Potential Heart Conditions: Symptoms and Next Steps

Are there any underlying heart diseases?

Hello, Doctor.
Thank you for taking the time to address some of my concerns.
This year, I was diagnosed with right bundle branch block during my military examination, which led to my exemption.
I also previously had mitral valve prolapse diagnosed at a clinic, and my research indicates that it usually has no clinical symptoms.
However, I have the following questions that are troubling me:
1.
I am unable to engage in intense exercise, such as basketball, as I experience a rapid heartbeat and weakness in my limbs.
However, I can perform regular aerobic exercises without issues; I can only play basketball for 15 minutes, while I can run for an hour without any problems.

2.
During sexual activity, masturbation, or even ejaculation, I experience symptoms such as increased heart rate, numbness in my hands and feet, and a lack of energy, which can last for two days.
I understand that fatigue can occur after ejaculation, but these symptoms clearly exceed normal fatigue and present as weakness.
This has been ongoing for five years.
Questions:
1.
Based on your experience, are these symptoms related to heart issues?
2.
How should I approach my doctor during a clinic visit regarding these concerns?
3.
What cardiac examinations should I undergo, and are there any relevant authorities I should consult?
Conclusion: The long-term nature of these symptoms has led me to change my lifestyle, including going to bed early, maintaining a healthy diet, and developing an exercise routine.
Health is a lifelong commitment, and I want to get to the root of these issues.
Thank you for reading this.

Jing, 20~29 year old female. Ask Date: 2023/11/27

Dr. He Dongjin reply Cardiology

Hello, jogging for an hour is fine for your heart.
These symptoms are not related to your heart.
If you're still concerned, please visit a family medicine clinic for an examination.
Changhua Hospital cares about you.

Reply Date: 2023/11/27

More Info

Thank you for sharing your concerns regarding your heart health. It’s commendable that you are proactive about understanding your symptoms and seeking clarity on potential heart conditions. Based on the information you've provided, let's break down your concerns and explore the next steps.

Understanding Your Symptoms
1. Right Bundle Branch Block (RBBB): This condition can sometimes be benign, especially if there are no other underlying heart issues. However, it can also indicate other heart problems, particularly if accompanied by symptoms like those you're experiencing.

2. Mitral Valve Prolapse (MVP): While MVP is often asymptomatic, it can sometimes lead to palpitations or anxiety, which may explain your symptoms during physical exertion or sexual activity.

3. Symptoms During Exercise: The fact that you experience increased heart rate and weakness during intense activities like basketball, but not during moderate activities like jogging, suggests that your heart may be reacting differently to varying levels of exertion. This could be due to several factors, including cardiovascular fitness, anxiety, or even the effects of MVP.

4. Symptoms Related to Sexual Activity: The heart rate increase and feelings of weakness after ejaculation could be linked to autonomic nervous system responses. It's not uncommon for individuals to experience fatigue or a drop in energy levels post-ejaculation, but the prolonged nature of your symptoms (lasting up to two days) is concerning and warrants further investigation.

Next Steps
1. Consulting Your Doctor: When you visit your healthcare provider, it's essential to be thorough in discussing your symptoms. Here are some questions you might consider asking:
- Do my symptoms suggest any underlying heart conditions?
- What tests do you recommend to evaluate my heart health?
- Should I be concerned about my right bundle branch block and mitral valve prolapse in relation to my symptoms?
- Are there lifestyle changes or medications that could help manage my symptoms?
2. Recommended Tests: Based on your symptoms and history, your doctor may suggest several tests, including:
- Electrocardiogram (ECG): To assess your heart's electrical activity and check for any abnormalities.

- Echocardiogram: This ultrasound test can provide detailed images of your heart's structure and function, particularly useful for evaluating MVP.

- Stress Testing: This can help determine how your heart performs under physical stress and may reveal any ischemic changes.

- Holter Monitor: A 24-hour ECG monitoring can help capture any irregular heart rhythms that may occur during your daily activities.

3. Referral to Specialists: If your primary care physician suspects that your symptoms may not be purely cardiac, they might refer you to other specialists, such as:
- Cardiologist: For a comprehensive evaluation of your heart health.

- Endocrinologist: If there are concerns about hormonal influences on your symptoms, particularly related to sexual activity.

- Psychologist or Psychiatrist: If anxiety or stress is contributing to your symptoms.

Conclusion
It's great to hear that you've made positive lifestyle changes, such as improving your diet and incorporating regular exercise. These habits can significantly benefit your overall health and potentially alleviate some symptoms. However, given the duration and nature of your symptoms, it’s crucial to pursue a thorough evaluation with your healthcare provider. Early detection and management of any potential heart issues can lead to better outcomes and peace of mind. Remember, your health is a lifelong journey, and addressing these concerns now can help you maintain a healthier future. Thank you for taking the time to share your story, and I wish you the best in your health journey.

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