Symptoms of Congestive Heart Failure and a Misdiagnosis Months Earlier

Note:  You may find references to heart failure or congestive heart failure in my writing.  I was scared when a nurse mentioned giving me a brochure on “congestive heart failure”, which sounded like a death sentence to me. It is actually a general term that refers to the heart’s failure to pump an adequate amount of blood.  This leads to a buildup of fluid in the lungs and surrounding body tissues.

Symptoms of Congestive Heart Failure and a Misdiagnosis Months Earlier

 There must be a good reason for the medical profession to do the tests that led to my diagnosis.  I was at the emergency room for symptoms of fluid in my lungs and in my liver.  I did have pneumonia, but other issues caused them to do further testing.  I was in the hospital for 8 nights.

The doctors and I were trying to estimate how long I have had dilated cardiomyopathy (DCM to abbreviate).  Often it starts out with no symptoms and then progresses.   Sometimes the signs start suddenly and severely.

Below is an overview of symptoms of heart failure 

I will elaborate partially on my personal experience further down and in my next post. What I experienced is marked **, and I have listed my most recent symptoms first.

  • Crackling sound in the chest (a sign of fluid buildup)**, heart murmur, or other abnormal sounds
  • Shortness of breath during exercise, while lying down or having been asleep for awhile.**
  • I’ll add, for my case, reduced cardiovascular capacity**.
  • Swelling of feet and ankles (in adults) **
  • Irregular or rapid pulse**
  • Chest pain or pressure (more likely when you exercise)
  • Cough
  • Fatigue, weakness, faintness
  • Loss of appetite

 A Misdiagnosis of Asthma (August-December 2013)

I was three weeks into my medical leave recovering from a replacement of my right hip.  I was lying on my back around 4:30 am returning to my bed from a visit to the bathroom. I could hear in my chest a sound like someone was crunching up paper.  My breathing was shallow but I was not struggling.  I propped myself up with pillows and eventually went back to sleep.  This kind of thing sporadically continued in the early morning hours.

I was not sure what wheezing sounded like, but I didn’t think it sounded like a crackle.  I did listen to the breathing sound through my mouth, and it did sound like a whistle, sort of.  I did some reading on asthma, and I was convinced that’s what I had.

I went to my family doctor on the first day I returned to work, September 3rd.  I described my recent symptoms.  He diagnosed me with asthma.  It made sense at the time.  I had allergies, perhaps being home all day I was exposed to more allergens, my son had moved back in with his cat in May, so perhaps those things had triggered full-blown asthma.

The Dulera broncho-dilator seemed to work….until mid-October after I sat by our firepit and the problem started up again with effects during the following two days.

I was put on prednisone for the next 7 days, and the breathing problems and sounds disappeared.  I did experience unusual fatigue and depression on the last day of prednisone, a Saturday.  I was then awakened in the middle of the night by the crackling and breathing difficulty again.  I tried to sleep in a recliner.  I was also coughing.  My heart was pounding so hard it felt like it would come out of my chest.  This eventually subsided.  I did not go back to sleep until late morning.

I live in a community surrounded by farmland and woodland, the combines are kicking out all kinds of allergens, people can burn leaves in my community.  At my office visit to our family doctor on Monday, we discussed how the fall would be a rough time for my “asthma”.  Let’s see how I feel after we have a good freeze and all the junk is out of the air.  This seemed reasonable.  He prescribed the generic form of oral Singulair.  I thought I needed a rescue inhaler, but he never offered it, and I didn’t ask, I don’t know.  The Singulair seemed to be helping.

Looking back, I regret that I did not take more charge of my healthcare. I received from a friend with an asthmatic husband the contact information for a pulmonologist and an allergist.  After some mild problems in early December, I kept telling myself I would contact the pulmonologist, and I never did.  Since the medications seemed to work most of the time, I guess I did not see an urgency.

My whole heart ordeal revealed that I DO NOT HAVE ASTHMA.   Yes, I am planning to get a new family doctor soon.  I can understand how asthma would be an easy diagnosis, I had no family history of heart disease, and I follow a healthy lifestyle, so a heart problem seemed like a longshot.  I think the biggest thing he missed is that the noise in my chest was a crackle – not a wheeze.

 Reading my report from the hospital again, it mentions bilateral pleural effusion, which is fluid on both lungs.  I had pneumonia only on a specific lobe of my right lung.   Wow, this was building for awhile.  Hence, the crackling.

Despite my consistent exercise, I had noticed over the last few years that my cardiovascular abilities had decreased during exercise.  I had other symptoms as well.  I will write about that in my next post.

 

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3 Comments

  1. Wow, sounds just like your talking about me! I’ve been diagnosed with asthma by loads of different doctors who have put me on both preventers and asthma inhaler, l thought they helped a little but the crackling in my chest definately did not. It seems over the past year lve had three or four chest infections which l was given predisolone and also different penicillin and amoxylins for which did help in the end, but lve noticed my immune system is very poor, as l can’t even be around my grandchildren if they have a cold..because l will get another chest infection! 😳 l am also always exhausted and have zero energy, l get very depressed and am on lexapro for that . But lm just wondering now..maybe l need to suggest to my doctor that l be checked for congestive heart failure. I’ve noticed its louder if l lay on my left side but still quite noisy even sitting upright ( which is how l have to sleep ) . Can you tell me any further info on how you were diagnosed and treatment please ? 🙂

    • Debbie,

      My posts before and after this one include more details. You would need an echocardiogram to determine if your “ejection fraction” was low. The ejection fraction tells us the percentage of blood being pumped out by your heart. The normal range is 55-60%. Mine started out at 15% at diagnosis.

      The most significant “miss” by my doctor months before my correct diagnosis, was that my chest was crackling – not wheezing/whistling. Crackling indicates fluid in the lung. I used both the word “crackling” and “like a paper bag is being crunched up” in my description of the sound. That should’ve caused him to order a chest x-ray. I had fluid even before I contracted pneumonia, because my heart was too weak to pump all of the fluid out of my lungs.

      The most important thing for any health issue is to exercise and to eat right. I was already doing those things, and I continued after I got home from the hospital. With the right medications, a biventricular pacemaker/defibrillator, and my commitment to exercise and healthy eating, just 1 1/2 years later my ejection fraction was at 53% (low normal).

      I have been remiss in posting follow-ups about my heart disease. I greatly appreciate your comment, as it has motivated me to write a post about how I have been doing since my last post.

      I hope you get the right diagnosis and feel better. Please keep me updated.

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