Normal echocardiogram and blood test?

[Ben1990]

Hi everyone for last year or so I've got built up fluid in my legs and ankles its still present now, also I get severe palpitations daily even in my sleep so 4 weeks ago I had a echocardiogram and it came back normal function normal ef and also blood test came back all good just weird I know anxiety can cause palpitations but it certainly cant cause oedema how accurate is the echocardiogram? I want opinions on whether or not go back for a second opinion at my gp?

[Milkfairy Heart Star]

Hello Ben 1990

Welcome to the forum.

It is good to hear that your blood test and echocardiogram are normal.

Was this the NTproBNP blood test?

I have this test from time to time as if it is normal it usually shows your heart muscle is working well.

An echocardiogram shows again if the muscle of the heart is able to pump the blood around your body.

As both your echocardiogram and blood test are normal this is reassuring.

If you have any further concerns especially about your swollen ankles and palpations make an appointment with your GP and perhaps write down a list of questions you wish to discuss with your GP. Ask the GP to go through your test results with you.

Another useful test to check your heart rhythm is to have a 24 hour recording of your heart rate a Holter test. This will record what's happening whilst you are feeling your palpitations.

We all have from time to time manage our anxiety and there are many strategies you could try.

From Tai Chi, yoga, meditation and relaxation techniques.

I hope you feel more at ease and calmer soon.

[Ben1990]

Hi I'm not sure I think it was a full blood count blood test? And my gp has explained the swelling has got be down to been overweight but I'm only 28 i didnt think carrying a extra weight can cause oedema in my legs and mildy in my ankles at my age and so does a echocardiogram rule out any heart problem?

[MichaelJH Heart Star]

Hello Ben... Being overweight (BMI 25 - 30) is indeed unlikely to cause odema at your age although obesity might.

Odema had many potential causes besides heart problems. Possible causes include the side effects of some drugs (calcium channel inhibitors are notorious), underlying kidney or liver problems, disorders of the lymph system and venous insufficiency. It might be worth running these past your GP.

Good luck in finding the cause. Walking can be helpful as it gets the circulation going as can resting with your feet up.

[Ben1990]

Hi Michaeljh my BMI is 39 I'm 21 stone but I'm 6ft.1 so alot of people get shocked when I tell then my weight I look about 16 to 17 stone but the scales obviously dont lie and I have explained all my concerns to my gp but as every test they have requested has come back normal all apart from I had pre diabetes but I had another blood test to confirm and they came lower blood glucose levels than previous.

[MichaelJH Heart Star in reply to Ben1990]

Hello Ben... Thank you for your honest reply. If your BG was a spot measurement this is not adequate for diagnosis. The blood test to have is HbA1c which shows the average for the preceding weeks.

Tackle weight loss in stages. The first stage should be to get down to 18/19 stone as around 20 stone some medications can become less effective (I was told this by a hospital pharmacist when talking about the various heart medications). Next stage aim for 16/17 stone. The aim is to achieve sustainable weight loss. Diets such as the 800 calorie one can achieve dramatic initial results but the aim is to change permanently not yo-yo. Many GPs can prescribe initial WW and Slimming World courses, and some exercise classes if appropriate. Good luck!

[Ben1990 in reply to MichaelJH]

Hi sorry for late reply my work routine is messed up I'm doing all hours at moment... 2 years ago I was referred to lifestyle management which was a gym prescription but I never heard back so I lost 3 stone doing my own stuff in 3 months but I quickly fell back into my old routine of drinking and eating the wrong stuff but my gp has promised trying to sort some it as apparently NHS have cut funding for lifestyle management.

[MichaelJH Heart Star in reply to Ben1990]

Hello Ben, as far as I am aware in my area they are still funding lifestyle management and even occasionally multiple ones such as Slimming World if WW fails. I think it like cardio rehab is s postcode lottery. I was referred for rehab but it would not have happened if I had not chased it up. One thing to be wary of is that both WW and SW push lots of fruit that can cause sugar overload because of the fruit sugars. Salads and lean protein are good with some complex carbs. Good luck...

[Bagrat]

It must be a worry. I don't know how active you are but gentle exercise is always good walking every day for example for 20 mins to start with and gradually increasing as MichaelJH said. If you are pre diabetic a change in diet may also help. We are what we eat and it's easy for weight to creep on. A move to a diet with lots of fruit and veg for example may help all round.

[Ben1990 in reply to Bagrat]

Hi you are very spot on it's very easy to eat the nice stuff but lose control, its very vicious cycle the stuff that makes you live also potentially can kill you.

