Will an ekg detect acute volume or pressure overload in a non enlarged heart?

Question

Im 19 years old and i dont know if im just being paranoid, but ive been feeling pretty weird lately. My main concern is whenever i smoke pot or exercise, i can feel a sort of stretching in my chest. Its hard to describe, it feels like someone is holding ther hand or a wedge on my heart, like a rising pressure. My blood pressure gets higher but not to crazy levels, its usually pretty stable at around 115-120/75 but when i feel this it can get around 128/88. My interpretation is that it feels like a stretching or a fluid overload, like the walls of my heart are being stretched or pulled due to excessive pressure from the blood near the bottom of my heart in the centre. It feels like the contractions are too forceful in relativity to the work its doing? Like i said its very subjective and difficult to articulate properly. These symptoms usually last about an hour, but i will feel very weak and drained for about a day afterward, and my blood pressure will usually be lower than it was for a day, like 102/65 or something.

Tests so far have been normal, normal chest xray from a few months ago, and normal echo results, although i wasnt feeling any symptoms during either test. I feel like an echocardiogram wouldnt detect any problems until theyve actually caused damage or dilation though.

Anyway regardless of whether or not you think im crazy, i wanted to ask about ekg or holter monitoring. If hypothetically my heart WAS being stressed or pulled like i described, would there be any changes in the ecg while it is occuring? Im mainly concerned about filling pressures preload/afterload problems that come on with exertion. Will a holter monitor detect this kind of thing in a normal sized heart if it is happening? T hanks

Answer 1

You done a little reading, but, you don't understand heart anatomy very well, or function.

Go back and read about vessels responding to fluid load coming in. You heart is able to handle differing volumes of blood coming in at a pretty surprising volume.

If I were to offer a professional opinion, most of what you are experiencing is THC side effects, prickles, skin and scalp are typical, and there is some correlation for effects on the big vessels feeding the heart. More than likely, your awareness of these changes is heightened.

If you are really that worried about it, design an experiment and see what happens, stop smoking pot for a while and see if you still experience these sensations... if you do, see what difference exercise will do. You can probably ferret out the real answer on your own.

And, an extra hint, the best way to reduce preload on the heart, without medication or anything too weird is to lie down on your left side, you can feel the fluid volume changing.

And as a side bar, I saw nothing in your vital signs to cause a huge level of concern. You had a normal echo, so you can eliminate heart anatomy and valve function and to a certain extent volume and pressure issues within the heart itself. Unless you can feel a constant skip in your pulse, or palpitations, I really don't think anything is going to show up on holter monitor.

Answer 2

First, stop smoking pot. That doesn't help at all. Your usual blood pressure is very low.

128 over 88 is more like a normal reading.

You say that tests so far have been normal but none of your BP readings are normal. Except for the ones that you don't think are normal.

If you stop smoking pot and believe what you are being told by medics, your BP will return to more of a normal reading (perfect is 120/80 for your age) and you will stop obsessing about your health. Worrying can cause illness you know.

Oh, isn't yellow skin a sign of jaundice?



Perhaps you need to get yourself a good hobby and get out and socialise. You sound as if you are overthinking things far too much.

Answer 3

I second everything the nurse said and only offer you with a differential diagnosis that you don't seem to have considered ... hypochondriasis ...