Anyone know about heart stuff? “Mildly enlarged right ventricle” in DS20

[Alte Veste Academy]

DS has had tons of dizziness over the past few months and two episodes of passing out. After the second, which happened at work, he went to the ER and was diagnosed with a benign irregular rhythm and his heart rate didn’t want to come down. In an abundance of caution, the ER doc referred him to a cardiologist for a work up since his symptoms were weird for his age. They did a two week monitor, other testing I can’t recall, and an ultrasound. The cardiologist’s NP told us on follow-up that everything was no big deal, that everything looked great, that he should come back if he was dizzy and feeling like passing out again. Except he is still, every day. So she says it could be this, it could be that, but really no biggie. I was prepared to accuse DS of being a malingerer. He kind of can be. But what’s the point of claiming dizziness all the time? And needing to have me pick him up from places he’s driven because he doesn’t feel safe driving home… 

The one thing that looked out of the ordinary at all in his testing was the ultrasound finding of “mildly enlarged right ventricle,” which I observed on the ultrasound report. The NP didn’t even bring it up. So, as I’m leaving, I think it can’t be great but can’t be that bad because the NP pooh-poohed all the findings. Except Dr. Google says in response to every search about the term MERT to get ye to the doctor and find out the reason for the enlargement, because there are multiple causes with varying degrees of seriousness, and putting off treatment for some of these things could lead to worsening of potential conditions which may just be silent now. 

They’re giving me grief and making me seem like a nutcase for wanting to know the cause. No doc likes to hear that Dr. Google told me to be concerned, even when I say Mayo Clinic, AHA, BMJ, etc. 

Anyone know the answer here?

Edited June 23, 2023 by Alte Veste Academy

[dirty ethel rackham]

I would insist to see the cardiologist, not the NP and emphasize that the symptoms are getting in the way of every day functioning.  That plus an unusual finding should get way more attention.  I hate it when people don't take stuff seriously.  (I'm not a doctor not do I play one on TV. )

[Harriet Vane]

22 minutes ago, dirty ethel rackham said:

I would insist to see the cardiologist, not the NP and emphasize that the symptoms are getting in the way of every day functioning.  That plus an unusual finding should get way more attention.  I hate it when people don't take stuff seriously.  (I'm not a doctor not do I play one on TV. )

Yeah. What she said. 

[Jean in Newcastle]

Agree with seeing the actual cardiologist. Or asking for a referral for a second opinion. I can’t see if you listed his age. Is he a minor?  We needed to go to two different pediatric cardiologists before we got one who took us seriously and really explained things. 

[Katy]

I agree with asking to speak to the cardiologist, or asking an appointment for another.  They seem to vary in their ability to talk to people, especially parents.

Generally I'm under the impression from various cardiologists my kids have seen over the years that after the age of about 3, mild enlargement on one side isn't an emergency.  Like they could repeat tests every 18-24 months to check progression but it isn't likely to be an emergency ever as long as there is routine follow up.  But obviously various heart defects are different than valve issues, so to speculate on anything more wouldn't be responsible on my part.

I do have some cardiac nursing experience, but it was brief and mostly involved filling in for people on vacation or out sick when my department wasn't busy, so I'm pretty useless there too.

[gardenmom5]

34 minutes ago, dirty ethel rackham said:

I would insist to see the cardiologist, not the NP and emphasize that the symptoms are getting in the way of every day functioning.  That plus an unusual finding should get way more attention.  I hate it when people don't take stuff seriously.  (I'm not a doctor not do I play one on TV. )

This.

my sil's dr's nurse told her something wasn't a big deal.  It was months later she went in, her dr found out, and wanted to know why the bleeb she hadn't come in sooner?  'cause his NURSE told her it wasn't a big deal.

[Arcadia]

42 minutes ago, Alte Veste Academy said:

They’re giving me grief and making me seem like a nutcase for wanting to know the cause

When my former oncologist wanted to expedite a test, the easiest “excuse” he used was that it affects the patient’s quality of life. Me having fainting spells definitely affects my quality of life because I don’t dare to be anywhere alone in case I pass out. I do wear an Apple Watch for the fall alert function but I am still worried.

Did your son felt dizzy during the two weeks of monitoring? My ex-boss and my brother have irregular heartbeat. None of them had dizzy spells. I would insist on having the cardiologist explain all the results and reiterate that your son’s dizziness is an ongoing problem. Else I would seek a second opinion (my insurance covers second opinions). I had transthoracic echocardiograms with doppler twice a year for monitoring purposes.

