someone was squeezing my heart. It kept getting worse until I was gasping for breath. I wanted to go home and go to sleep. My husband said no we are going to the hospital. A care now facility was across the street, so my husband drove me there, doctors came to the car and called an ambulance, they did an EKG, aspirin, and nitroglycerin. At hospital they said no heart attack, but it was a heart incident. Stayed in hospital 7 days, got angiogram, stress test, etc. Arteries are all totally clear and good. EF is at 25-30%
Heartbeat was at 150 in emergency room. Came down eventually to 128, today is 115.
Conclusion: lower left ventricle damaged by chemotherapy treatment of adrimyacin and herceptin, causing weakened heart muscle for pumping action. Now on Carvedilol, lisinopril, and Digoxin. And wearing a Life Vest portable defibrillator. Feel tons better...no squeezing, no rock on my chest, no gasping, but still can't walk through the house without needing to rest and catch my breath. I have a good cardiologist here now. He's taking good care of me. And I'm much more confident. He says sometimes a heart damaged by chemo specifically can get better and that's what I will be working towards.
I talked with you a week or so ago about recent diagnosis of cardiomyopathy. Since then I have been in the hospital... Cardiac unit. My husband and I went to a movie, (calm situation with lay back chairs) at end of it, I started to not be able to catch my breath, and my heart was in my throat, and a heavy feeling in my chest, and as if someone was squeezing my heart. It kept getting worse until I was gasping for breath. I wanted to go home and go to sleep. My husband said no we are going to the hospital. A care now facility was across the street, so my husband drove me there, doctors came to the car and called an ambulance, they did an EKG, aspirin, and nitroglycerin. At hospital they said no heart attack, but it was a heart incident. Stayed in hospital 7 days, got angiogram, stress test, etc. Arteries are all totally clear and good. EF is at 25-30%
Heartbeat was at 150 in emergency room. Came down eventually to 128, today is 115.
Conclusion: lower left ventricle damaged by chemotherapy treatment of adrimyacin and herceptin, causing weakened heart muscle for pumping action. Now on Carvedilol, lisinopril, and Digoxin. And wearing a Life Vest portable defibrillator. Feel tons better...no squeezing, no rock on my chest, no gasping, but still can't walk through the house without needing to rest and catch my breath. I have a good cardiologist here now. He's taking good care of me. And I'm much more confident. He says sometimes a heart damaged by chemo specifically can get better and that's what I will be working towards.
Brief Answer:
You gotta take care now and things will get better.
Detailed Answer:
Hello,
Thanks for writing back, I am sorry for what happened, but I am glad that you are back and test results as you told are quite satisfactory except the EF which will hopefuly improve.
If you remember in our previous discussion I told you some signs like shortness of breath on lying down , bad chest etc which are signs of decompensation in cardiomyopathy. This didn't happen to you before our discussion but it did happen after it.
Now as you have recovered from the emergency situation I will hereby lile to discuss a few things with you.
Present condition:
1)Heart electrical circuit is normal.
2) Blood supply of heart is normal.
3) Heart muscle is a bit damaged by the cancer drug.
4) EF is 30% which is a result if heart muscle damage.
What does EF 30% mean? .
A Normal human being who has no cardiac problem has ejection fraction of 60% so it mean your heart is pumping at half the efficiency of a normal heart.
How is life going to be with it?
1) You will have to use medicines probably for long time.
2) You will have to take care of your intake specially salt for probably rest of your life.
3) Heart working at 50% of efficiency means your body can bear only 50% stress compared to a normal individual by this i mean.
You will have to keep
A) Half the heart rate like 60-70
B) Half the exertion.
C) Half the weight you can lift.
E) Half the Salt intake.
F) Half the cheating in food and other care.
G) You can not afford to skip meds even once.
H) You can not afford to Cross your exertion limit even once.
You are standing at a border where heart is compensating and couping up with it's lowered efficiency. Meds will help your heart do that more easily but if there is something which might worsen the problem like an exertion, mental or physical stress high grade fever, high salt intake, high blood pressure , bad compliance with medication, then your heart will not be able to compensate.
When heart fails to compensate then your lungs will get filled with fluid ans you will feel it difficult to breathe.