[Mirell]

Hello

I would go back to check your kidneys. I struggled with edema for almost 2 years, doctors didnt know why. It became worse and worse til i felt really sick and got hospitalized in may this year. Turned out I had nephrotic syndrome (kidneys) and was diagnosed with minimal change disease after biopsy. It can come slowly over time or suddenly. The indicator here is the protein albumin, if its low it can no longer hold the fluid within the blood vessels and it leaks out into the tissue around causing edema.

I was told nothing could be found and that I just had to live with the edema since he couldnt find the reason why. It got worse, and my gp finally did full blood work (as he had done before without result), and it finally showed.

Could be worth checking out? Bring a urine sample as well. Its not normal to suddenly start having edema so if I were you I would not give up. If its an underlying cause its important to get treatment as it can lead to more complications. In my case trombosis, high blood pressure and high colesterol (the lack of fluid in the blood makes it thicker).

[Ben1990 in reply to Mirell]

Hi did you get any pains In back cause for last few months I have been getting burning pains around my lower to middle back both sides but it has not been a problem since recently?

[Mirell in reply to Ben1990]

Well yes I did, mostly on my right side of the abdomen and right lower back. BUT the pain has come back lately even though my kidney tests are normal and ultrasound of the abdomen showed everything is normal so I guess we have no idea whats causing it. Doctor are ordering more tests though. Still on medication, kortison, the pain has come back slowly as we have decreased the dose, its a puzzle!

But when i was diagnosed I was sure we found the cause of the pain, but maybe its a coincidence that I have pain the same place? Back and abdomial pain is a tricky thing, so many things can cause it so thats frustrating!

Of course it could be muscular or nerves? Dont know about you, but in my case the pain is there constant, movement or not.

Oh and with nephrotic syndrome you leak the protein out the urine which can cause a foamy layer on top of your urine in the toilet.

Hope you find out whats causing it and trust your instinkts!

[Ianc2]

Hi Ben

Have a look at Diabetes.org, with particular regard to diabetes type 2. It is one of the few afflictions that can be stopped dead in it's tracks and reversed, Have a good look at the case studies which show quite graphically what this nasty disease can do to your legs and eyes, Try losing the bread, the cakes, the biscuits and the beer, and treat sugar like poison. Spend the money you save on some decent wet weather gear and get active.

Spend about £30 on a decent weighing machine that will tell you your % fat, etc. WW (used to be weight watchers) do a very informative one. You are young enough to transform your life. Get a bit of string exactly 6 foot long. Your waist should be half your height - have a good look at the international rugby players, the days of the beer gut have long gone, and been replaced with solid muscle.

If you can fit in some circuit training you may find it useful, but try and lose weight first or your excess weight will act like a pile driver on your knee joints.

I have seen this process work and transform peoples lives. A friend of my wife's is currently fighting this problem and she has to pass a Gregg's shop every day. "How do you manage" I said. She replied "I see a shop full of syringes" she said.

[Ben1990 in reply to Ianc2]

Hi thanks for that information apparently you are right my eyes over last 12 months have become blurry which probably explains the pre diabetes but the recent blood test shows ok levels which I'm under observation for next 12 months but I'm certainly on the path now to lose weight my goal is to lose alot of weight at least 6 to 8 stone.

[Ianc2 in reply to Ben1990]

If you have the time, have a look at insulin resistance and how it fits into your body's ability to process sugar. We live in a world where fast food is everywhere, with lots hidden sugar. Bagrat and MichaelJH have good advice, especially the HbA1c test. I think you know what to do as you have done it before so I hope you can reorganise your lifestyle and perhaps find an absorbing hobby or activity to distract yourself from food as you drive down your weight.

[Qualipop]

If you only had an immediate ECG, chances are that it wouldn't pick up the palpitations. You need a Holter monitor that takes readings over 24 hours. I'd been having heart fluttering that would last for 90 minutes yet by the time I'd waited 5 hours in Urgent Care for an ECG, they had obviously stopped. However the monitor showed many episodes. Most palpitations are harmless but it is important to find out just which part of the heart they are coming from.

[Ben1990 in reply to Qualipop]

Thanks for your reply can I ask is it dangerous to get palpitations from certain parts of the heart because I get nearly every palpitation going, I get long pauses, i get 2 beats at once, I get a rhythm which lasts for about 2 seconds which is very fast and irregular and uncomfortable but when I cough really hard it stops?

[Qualipop in reply to Ben1990]

That sounds like what I've had for years. Afraid I didn't ask where it came from. I was just happy to be told it was nothing to worry about.

[Ben1990]

Thanks for all the replys I'm going back to my gp and have further discussions about edema some days it's not too bad others its quite bad.. so I think its probably worth another visit I never really thought I had any heart condition cause i dont get short breathless unless I do some it really strenuous but I think that is normal for a overweight man.