[Alte Veste Academy]

DS is 20. To be clear, we saw the cardiologist first. I actually liked him a lot. He agreed the symptoms were weird for his age and did order a lot of testing. We saw the NP only for follow-up, which I assumed was because the cardiologist had looked at the results and delegated because he thought they were no big deal. Supposedly, the NP asked the cardiologist about an MRI or catheterization to explore the cause, and he said nothing was necessary.

Just before I asked you all about it this evening after a hissy fit, lol, I did tell her that I am not a mom who takes kids (especially a 20 year old “kid” lol) to the doc for nothing. I’m more likely to pooh-pooh my kids and tell them to hydrate, get more sleep, get more exercise, etc. in the face of physical discomfort. I told her that, with all due respect, as a concerned mom who usually isn’t that concerned, I want to pursue the cause for the enlargement because literally every (reputable!) site I visit says it’s important.

She said she will get back to me tomorrow. If she doesn’t order the imaging, I’ll take him elsewhere. 

[LifeLovePassion]

Your plan sounds good. Hopefully they get to the bottom of things.

[Alte Veste Academy]

7 minutes ago, Arcadia said:

When my former oncologist wanted to expedite a test, the easiest “excuse” he used was that it affects the patient’s quality of life. Me having fainting spells definitely affects my quality of life because I don’t dare to be anywhere alone in case I pass out. I do wear an Apple Watch for the fall alert function but I am still worried.

Did your son felt dizzy during the two weeks of monitoring? My ex-boss and my brother have irregular heartbeat. None of them had dizzy spells. I would insist on having the cardiologist explain all the results and reiterate that your son’s dizziness is an ongoing problem. Else I would seek a second opinion (my insurance covers second opinions). I had transthoracic echocardiograms with doppler twice a year for monitoring purposes.

That is a great tip. Thank you!

The monitor was worn in February, and the rest of the testing was in the months between then and his results appointment on Monday. His dizziness has gotten worse since February, and back then it was more likely to happen during super busy times. He was on his feet and running around all the time at work, where he passed out the second time. So probably he wasn’t super dizzy during monitoring because he wasn’t allowed to go back to work until he got a clearance. 

[Katy]

If he passes out again I'd take him to the ER.  They are more likely to not let him get released without imaging.

[Brittany1116]

I have experience in this area. I will say numbers are largely tech-dependent and being off 2mm (inside echogenic wall vs on edge) can push values from WNL to abnormal. Some techs are sloppy, some views are poor, etc. However, given his symptoms and the preponderance of cardiomyopathy in young men, I would further pursue the issue with another doctor. I would encourage him to eliminate caffeine in the meantime. 

Editing to add...

Did he have normal BP? Did his holter monitor show anything at all?

Edited June 23, 2023 by Brittany1116

[TechWife]

1 hour ago, Alte Veste Academy said:

… Except Dr. Google says in response to every search about the term MERT to get ye to the doctor and find out the reason for the enlargement, because there are multiple causes with varying degrees of seriousness, and putting off treatment for some of these things could lead to worsening of potential conditions which may just be silent now. 

They’re giving me grief and making me seem like a nutcase for wanting to know the cause. No doc likes to hear that Dr. Google told me to be concerned, even when I say Mayo Clinic, AHA, BMJ, etc. 

Anyone know the answer here?

I don’t know the answers & I hope you are able to find a some answers soon.
 

I do want to comment on the Dr. Google part. Please don’t ever be self conscious about talking about the reading you have done. IMO, good physicians want their patients to be educated about their condition or symptoms and want them to participate in their care. In the 21st century this means that they should all be getting used to their patients coming in with a list of questions. IMO, those that have a problem with this have a problem respecting their patients in other ways as well. Informed, respectful patients and knowledgeable, caring physicians can make a formidable team. Physicians should be recommending reputable resources to their patients, like you are using. 

I have one doctor who directly asks me if I have any questions about my test reports, lab results or any reading that I have done. In the days when we have quick access to our labs and a host of information at our fingertips, physicians should be getting comfortable with this approach and be proactive in engaging their patients as part of their care team. Sometimes this means explaining subtle differences in results or treatment options along with why they are recommending one path over another when patients ask.

