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What Causes Orthostatic Intolerance And DVT After Chemotherapy?
Question: I'm 24 years old. Survived brain cancer and as a result of chemotherapy 3 years ago have Orthostatic problems and sometimes have sinus tachycardia that turns to SVT. They call it's P.O.T.S. I have a blood clot in my leg (D.V.T) as well for a few months now. I've been feeling weak and having chest and arm discomfort on and off for a few days. I was advised by an online Doctor here to make sure it was not a P.E by going to the E.R. I went and was cleared for that. I've had many tests done and they are all normal. I still feel extremely weak and am starting to get the chest discomfort (feels like pressure and sometimes squeezing when I take a big breath) again. I've had this pain before but never this intense. It starts up when I stand, walk, or exert myself in any way. They did a stress test a year ago and I was told I do not have coronary artery disease. I was given Nitroglycerin anyway because it seems to help. I usually use it only when the pain is terrible, but my blood pressure is a little low to take it. Should I go back to the E.R. or should I wait it out??? I am a bit concerned because my heart rate has been anywhere from 125 to 180 today. It's starting to make me feel a little short of breath. What could this be???
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that orthostatic intolerance and DVT are closely related to the cancer and chemotherapy.
Regarding the chest pain that you experience time after time, I would explain that it is not typical of coronary artery disease (especially the fact that it is modulated by deep breathing). The fact that your performed cardiac stress test was normal is another argument in favor of this.
It could be related to pulmonary embolism, chest metastatic lesions or a musculo-skeletal issue. An aortic disorder or pericardial infusion could also trigger this symptomatology. The fact that Nytroglycerin helps a little may be related to its other effects of muscular relaxation and dilation (that can act on the chest muscles and esophagus).
What tests have you performed in the ER to exclude a pulmonary embolism? The fact that you have DVT raises high suspicions of this disorder.
Can you upload your latest performed tests result for another second opinion?
From the other hand chemotherapy can lead to chemotherapy induced cardiomyopathy.
Coming to this point, I would recommend going to the ER for a physical exam and some tests:
- a resting ECG and a cardiac ultrasound to examine your heart function
- D-Dimmer levels
- a ventilation-perfusion chest CT scan to exclude possible pulmonary embolism
- blood electrolytes
- a blood gas analysis.
Let me know about everything! I would be glad to review all your uploaded tests for another second professional opinion.
Hope to have been helpful!
Kind regards,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that orthostatic intolerance and DVT are closely related to the cancer and chemotherapy.
Regarding the chest pain that you experience time after time, I would explain that it is not typical of coronary artery disease (especially the fact that it is modulated by deep breathing). The fact that your performed cardiac stress test was normal is another argument in favor of this.
It could be related to pulmonary embolism, chest metastatic lesions or a musculo-skeletal issue. An aortic disorder or pericardial infusion could also trigger this symptomatology. The fact that Nytroglycerin helps a little may be related to its other effects of muscular relaxation and dilation (that can act on the chest muscles and esophagus).
What tests have you performed in the ER to exclude a pulmonary embolism? The fact that you have DVT raises high suspicions of this disorder.
Can you upload your latest performed tests result for another second opinion?
From the other hand chemotherapy can lead to chemotherapy induced cardiomyopathy.
Coming to this point, I would recommend going to the ER for a physical exam and some tests:
- a resting ECG and a cardiac ultrasound to examine your heart function
- D-Dimmer levels
- a ventilation-perfusion chest CT scan to exclude possible pulmonary embolism
- blood electrolytes
- a blood gas analysis.
Let me know about everything! I would be glad to review all your uploaded tests for another second professional opinion.
Hope to have been helpful!
Kind regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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