Question 1

Ive been getting this warm sensation near my left ribs and just below my breast lately. I went for a master checkup and had an ECG and 2D Echo done, and everything came back normal. But I couldn't do the TMT test because of an ACL ligament tear, so walking on the treadmill isn't an option for me. Do you think I need the TMT or any other tests to make sure it's not a heart issue?

Accepted Answer

Since your ECG and 2D Echo reports are normal, it is less likely that the heat feeling near your left ribs and below your breast is related to a heart issue. However, considering your symptoms, it may still be beneficial to undergo further testing to rule out any other potential causes. One option could be a CT scan or MRI to evaluate the area near your left ribs and below your breast for any abnormalities. Additionally, a consultation with a gastroenterologist may also be helpful to assess for any gastrointestinal issues that could be causing your symptoms.

Question 2

I'm looking for some advice about my heart health. I had a CT coronary angiogram about three years ago because I was having chest pains and my exercise capacity was low. The results showed no significant stenosis in any artery, but Im wondering if minor blockages might have been overlooked. Also, it mentioned that my circulation is left dominant, and I'm curious if that could be related to my chest pain. Do you think it's necessary to repeat the CT angio even though I'm worried about the radiation exposure?

Accepted Answer

If your CT coronary angiogram from 3 years ago showed no significant stenosis in any artery, it means that there were no major blockages detected at that time. Minor blocks may not have been mentioned in the report because they were not significant enough to cause concern. The fact that your circulation is left dominant is just a variation in the blood supply to your heart and is not necessarily a cause for chest pain. Based on the information provided, if you are still experiencing chest pains or other concerning symptoms, it may be advisable to consult with a cardiologist to determine if a repeat CT angio or other cardiac tests are necessary. However, the decision to repeat the CT angio should be based on your current symptoms and risk factors, rather than just for routine surveillance. It is important to weigh the potential benefits of the test against the risks of radiation exposure.

Question 3

I've been having a really hard time with my sleep schedule. I tend to crash around 7 or 8 in the evening and can barely stay up past 9 p.m. It's like my body just shuts down after dinner, and I'm struggling to understand why this is happening. On top of that, I'm experiencing some other weird stuff. Whenever I sit down or stand up quickly, my heart starts racing like crazy, and it also happens if I suddenly fall onto the bed. I've heard of postural orthostatic tachycardia syndrome and anxiety symptoms, and I know they can cause things like this, along with heavy sweating and really dry skin. But even after trying anxiety meds, nothing seems to change. What could be going on with me? Any ideas?

Accepted Answer

It sounds like you may be experiencing symptoms of postural orthostatic tachycardia syndrome (POTS). POTS is a condition characterized by an abnormal increase in heart rate that occurs after sitting up or standing. The symptoms you described, such as racing heart when changing positions, feeling tired in the evening, and sweating, can be associated with POTS. For the symptoms of POTS, you can try increasing your fluid and salt intake, wearing compression stockings, and doing exercises to improve blood flow. Additionally, medications like midodrine or fludrocortisone may be prescribed to help manage your symptoms. It is important to consult with a healthcare professional for a proper diagnosis and treatment plan.

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