FWIW, phrasing really matters in sciences. Research has a specific meaning in the sciences and it is not the same process as research in other disciplines. It can be off putting, I think, to have a patient come in and claim to have done “research” when really what they are doing is reading the reports that come out of studies or articles that summarize studies and may delve into implications of the findings. Physicians are absolutely familiar with what a research study entails and when people present their “findings” I think it really does minimize the importance of the physicians experience & expertise and it can come across as disrespectful. That’s my 2 cents, anyway. 

[Alte Veste Academy]

1 hour ago, Brittany1116 said:

I have experience in this area. I will say numbers are largely tech-dependent and being off 2mm (inside echogenic wall vs on edge) can push values from WNL to abnormal. Some techs are sloppy, some views are poor, etc. However, given his symptoms and the preponderance of cardiomyopathy in young men, I would further pursue the issue with another doctor. I would encourage him to eliminate caffeine in the meantime. 

Editing to add...

Did he have normal BP? Did his holter monitor show anything at all?

I didn’t see measurements at all, and I was totally prepared to dismiss it. But, yeah, the symptoms have been getting worse. And Dr. Google says find the cause. 

His BP was normal at his appointments, but a month or two before the first episode of passing out (I need to get the ER papers together to figure out the actual timeline), he had another episode where he says his heart was fluttering and his chest hurt. DH took his pulse (high) and his BP (very high). DH took him to the ER for that, and his BP and heart rate did not want to come down even laying down on a gurney. They ended up giving him IV saline and got him stabilized and told him to see his primary. At that appt, his vitals checked out fine, but he still reported dizziness. 

And all this reminds me of another thing the NP said at the appt, along the lines of if symptoms persist or he passes out again, come back. She said he should come back if he has any swelling in his feet, legs, or face, and OMG he had that a while back, a weird episode of facial swelling that wouldn’t go down for days. We assumed it was allergies and gave him Benadryl, but it did not go down. Took him to urgent care, who figured it was allergies and gave him more allergy drugs, but the swelling still didn’t go down for quite a few more days. The NP wanted to dismiss this too, even though she had literally just told him to come back if he had facial swelling. 🙄

1 hour ago, TechWife said:

I don’t know the answers & I hope you are able to find a some answers soon.

I do want to comment on the Dr. Google part. Please don’t ever be self conscious about talking about the reading you have done. IMO, good physicians want their patients to be educated about their condition or symptoms and want them to participate in their care. In the 21st century this means that they should all be getting used to their patients coming in with a list of questions. IMO, those that have a problem with this have a problem respecting their patients in other ways as well. Informed, respectful patients and knowledgeable, caring physicians can make a formidable team. Physicians should be recommending reputable resources to their patients, like you are using. 

I have one doctor who directly asks me if I have any questions about my test reports, lab results or any reading that I have done. In the days when we have quick access to our labs and a host of information at our fingertips, physicians should be getting comfortable with this approach and be proactive in engaging their patients as part of their care team. Sometimes this means explaining subtle differences in results or treatment options along with why they are recommending one path over another when patients ask.

FWIW, phrasing really matters in sciences. Research has a specific meaning in the sciences and it is not the same process as research in other disciplines. It can be off putting, I think, to have a patient come in and claim to have done “research” when really what they are doing is reading the reports that come out of studies or articles that summarize studies and may delve into implications of the findings. Physicians are absolutely familiar with what a research study entails and when people present their “findings” I think it really does minimize the importance of the physicians experience & expertise and it can come across as disrespectful. That’s my 2 cents, anyway. 

Thank you so much. That makes me feel better. I did try to be careful and respectful with my phrasing. 

[Arcadia]

13 minutes ago, Alte Veste Academy said:

His BP was normal at his appointments, but a month or two before the first episode of passing out (I need to get the ER papers together to figure out the actual timeline), he had another episode where he says his heart was fluttering and his chest hurt. DH took his pulse (high) and his BP (very high). DH took him to the ER for that, and his BP and heart rate did not want to come down even laying down on a gurney. They ended up giving him IV saline and got him stabilized and told him to see his primary. At that appt, his vitals checked out fine, but he still reported dizziness. 

