Stress could complicate heart condition

Dear Dr. Gott: I am a 69-year-old woman who has had hypertrophic cardiomyopathy for over seven years. I periodically take a stress test and echocardiogram. I took both recently and compared them to earlier ones. My cardiologist says they show no worsening.

I can’t understand this when I now have chest pains and wild thumping of the heart. I can’t wash my car, and even peeling potatoes stresses my heart. I have been an extremely stressed (with manageable depression) person all my life. I take metoprolol and verapamil, and my cardiologist thinks these are the best medications. These do control my blood pressure but do not stop my heart symptoms. For my chest pains, he as much as said this goes with the ailment. Couldn’t he have prescribed something for this?

Dear Reader: Cardiomyopathy (heart-muscle weakness) is sometimes associated with coronary disease, untreated hypertension and extra systoles (heart pumping). Your cardiologist has covered the bases with his noninvasive testing. Frankly, I do not know the cause of your symptoms. I accept your explanation of stress as a complication. If this is the case, perhaps anxiety or depression medication will help. Ask your cardiac specialist about this.

Also, you don’t mention the cause of your cardiomyopathy and whether that specific cause is being addressed. Again, this may be a suitable topic for you to discuss.

Finally, note that I termed your cardiac work-up to be noninvasive, as it should be. Nonetheless, maybe it’s time to get a better idea of the inner workings of your heart. Do you, for example, have significant coronary blockages that should be bypassed or stented? This would show up during an X-ray coronary study. Again, this is a topic for you and your cardiologist to explore. Let me know what you decide.

To give you related information, I am sending you a copy of my Health Report “Coronary Artery Disease.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dear Dr. Gott: I am an 80-year-old female. My problem is that I am so tired all the time. I had two knee replacements, a stent implant and a cornea transplant, which was not successful. I really enjoy life but am too tired to do anything.

I wake up at 8 a.m., eat breakfast and read the paper, and by then I am so tired I’m ready for a nap. I wake up, do a load of wash, eat a little lunch, dust and am again tired.

I take vitamins B-12, C, E, and Os-Cal. What is my problem?

Dear Reader: Your symptoms could reflect a huge number of illnesses, ranging from depression to hidden cancer, anemia and thyroid disease.

This is just the sort of situation that doctors in internal medicine love to get their hands on because once the cause of your symptoms has been diagnosed, the treatment is usually straightforward and very satisfying.

So see your primary care physician. He or she is much more capable than some old, worn-out medical columnist.