Persistent Fever and Chest Discomfort: When to See a Cardiologist?

Mild chest tightness and low-grade fever?

Hello doctor, about two months ago I had a severe cold, and my cough lasted for about a month before it improved.
After that, I started experiencing abdominal pain and vomiting.
I first went to the gastroenterology clinic, where blood tests showed some inflammatory response.
An upper endoscopy was scheduled, but on the day of the procedure, the nurse checked my temperature and found I had a fever of about 38 degrees Celsius, so I was advised to go home and rest and return the following week.
The following week, I still had a low-grade fever, and I gradually developed a sore throat for three days, but I had no other cold symptoms, just a persistently elevated temperature.
I was then referred to an infectious disease specialist, where blood and urine tests were conducted, and the doctors said the inflammatory markers were not high and everything seemed fine.
However, it is now March, and I still have a persistent temperature between 37.6 and 38 degrees Celsius, along with symptoms of chest tightness and palpitations.
Should I consider seeing a cardiologist to investigate the issue?

Wei, 30~39 year old female. Ask Date: 2020/03/07

Dr. He Dongjin reply Cardiology

Hello, if you have a fever, it is advisable to first consult an infectious disease specialist.
If there are any concerns, that specialist will coordinate with other relevant departments.
It will be handled by the infectious disease physician.
Take care from Changhua Hospital.

Reply Date: 2020/03/07

More Info

Based on your symptoms and medical history, it is advisable to consult a cardiologist, especially given the persistent fever, chest discomfort, and heart palpitations you are experiencing. While your initial symptoms of a severe cold and subsequent gastrointestinal issues may seem unrelated, the development of chest discomfort and palpitations warrants further investigation, particularly in the context of your ongoing fever.

Persistent fever can be indicative of an underlying infection or inflammatory process, which may affect various systems in the body, including the cardiovascular system. The fact that you have experienced chest discomfort alongside these symptoms raises concern for potential cardiac involvement, especially if there is any underlying myocarditis (inflammation of the heart muscle) or pericarditis (inflammation of the lining around the heart). These conditions can sometimes arise following viral infections, including respiratory viruses.

Your symptoms of chest discomfort and palpitations could be related to several factors, including anxiety, which can manifest physically, or they could indicate a more serious condition such as arrhythmias or ischemic heart disease. Given that you have a history of fever and inflammation, it is essential to rule out any cardiac complications that may have arisen as a result of your recent illness.

When you visit a cardiologist, they may perform several tests to assess your heart's health. These could include:
1. Electrocardiogram (ECG): This test records the electrical activity of your heart and can help identify any irregularities in heart rhythm or signs of previous heart damage.

2. Echocardiogram: An ultrasound of the heart that can provide information about the heart's structure and function, including the size of the chambers and the condition of the heart valves.

3. Holter Monitor: A portable device that records your heart's rhythm over 24-48 hours to detect any irregular heartbeats that may not be present during a standard ECG.

4. Blood Tests: These can help assess markers of inflammation, cardiac enzymes, and other relevant factors that could indicate heart stress or damage.

5. Stress Testing: This evaluates how your heart performs under physical stress and can help identify any ischemic changes.

It is also important to discuss your fever with the cardiologist, as they may want to collaborate with an infectious disease specialist if there is a suspicion of an infectious process affecting your heart.
In the meantime, it is crucial to monitor your symptoms closely. If you experience worsening chest pain, shortness of breath, or any other alarming symptoms, seek emergency medical attention immediately.
In summary, given your persistent fever, chest discomfort, and heart palpitations, seeing a cardiologist is a prudent step. They can provide a comprehensive evaluation and determine the appropriate course of action based on your specific situation. Early intervention can be key in addressing any potential cardiac issues and ensuring your overall health and well-being.

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