And all this reminds me of another thing the NP said at the appt, along the lines of if symptoms persist or he passes out again, come back. She said he should come back if he has any swelling in his feet, legs, or face, and OMG he had that a while back, a weird episode of facial swelling that wouldn’t go down for days. We assumed it was allergies and gave him Benadryl, but it did not go down. Took him to urgent care, who figured it was allergies and gave him more allergy drugs, but the swelling still didn’t go down for quite a few more days. The NP wanted to dismiss this too, even though she had literally just told him to come back if he had facial swelling. 🙄

His ER visit and his Urgent Care visit is likely not documented in his patient portal. If the NP doesn’t get back to you tomorrow, you could use your son’s patient portal to send a note documenting your son’s ER visit and Urgent Care visit. That way the note would be in his system. If you have the notes for the ER visit and urgent care visit, I would scan and attach to that note.

Also on your son’s patient portal, you should be able to see his visit notes for the NP appointment and look at what advice was given. I wonder if she documented the advice to come back if he had facial swelling. Also whether she acknowledged the facial swelling at Urgent Care after she was informed. I had facial swelling (even sipping became difficult) from prednisone and my general practitioner treated it as a case of drug allergy. Had edema on hands and feet from the Pfizer vaccinations and my care team told me to alert them if the edema worsen.

 

[kbutton]

19 hours ago, Arcadia said:

When my former oncologist wanted to expedite a test, the easiest “excuse” he used was that it affects the patient’s quality of life. Me having fainting spells definitely affects my quality of life because I don’t dare to be anywhere alone in case I pass out. I do wear an Apple Watch for the fall alert function but I am still worried.

Did your son felt dizzy during the two weeks of monitoring? My ex-boss and my brother have irregular heartbeat. None of them had dizzy spells. I would insist on having the cardiologist explain all the results and reiterate that your son’s dizziness is an ongoing problem. Else I would seek a second opinion (my insurance covers second opinions). I had transthoracic echocardiograms with doppler twice a year for monitoring purposes.

I think this is likely to get some attention (and potentially a tilt table test).

20 hours ago, dirty ethel rackham said:

I would insist to see the cardiologist, not the NP and emphasize that the symptoms are getting in the way of every day functioning.  That plus an unusual finding should get way more attention.  I hate it when people don't take stuff seriously.  (I'm not a doctor not do I play one on TV. )

Not to be picky, but this advice drives me crazy. My DH is an advanced practice provider/midlevel, and they often take more care than the doctor. My son had a cardiology NP, for instance, that seemed to share all our concerns, but when she ran them by the cardiologist, the cardiologist would nix it all. We had the same treatment when we eventually were scheduled to see the actual cardiologist.

I have heard more complaints about dismissive cardiologists than literally any other specialty except family/primary care. It's maddening. We had a church friend who almost died because his cardiologist dismissed serious concerns (he would've died if his wife hadn't done CPR). My dad has had total crap advice from a cardiologist, and I'm on my second cardiologist because my first one decided he'd rather nitpick definitions of things like bradycardia to dismiss my concerns, preferring to use his own definition of bradycardia than the one on literally every reputable website (all of which were consistent with my DH's training as well).

They are all very pigeonholed. Asking a cardiologist who treats heart rhythm issues a question about aneurysms is worse than useless in most cases (they will parrot back horribly outdated advice, IME), but to find the cardiologist that can treat your issue, you have to know what it is first. It's maddening.

19 hours ago, Alte Veste Academy said:

Supposedly, the NP asked the cardiologist about an MRI or catheterization to explore the cause, and he said nothing was necessary.

I'm not surprised. SMH.

18 hours ago, Brittany1116 said:

I have experience in this area. I will say numbers are largely tech-dependent and being off 2mm (inside echogenic wall vs on edge) can push values from WNL to abnormal. Some techs are sloppy, some views are poor, etc. However, given his symptoms and the preponderance of cardiomyopathy in young men, I would further pursue the issue with another doctor. I would encourage him to eliminate caffeine in the meantime. 

QFT

FWIW, my other son had a screening echo (lots of familial issues), and he has some anomalies that are being dismissed, and I am listening in because I am in a similar boat (different findings but findings that show up on lists of things that go with sudden cardiac death), sigh. 

[Brittany1116]

17 hours ago, Alte Veste Academy said:

I didn’t see measurements at all, and I was totally prepared to dismiss it. But, yeah, the symptoms have been getting worse. And Dr. Google says find the cause. 

His BP was normal at his appointments, but a month or two before the first episode of passing out (I need to get the ER papers together to figure out the actual timeline), he had another episode where he says his heart was fluttering and his chest hurt. DH took his pulse (high) and his BP (very high). DH took him to the ER for that, and his BP and heart rate did not want to come down even laying down on a gurney. They ended up giving him IV saline and got him stabilized and told him to see his primary. At that appt, his vitals checked out fine, but he still reported dizziness. 