So you will have to take strict care of every single thing your doctor asks you to , to lead a normal life. This will also help your heart to recover well...yes your doctor is right.. in many cases cardiomyopathy due to chemotherapy gets better with time.
But you will have to save your heart from decompensation events to let it heal better this. Now you have to define your limits and have to live within them and you can live perfectly normal life within those limits.
As far as defibrilator jacket is concerned that is to save you from any sudden cardiac event.. later on you can discuss your cardiologist about permanent defibrilator device which is implanted in body but before that portable defib is attached just to see how you are recovering and to determine wether you need this permanent device or not.
For now I would suggest you not to panic.just take good care of yourself and your heart ..keep regular follow ups with your doctor, you can always discuss any concerns with me at any time.. any day you want to... Hopefully things will get better for you with time and your heart will recover.
I wish you the very best of health and i am open to any further queries you might be having
Regards.
Dr.Muhammmad Ahmad
You gotta take care now and things will get better.
Detailed Answer:
Hello,
Thanks for writing back, I am sorry for what happened, but I am glad that you are back and test results as you told are quite satisfactory except the EF which will hopefuly improve.
If you remember in our previous discussion I told you some signs like shortness of breath on lying down , bad chest etc which are signs of decompensation in cardiomyopathy. This didn't happen to you before our discussion but it did happen after it.
Now as you have recovered from the emergency situation I will hereby lile to discuss a few things with you.
Present condition:
1)Heart electrical circuit is normal.
2) Blood supply of heart is normal.
3) Heart muscle is a bit damaged by the cancer drug.
4) EF is 30% which is a result if heart muscle damage.
What does EF 30% mean? .
A Normal human being who has no cardiac problem has ejection fraction of 60% so it mean your heart is pumping at half the efficiency of a normal heart.
How is life going to be with it?
1) You will have to use medicines probably for long time.
2) You will have to take care of your intake specially salt for probably rest of your life.
3) Heart working at 50% of efficiency means your body can bear only 50% stress compared to a normal individual by this i mean.
You will have to keep
A) Half the heart rate like 60-70
B) Half the exertion.
C) Half the weight you can lift.
E) Half the Salt intake.
F) Half the cheating in food and other care.
G) You can not afford to skip meds even once.
H) You can not afford to Cross your exertion limit even once.
You are standing at a border where heart is compensating and couping up with it's lowered efficiency. Meds will help your heart do that more easily but if there is something which might worsen the problem like an exertion, mental or physical stress high grade fever, high salt intake, high blood pressure , bad compliance with medication, then your heart will not be able to compensate.
When heart fails to compensate then your lungs will get filled with fluid ans you will feel it difficult to breathe.
So you will have to take strict care of every single thing your doctor asks you to , to lead a normal life. This will also help your heart to recover well...yes your doctor is right.. in many cases cardiomyopathy due to chemotherapy gets better with time.
But you will have to save your heart from decompensation events to let it heal better this. Now you have to define your limits and have to live within them and you can live perfectly normal life within those limits.
As far as defibrilator jacket is concerned that is to save you from any sudden cardiac event.. later on you can discuss your cardiologist about permanent defibrilator device which is implanted in body but before that portable defib is attached just to see how you are recovering and to determine wether you need this permanent device or not.
For now I would suggest you not to panic.just take good care of yourself and your heart ..keep regular follow ups with your doctor, you can always discuss any concerns with me at any time.. any day you want to... Hopefully things will get better for you with time and your heart will recover.
I wish you the very best of health and i am open to any further queries you might be having
Regards.
