Managing Congenital Heart Disease: Seeking Effective Solutions for Symptoms

Q: Managing Congenital Heart Disease: Seeking Effective Solutions for Symptoms

Hello： Your heart issue is not a congenital heart disease. <br>An echocardiogram is a very sensitive examination, and even a slight amount of blood regurgitation can be detected. <br>However, this does not necessarily indicate valvular heart disease. <br>If you have seen so many

The heart condition that has troubled me for many years?

Hello Doctor: I have congenital heart disease, specifically a valvular issue, which has caused me symptoms such as chest tightness, palpitations, and dizziness since childhood.
However, these symptoms would only occur during intense physical activity or irregular routines; otherwise, everything seemed relatively normal.
As I have aged, my condition has worsened, and after experiencing several heart attacks over the past year (which had never happened before), I now suffer from daily angina, characterized by chest pain radiating to my back (especially around the area known as "kho-bang" in Taiwanese), shortness of breath, and fainting, particularly when lifting heavy objects, resting, or lying flat at night.
This situation occurs daily, varying only in severity.
In severe cases, the pain is so intense that it disrupts my daily activities, leading to insomnia and a disrupted circadian rhythm.
In milder cases, I experience just chest tightness and pain.
Recently, I have frequently visited the hospital for examinations, but there has been no improvement.
The test results indicated tricuspid regurgitation, mitral valve prolapse, and vasovagal syncope.
However, the doctor did not provide any treatment options, only advising me to pay attention to my diet and engage in appropriate exercise.
He mentioned that surgery would only be considered in cases of life-threatening conditions or severe prolapse or regurgitation; otherwise, medication would be the primary treatment.
I have taken many medications in the past, but they have increasingly become ineffective, which is quite distressing.
Currently, I often have to swing my left arm and massage the "kho-bang" area to alleviate the sharp pain, which feels like being pricked by needles.
I would like to ask the doctor if you have any better strategies for my situation.
If you need me to explain my symptoms or condition in more detail, I am more than willing to cooperate.
I have also read many related books to understand my condition and its causes, but I am unsure why the medications have not been effective.
Therefore, I would appreciate your valuable advice! Thank you very much!

Fu Ge, 20~29 year old female. Ask Date: 2004/11/02

Dr. Lin Liangyu reply Cardiology

Hello: Your heart issue is not a congenital heart disease.
An echocardiogram is a very sensitive examination, and even a slight amount of blood regurgitation can be detected.
However, this does not necessarily indicate valvular heart disease.
If you have seen so many doctors without finding a cause, it is quite possible that you have a problem with autonomic nervous system dysregulation.
This issue is quite common in modern individuals; some experience it due to excessive stress, some due to irregular lifestyles, and others may not find a clear cause.
You might consider practicing Qigong or Tai Chi to help regulate your energy, which should lead to improvement.

Reply Date: 2004/11/02

More Info

Managing congenital heart disease, particularly when it involves valvular issues, can be quite complex and requires a comprehensive approach to treatment and symptom management. Given your history of symptoms such as chest tightness, palpitations, dizziness, and the recent exacerbation of these symptoms, it is crucial to address both the underlying heart condition and the symptomatic relief.

Understanding Your Condition
From your description, it appears that you have been diagnosed with tricuspid regurgitation and mitral valve prolapse, which can lead to significant hemodynamic changes in the heart. These conditions can cause the heart to work harder, leading to symptoms like chest pain, shortness of breath, and fatigue. The fact that you have experienced episodes of chest pain radiating to your back, especially during physical exertion or when lying flat, suggests that your heart is under stress, possibly due to the regurgitation and the resultant volume overload.

Importance of Regular Monitoring
Given your history of heart attacks and the worsening of symptoms, regular follow-up with a cardiologist is essential. This should include periodic echocardiograms to assess the function of your heart valves and the overall function of your heart. If the regurgitation becomes severe or if there are signs of heart failure, surgical intervention may be necessary. However, as your doctor mentioned, surgery is typically reserved for cases where there is a significant risk to life or severe symptoms that cannot be managed medically.

Symptomatic Management
1. Medications: While you mentioned that medications have not been very effective, it is important to ensure that you are on the right regimen. Common medications for managing symptoms of heart failure and valvular heart disease include diuretics to reduce fluid overload, beta-blockers to manage heart rate and rhythm, and ACE inhibitors to help with blood pressure and heart function. If you haven't already, consider discussing with your doctor the possibility of adjusting your medication or trying different classes of drugs.

2. Lifestyle Modifications: Diet and exercise play a crucial role in managing heart disease. A heart-healthy diet low in sodium, saturated fats, and cholesterol can help reduce the workload on your heart. Regular, moderate exercise can improve cardiovascular health, but it is essential to tailor your activity level to your tolerance. Avoiding heavy lifting and extreme exertion is advisable, especially if it triggers your symptoms.

3. Physical Therapy: Given your symptoms of pain and discomfort, physical therapy may be beneficial. A physical therapist can help design a program that focuses on strengthening your cardiovascular system without overexerting yourself. They can also provide techniques to manage pain and improve your overall physical function.

4. Stress Management: Chronic pain and discomfort can lead to anxiety and stress, which may exacerbate your symptoms. Techniques such as mindfulness, yoga, or cognitive-behavioral therapy can be helpful in managing stress and improving your overall well-being.

5. Alternative Therapies: Some patients find relief through acupuncture or massage therapy. While these should not replace conventional treatment, they may provide additional relief from symptoms.

When to Seek Immediate Care
Given your history of heart issues, it is crucial to know when to seek immediate medical attention. If you experience severe chest pain, shortness of breath that worsens, or symptoms of fainting, you should seek emergency care. These could be signs of worsening heart function or other complications.

Conclusion
Your situation is indeed challenging, but with the right combination of medical management, lifestyle changes, and possibly physical therapy, you can find ways to manage your symptoms more effectively. It is essential to maintain open communication with your healthcare provider about your symptoms and treatment options. If you feel that your current treatment plan is not effective, do not hesitate to seek a second opinion or ask for a referral to a specialist in congenital heart disease. Your health and comfort are paramount, and there are options available to help you lead a more comfortable life.

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