And all this reminds me of another thing the NP said at the appt, along the lines of if symptoms persist or he passes out again, come back. She said he should come back if he has any swelling in his feet, legs, or face, and OMG he had that a while back, a weird episode of facial swelling that wouldn’t go down for days. We assumed it was allergies and gave him Benadryl, but it did not go down. Took him to urgent care, who figured it was allergies and gave him more allergy drugs, but the swelling still didn’t go down for quite a few more days. The NP wanted to dismiss this too, even though she had literally just told him to come back if he had facial swelling. 🙄

Thank you so much. That makes me feel better. I did try to be careful and respectful with my phrasing. 

Most if not all machines are preset with standard parameters and can basically auto-fill reports. So even if you don't see a measurement, an abnormal measurement would prompt a system response of mildly dilated etc. If the Dr saw the number and the imaging, he could theoretically decide it is actually within normal range. In the absence of other symptoms, I would say that could be a likely scenario. What you are describing should prompt further investigation. Atrial flutter or fibrilation is serious, but tricky because he could have it a few times and just have the bad luck not to catch it on a 2 week monitor. Swelling of the face is also cause for concern. He definitely needs to stay off caffeine. Praying for you both and hope you get an answer soon. 

[dirty ethel rackham]

On 6/23/2023 at 4:06 PM, kbutton said:

I think this is likely to get some attention (and potentially a tilt table test).

Not to be picky, but this advice drives me crazy. My DH is an advanced practice provider/midlevel, and they often take more care than the doctor. My son had a cardiology NP, for instance, that seemed to share all our concerns, but when she ran them by the cardiologist, the cardiologist would nix it all. We had the same treatment when we eventually were scheduled to see the actual cardiologist.

I have heard more complaints about dismissive cardiologists than literally any other specialty except family/primary care. It's maddening. We had a church friend who almost died because his cardiologist dismissed serious concerns (he would've died if his wife hadn't done CPR). My dad has had total crap advice from a cardiologist, and I'm on my second cardiologist because my first one decided he'd rather nitpick definitions of things like bradycardia to dismiss my concerns, preferring to use his own definition of bradycardia than the one on literally every reputable website (all of which were consistent with my DH's training as well).

 

 

I am sorry about lumping all NPs together. In a recent job, I had several run-ins with incompetent NPs who were ordering inappropriate tests, didn't use any critical thinking when ordering the tests that got me out of bed in the middle of the night for nothing, and then threatened me with writing me up for questioning their orders and trying to help them put in the correct order that insurance would pay for.  And then ignored a significant incidental finding.  

However, thinking back to my disaster ankle surgery, I had much better responsiveness from the NP than the orthopedic podiatrist.

 

[Halftime Hope]

@Alte Veste Academy  I don't know a lot about the intricacies of heart testing, but I would say that, based on common sense and what I'm hearing from cardiologists including my son's, this is not the time to allow a kid with undiagnosed heart issues to do any strenuous exercise.  No matter the etiology, whether a covid illness injury or a covid vaccine reaction, or something else, there are too many sudden deaths happening now, and a sizable fraction of them in young men in particular, are concurrent with exercise/sports exertion.  

I wish you all the best being persistent and getting him excellent medical care.

Edited June 25, 2023 by Halftime Hope

[Alte Veste Academy]

On 6/22/2023 at 9:26 PM, Arcadia said:

His ER visit and his Urgent Care visit is likely not documented in his patient portal. If the NP doesn’t get back to you tomorrow, you could use your son’s patient portal to send a note documenting your son’s ER visit and Urgent Care visit. That way the note would be in his system. If you have the notes for the ER visit and urgent care visit, I would scan and attach to that note.

Also on your son’s patient portal, you should be able to see his visit notes for the NP appointment and look at what advice was given. I wonder if she documented the advice to come back if he had facial swelling. Also whether she acknowledged the facial swelling at Urgent Care after she was informed. I had facial swelling (even sipping became difficult) from prednisone and my general practitioner treated it as a case of drug allergy. Had edema on hands and feet from the Pfizer vaccinations and my care team told me to alert them if the edema worsen.

I have been working on this and wouldn't really have thought of it before. Thank you.

