May 25, 2013

Hypochondriasis? Or heart/lung problem…

Hah – one thing that studying for med school/Step 1 really does is turn us all into hypochondriacs (people who worry about/think they have a disease despite medical assurance that they don’t).  Well, I was feeling my heart yesterday and noticed that I definitely felt some heartbeats/flutters in the left sternal border (slightly left of midline in between the ribs).  Normally, you’re only supposed to feel a heartbeat at the point of maximal impulse on the left side of your chest, not near the midline.  In addition, I had been having some chest pains (for years mind you), and a semi-recent bout of a weird feeling of coldness in my lungs for a while, and recently also noticed that I either have an S3 heart sound or a very clear splitting of the second heart sound that is not affected by inspiration.

So of course I talked with my med school friend about it, and after looking up a bunch of stuff, we determined the heartbeat I felt was probably a right ventricular heave, which can have all kinds of bad stuff be the cause, or (hopefully) just subconscious high anxiety that manifests physiologically.  The other thing it could be however, given my other symptoms, and also the fact that I’ve always had some sort of exercise intolerance, is idiopathic pulmonary arterial hypertension (iPAH), which is not very good.  :\  Also most other things that cause a RV heave are also not very great… so I may end up getting that chest X-ray after all… bah.

It was also kind of funny because yesterday, my friend was saying, well, this iPAH this is pretty rare in real life – like 1/1 million.  But if you see this on a test with those symptoms, you should probably pick that.  So today, as I’m going over old test blocks (since my UWorld subscription for the test I took 2 Sundays ago expires tomorrow morning), what happens to be the first question (that I got wrong at the time)?  A question about iPAH.  Haha, oh life.  You’re funny.


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