Submitted by Dr T on January 14, 2013 – 1:57pm
I am not convinced your cardiac evaluation is complete, because some of your symptoms are consistent with heart failure. There is a test that calculates your ejection fraction, but that test doesn’t always all questions of cardiac function. I specifically think of some forms of cardiomyopathy, called restrictive cardiomyopathy, or another condition called pulmonary hypertension.
I also miss information about a final evaluation of these “tachycardias” and “extrasystolic beatings“. The fact you were treated with IV meds for control, suggests there was a real problem. You should ask your doctors to review your medical records from that time to make sure there your palpitations and arrhythmias were not serious and disappeared when you delivered your baby.
Here are some common tests used to evalaute a pregnant patient with an arrhythmia:
This should be considered an integral part of the investigation of any pregnant patient with proven arrhythmia to diagnose structural and functional disease.
This can be reasonably carried out during pregnancy providing exercise is not contraindicated for obstetric reasons. Care should be taken not to exceed the woman’s normal exercise capability and the test should be stopped if hypotension develops as this may impair placental perfusion.
While there has been experience of this in pregnancy, it is usually possible to delay this investigation until after pregnancy. It is also difficult to do beyond 24 weeks as women are unable to lie flat on their backs as the gravid uterus impedes inferior vena cava flow.
- Pharmacological testing
A pharmacological challenge may provide important diagnostic information, particularly in narrow complex tachycardia.
- Electrophysiological studies
This is rarely required in pregnancy as the arrhythmia can usually be managed pharmacologically until after delivery.
If it is not your heart, swollen lymph glands, fatique and a severely decreased exercise tolerance can point to other illnesses. This is something you should discuss with your doctors.
Hope this helps,