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Heart & Cardiology/Water retention and heart disease.

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Question
Hello,

I have had Shortness of breath and abnormal fatigue for over a year now. I am 50 years old. I am overweight. Having said that, and I'm working on the weight issue, this past summer I started having pitted edema. I have water retention all the time, if I don't take a prescribed water pill for it my shortness of breath gets worse. I do have some occasional heart pain. Heart disease runs in my dad's family.

I have had a stress test that I did extremely well on. I've had an electrocardiogram that came back normal. My blood work seems fine except for good cholesterol is 28. My doctor wants to see me back in 3 months. In the meantime I'm working 40 hours a week and just surviving and my legs hurt especially at night from the water retention.

Is it possible that it's not my heart and I should pursue other avenues? Such as doctor's? I'm confused and tired.

Thanks for your help,
Bonnie

Answer
Hello Bonnie,

There's a condition called diastolic heart failure where the heart contracts well on echo, but doesn't relax well and fails to pump enough blood to the body.   Usual heart failure medicines work;  ARBs, beta blockers and diuretics.  Ask your doc about diastolic heart failure.

Loss of protein in urine can cause pitting edema and maybe breathlessness.  Easy to check by measuring protein in urine and blood.

Lung trouble can cause breathlessness and eventually cause edema from right heart failure.  Cough and maybe wheezing are signs of lung trouble.

Please write back if this note doesn’t answer all your questions.

David Richardson

Heart & Cardiology

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David Richardson

Expertise

Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.

Experience

Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.

Organizations
Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Publications
Circulation, American Heart Journal, Hypertension.

Education/Credentials
M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.

Awards and Honors
Gold Heartt Award from American Heart Association in 1995.

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