I written a few months back after having an echo which showed the possibility of a PDA. I went to see a cardiologist. His diagnosis is
Palpitations secondary to strial ectopy,
Pre-syncope? hypotension related.
Possible PDA on echo - of no clinical significance.
He said that although this finding was of interest to him as a cardiologist it should cause no problems. My heart is strucurally sound. He has arranged for a tilt test to be done. He has not offered any further check ups or appointments. Is this the correct thing to do? Thank you in advance.
Wendy

Hello Wendy,

Patent Ductus Arteriosis in an otherwise healthy adult is merely an incidental finding because they are always very small and asymptomatic.

Since they are congenital in nature, those of clinical significance are repaired if they fail to self-resolve.

Presycope would describe the aura of symptoms experienced just prior to an actual syncopal episode, ie light-headedness, paresthesia or tingling sensations of the extremities, tunnel vision, etc. The term is not a diagnosis, but is used to describe the relative state of problems like hypotension. I would suspect that the original echo was performed based upon symptoms you were describing to your physician and many patients with significant anxiety describe the features of presyncope.

The tilt test is used to define any significant departure between blood pressure while supine or laying down and while sitting and standing and while can in some instances indicate conditions such as dysautonomia or postural orthostatic tachycardia syndrome, this is rarely the case. Although many patients with anxiety who undergo the test will subsequently come under the belief that they have been diagnosed with POTS, this is actually not the case and the influence of anxiety upon the nervous system is responsible for their symptoms.

Your heart is structurally sound, with the presence of benign palpitations. I see nothing here of any clinical significance at all to indicate that an actual problem exists. The report is unremarkable and indicates a healthy heart. You have anxiety of significance capable of inducing physical effects, an extremely common occurrence.

Best regards,

Rutheford Rane, MD (ret.)