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Suggest Treatment For Light Headedness And Upper Abdominal Discomfort

Posted on Tue, 8 Nov 2016

Question: I'm in the UK and had a second echocardiogram just over a month ago. The first one three months ago showed a moderate pericardial effusion. The cardiologist said then he hoped it would go by the second. I know it hasn't from what the technician said (sounded like it may be worse, also got a couple of leaky valves and PVCs). I keep ringing the cardiologist's secretary, who says the results haven't come back to him from cardiac physiology due to a backlog there. Am having no treatment (GP awaiting results of second echo). Very worried, no obvious symptoms, but occasional light headedness and weird upper abdominal discomfort. Travel overseas quite a lot and don't know what to tell travel insurers - had to cancel trip this month, but have to fly to NY next month! Don't know what to think or do.

Answered by Dr. Rajesh Teli (2 hours later)

Brief Answer:
we need to find cause of Pericardial effusion

Detailed Answer:
Hello,
I am Dr.Rajesh Teli,MD.I have gone through your query.Thanks for using HCM.
First of all I would like to know what were your initial complaints for which Echocardiogram was asked for ?kindly provide your complete history.
As I understand that you dont have significant symptoms as on today.
we must try to find out cause of effusion first.Once we know the cause we can plan the line of treatment.
Kindly provide me following details
1.what is the status of your present Thyroid control?
2.Kindly get basic inevestigations like Hemogram with ESR,X ray chest etc.done.
I presume that basic work up must have been done.Please furnish those details.
3.give me complete information on your present and past complaints with details of investigations done.
since you are relatively asymptomatic, there is no urgency to start treatment.But you must avoid distant travel untill your case is fully evaluated.
I would be glad to guide you further once i get your reply.
My best wishes
Dr.Teli.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rajesh Teli (28 minutes later)

Thank you. Underactive thyroid condition treated from 2002 and stable, PVCs diagnosed 2002 (benign, no treatment). Mitral valve prolapse with mild regurgitation diagnosed 3 years ago by echo after heart murmur found before minor op on foot. Follow up echo 3 months ago on return from trip to Australia found no MVP, but mild leakage from MV and moderate leakage from AV, plus anterior moderate pericardial effusion loacalised around RV (no tamponade). Blood tests clear after return from Australia mid-May - had unusually severe skin reaction to mosquito bites with possibly associated bacterial or viral infection soon after. Cardiologist thought PE could be associated with infection in July and said follow up echo 2 months later (just over a month ago) may be okay in which case he wouldn't need to see me again. I know from technician who did scan and was concerned enough to call in his superior that it hasn't. I'm slim, fit and active, eat well and don't smoke.

Answered by Dr. Rajesh Teli (10 hours later)

Brief Answer:
Effusion may be post infective and resolving

Detailed Answer:
hello,
As you have no fever ,joint pain and any other symptoms pertaining to effusion ,I feel that whatever is cause it is in resolving state and you may not need any specific treatment .
However I would like to review reports of both sittings of Echo comparing extent of effusion.
If it is static or regressing then it can be safely left alone ,but if increasing we need to evaluate by tapping the fluid and analysing it.
kindly provide me both reports,
my best wishes
Dr.Teli.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Rajesh Teli (13 hours later)

Thank you again. My cardiologist's secretary contacted me this morning to say that the echocardiogram done just over a month ago showed no change from the one done three months ago, so static. She said the earliest clinic appointment is end of November as there's a long waiting list. I was told no treatment at the moment (to be considered end November) and I can fly long-haul before then. I don't have a copy of either echo report, so I'll have to wait to see what he says at clinic. I'd appreciate your advice on what questions to ask then and also any lifestyle or self-help guidance. Many thanks.

Answered by Dr. Rajesh Teli (14 hours later)

Brief Answer:
Wait till appointment without stress

Detailed Answer:
Hello,
As the report is static you should not worry.i presume that first report must be showing mild effusion ,so as on today no need to worry .you may wait till your appointment in november .
you must ask following questions
1.what is the cause of effusion ?
2.what should be line of treament for its resolution ?
3.what precautions needed to prevent recurrence !
Meanwhile you may travel and protect yourself against infections .
my best wishes
Dr.Teli.

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Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar