DEAR DR. ROACH: I am 26 years old, 6 feet, 3 inches tall and weigh 290 pounds. About two years ago, I had chest pain and palpitations. I saw a cardiologist, who performed an echocardiogram. It showed mild LVH and mild pulmonary hypertension. I had multiple EKGs, and my doctor says I have a clean bill of health. Are any of the symptoms I have dangerous, or am I overreacting? — J.A.
ANSWER: Chest pain and palpitations are common concerns that occasionally represent serious heart disease but often don’t. It’s estimated that the average person has 500 or so abnormal heartbeats a day, and these can be felt as palpitations. Chest pain should raise the concern for angina caused by heart blockages, but that would be extremely unusual in a 26-year-old.
The concern I have in hearing about your echo results is that they could represent obstructive sleep apnea. Left ventricular hypertrophy (LVH) is the heart’s response to chronic stress, especially to elevated blood pressure, which is common in sleep apnea. Pulmonary hypertension has many causes, but in someone very overweight (your body mass index, BMI, is 36.2, where “obese” is defined as over 30), I have to be concerned about chronic low oxygen to the lungs. There are many people with sleep apnea who aren’t diagnosed. I would recommend a sleep study. Certainly I recommend careful checking of your blood pressure, and weight loss.
Heart disease remains the No. 1 killer. The booklet on clogged heart arteries explains why they happen and what can be done to prevent clogging. Readers can obtain a copy by writing: Dr. Roach -- No. 101, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. ROACH: I am an 85-year-old woman living in a nursing facility. A little before my arrival here, I began experiencing night sweats. I have seen my doctor regarding this, and he said he cannot help me. I feel weak when I wake in the morning, and I need to constantly change the towels I put under myself. This is a big concern. — A.M.