Nothing much is wrong, but it's slowly killing me nevertheless....I was diagnosed with inflammatory breast cancer in 2009 and received dose-dense (every two weeks) chemo for 4 months, followed by surgery and then 6 weeks of daily radiation. The rads were on the right--not the left, where the heart is. But the chemo contained quite a bit of known cardiotoxic drugs.
Immediately after my treatments were done, I was debilitated but more or less functional in my daily life. I began an exercise program for cancer survivors, which I participated in for 3-4 months (the limit). During that program, my target heart rate was 120, and I'd have to walk on a treadmill briskly for 12-15 minutes to reach that heart rate. After the exercise program, I walked half a mile twice a day (on an incline), 5 days a week. I also walked up and down a flight of stairs at least 3-4 times a day, 5 days a week.
As the years went on, I became progressively less able to do these exercises. By the end of three years, I couldn't walk up the stairs even once without my heart rate zooming into the 130s, my muscles burning and hurting like I'd just run a marathon, my heart thumping out of my chest, and my breath hard and heavy but I still felt like I wasn't getting enough oxygen. I couldn't walk my half-mile course without feeling like I'd just run a marathon. Eventually it got so bad that merely getting up out of my rocker to put a load of clothes on to wash would make my heart rate jump into the 140s. And if I pushed myself to do the things that I could do fairly easily immediately after my cancer treatments, a couple of hours *after* I had finished the chore I would get an acute manifestation of symptoms that included extreme weakness, shakiness, racing heart that felt like it was working WAAAAYYYY too hard for what I was asking it to do, feeling like I just couldn't get enough oxygen, going ice-cold from the inside out,....
Even without these extreme symptoms, I can develop SOB that feels obstructive---it feels like something is in the way of my diaphragm and won't let me breathe deeply enough. I have spells when I have palpitations that can send me to the floor to lie down so that I don't fall down (even if I'm sitting in a chair at the time it happens).
As my functional ability declined, I searched for answers: what was causing this and how do I stop it? I got evaluations from a variety of specialists, including a cardiologist. Nothing. I started telling my doctors that it was OK that they couldn't find a reason for my decline. They'd figure it out at the autopsy. And I was not entirely joking.
Then a pulmonologist gave me a cardiopulmonary stress test, which, on the face of it, I passed with flying colors. (Test a consequence of following up on a possible cancer recurrence.) No surprises there. I was passing every medical test with flying colors. On paper, I was healthy as a horse! But a couple of hours later, when I was home that evening, the acute symptoms came on again. Since the doctor knew exactly how much effort I had expended for the test, I reported to her via EPIC messaging, in real-time, how I was feeling. This freaked her out, and it freaked her out even more when I refused to go to the emergency department because experience had shown that these symptoms were NOT a heart attack. She looked more closely at my test results and found an anomaly--not a big one, but one suggestive of a heart issue.
I went back to the cardiologist, who this time managed to find something on echo---diastolic dysfunction. I wore a holter monitor, had a nuclear stress test, etc. What she diagnosed me with was a LITTLE BIT of diastolic dysfunction due to left ventricular hypertrophy and mild tachycardia. MILD. She kept insisting I do not have heart failure. A little bit of a beta blocker (metoprolol succinate) would fix it. And the reason I had become progressively unable to do my regular exercise program was because I needed to exercise -- I was deconditioned. (Yeah...go figure out how you become deconditioned due to lack of exercise WHILE you are regularly exercising!)
I, meanwhile, was doing a bit of reading on my own in the medical journal literature and realizing that I had been reporting the exact symptoms of diastolic heart failure with preserved ejection fraction for the last 5 years--with slowly increasing severity. I found an article about exercise for heart patients that described the exact symptoms I was having when I exerted myself too hard. And I found the NYHA classification system and realized that "too hard" didn't take much for me, nowadays, because I had been (before seeing the cardiologist this time) entering Class III functional status.
The beta blocker has backed my functional status off to a Class II again, but I'm noticing, after taking it for 6 months, that it's not working as well. I've had some episodes of sudden weight gain -- like 5 lbs overnight -- so have taken Lasix on an as-needed basis to reduce fluid build-up. But the Lasix never removes all of whatever I gain overnight, when I gain significant amounts like that.
But, says my cardiologist, I'm not in heart failure. (Or rather, my cardiologist's NP, who is the person I see.) And despite my having sent her the medical journal article that perfectly describes the post-exertion symptoms I have reported, she says she can't figure out why I have those symptoms. They mystify her.
So.... My official diagnosis is mild left ventricular hypertrophy, preserved ejection fraction, and a bit of tachycardia. However, functionally I'm in Class II and hovering on the edge of being Class III (thanks to metoprolol, only hovering, now) -- a level of debility not likely with such a low-grade diagnosis. If you listen to my symptom pattern over time and not just the formal test results, I have diastolic heart failure with preserved ejection fraction. It's your call, how you want to think of me and my situation.