As to the bolded, no, she didn't. Honestly, at that point I really felt like she was saying stuff to get rid of us in that moment. When I immediately responded affirmatively to the facial swelling the second she mentioned it, she wanted to dismiss it immediately. Like, well that was then...so let's wait for it to happen again...just "buh-bye" is how it felt. 

On 6/23/2023 at 2:06 PM, kbutton said:

I think this is likely to get some attention (and potentially a tilt table test).

Not to be picky, but this advice drives me crazy. My DH is an advanced practice provider/midlevel, and they often take more care than the doctor. My son had a cardiology NP, for instance, that seemed to share all our concerns, but when she ran them by the cardiologist, the cardiologist would nix it all. We had the same treatment when we eventually were scheduled to see the actual cardiologist.

I have heard more complaints about dismissive cardiologists than literally any other specialty except family/primary care. It's maddening. We had a church friend who almost died because his cardiologist dismissed serious concerns (he would've died if his wife hadn't done CPR). My dad has had total crap advice from a cardiologist, and I'm on my second cardiologist because my first one decided he'd rather nitpick definitions of things like bradycardia to dismiss my concerns, preferring to use his own definition of bradycardia than the one on literally every reputable website (all of which were consistent with my DH's training as well).

They are all very pigeonholed. Asking a cardiologist who treats heart rhythm issues a question about aneurysms is worse than useless in most cases (they will parrot back horribly outdated advice, IME), but to find the cardiologist that can treat your issue, you have to know what it is first. It's maddening.

I'm not surprised. SMH.

QFT

FWIW, my other son had a screening echo (lots of familial issues), and he has some anomalies that are being dismissed, and I am listening in because I am in a similar boat (different findings but findings that show up on lists of things that go with sudden cardiac death), sigh. 

The funny thing is that before this, I always said I'd never met an NP I didn't like.

She did mention a table test if his dizziness persists, even as we're sitting right there in his office saying he is still dizzy practically all the time. And the thing is...related to what Brittany is saying...

On 6/23/2023 at 2:55 PM, Brittany1116 said:

Most if not all machines are preset with standard parameters and can basically auto-fill reports. So even if you don't see a measurement, an abnormal measurement would prompt a system response of mildly dilated etc. If the Dr saw the number and the imaging, he could theoretically decide it is actually within normal range. In the absence of other symptoms, I would say that could be a likely scenario. What you are describing should prompt further investigation. Atrial flutter or fibrilation is serious, but tricky because he could have it a few times and just have the bad luck not to catch it on a 2 week monitor. Swelling of the face is also cause for concern. He definitely needs to stay off caffeine. Praying for you both and hope you get an answer soon. 

I feel like I'm being treated like an over-involved moron incapable of understanding at this point. If the NP or doc conveyed the measurement thing to me, I would be able to rationally say, ok expert, got it. But they haven't said oh we're not worried because of x, y, z. They're saying let it go but giving me no reason why. 

The NP keeps talking about this or that test related to dizziness, and yes, I want him to have those. But then she is dismissing the enlarged ventricle concern. I'm saying I want answers to both of them, connected or not.

He was THRILLED to be told to quit caffeine. LOL Thanks. I wouldn't have thought of it. DH and I were sitting in the living room when I read your advice, and I texted DS that he needs to quit caffeine for now because of all this, and he just responded "ok." So, again, DH and I were like crap, he is for sure not malingering, because he would have put up a fight if any percentage of this was just drama. They just put up a Black Rock at the front of our neighborhood, and let's just say he's a fan. 

35 minutes ago, Halftime Hope said:

@Alte Veste Academy  I don't know a lot about the intricacies of heart testing, but I would say that, based on common sense and what I'm hearing from cardiologists including my son's, this is not the time to allow a kid with undiagnosed heart issues to do any strenuous exercise.  No matter the etiology, whether a covid illness injury or a covid vaccine reaction, or something else, there are too many sudden deaths happening now, and a sizable fraction of them in young men in particular, are concurrent with exercise/sports exertion.  

I wish you all the best being persistent and getting him excellent medical care.

Thank you. He has actually quit that job since then. He's focusing on school and spends his off time learning programming languages. Nice and lazy for now. LOL

[Brittany1116]

@Alte Veste Academy I am sorry. I doubt anyone here considers you an over-involved moron. You are a rightfully concerned mother. It sounds incredibly frustrating, and I would consider finding another doctor/clinic/group if they can't answer all of your questions or order additional testing.