Dr.Muhammmad Ahmad
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for the detailed answer. Lots of info I can use. I own and run a school (head of school) of 95 students (Flint Academy). We have boarding for students who have no family or have family problems. We also educate advanced, typical, and special education. So lots of work and can be lots of stress. We have made arrangements for other staff to give tours (since I now can't walk and talk that far). I will spend more of my time on writing a book, helping with teacher training, classroom observations and advice, and people can come to me. I have taken on a well-known and well vetted business partner to deal with money and alleviate my stress. I have great support from my husband. He is cooking healthy meals for me now...salmon and salad, or cottage cheese and blueberries. I don't like salty food so avoiding that will be easy. I added up my sodium level per day and it does not even get close to the amount they say I should avoid. I am swimming everyday (but my doctor said don't do too much). I swam competitively in high school and college. I will work hard to lose weight by the only method I have left (low calorie food and small portions). I have lost 10 lbs since the hospital stay, weighed by my doctor. I am very organized about taking medicine, so I will do that well. I take something morning, noon, and night. I am sad about this situation. My plan was to get thin and have the energy to go hiking with my husband or walk through foreign cities and museums. Now that won't happen to the extent I imagined. My husband is normal thin, athletic, and healthy. So I'm sorry this happened to me, and it changes his plans too. We'll have to learn how to enjoy this new normal. And I'll try to stay alive as long as I can...as we all should. Thank you for all your help. You're a kind man. I think I'm good now.
Brief Answer:
It's time to change some plans, aims, strategies.
Detailed Answer:
Hello ,
Thanks for writing back , and your kind words
I am so amazed that you are doing such a service ...these are 95 future families you are educating and this will go on and on.
Indeed that's a stress mentally and physically , managing it, but here's how your management skills are going be tested, just divide work with others and with your self. Take rest intervals and don't over work, It's better to work less at a time instead of getting that breathlessness again and not working for next 7 days.
There are plans which we make and there are circumstances which surround us and then plans have to be changed to survive , at this stage you can still do so much divide things with others and writing a book is a great idea, either ways you are helping, serving.
You can still walk the cities and museums in some time hopefully, after losing some weight and after some improvement in you problem yes i can't promise you bout the hiking part but well, that what life is we don't get everything we want to.
I would alos suggest you not to swim for now it's quite strenuous physically and for now chances shouldn't be taken.
Weight loss is always going to help you it ..will improve stamina and will also take load off the heart ans you will improve symptomatically.
After knowing that your salt intake is within safe limits and you are organized in medication I am quite positive that things will keep getting better for you. And don't worry you will learn long , you just have to learn living with this new normal , as you said, your new normal is about half the normal and this will improve , with meds and life style changes it will become more than half the normal and you wont be facing any problems.
At this time you have to make some changes in plans, aims , and strategies everything will be fine if kept organized.
I Hope this answers your question, if your have more queries feel free to ask, otherwise close the discussion and rate it. Wish you the best of health.
Regards,
Dr.Muhammad Ahmad.(Licensed Family Physician)
M.B.B.S.
Resident Cardiologist.
You can directly discuss with me at.
http://doctor.healthcaremagic.com/doctors/dr-muhammad-ahmad/69304
It's time to change some plans, aims, strategies.
Detailed Answer:
Hello ,
Thanks for writing back , and your kind words
I am so amazed that you are doing such a service ...these are 95 future families you are educating and this will go on and on.
Indeed that's a stress mentally and physically , managing it, but here's how your management skills are going be tested, just divide work with others and with your self. Take rest intervals and don't over work, It's better to work less at a time instead of getting that breathlessness again and not working for next 7 days.
There are plans which we make and there are circumstances which surround us and then plans have to be changed to survive , at this stage you can still do so much divide things with others and writing a book is a great idea, either ways you are helping, serving.
You can still walk the cities and museums in some time hopefully, after losing some weight and after some improvement in you problem yes i can't promise you bout the hiking part but well, that what life is we don't get everything we want to.
I would alos suggest you not to swim for now it's quite strenuous physically and for now chances shouldn't be taken.
Weight loss is always going to help you it ..will improve stamina and will also take load off the heart ans you will improve symptomatically.
After knowing that your salt intake is within safe limits and you are organized in medication I am quite positive that things will keep getting better for you. And don't worry you will learn long , you just have to learn living with this new normal , as you said, your new normal is about half the normal and this will improve , with meds and life style changes it will become more than half the normal and you wont be facing any problems.
At this time you have to make some changes in plans, aims , and strategies everything will be fine if kept organized.
I Hope this answers your question, if your have more queries feel free to ask, otherwise close the discussion and rate it. Wish you the best of health.
Regards,
Dr.Muhammad Ahmad.(Licensed Family Physician)
M.B.B.S.
Resident Cardiologist.
You can directly discuss with me at.
http://doctor.healthcaremagic.com/doctors/dr-muhammad-ahmad/69304
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
