Hello Thank you for sharing your detailed history. You’ve had a complex set of symptoms over many years—shortness of breath (especially on exertion), high heart rate (even up to 240 bpm), history of inflammatory colon polyp and piles, blood in stool, nasal polyp, and iron deficiency with very low ferritin. Your heart ultrasound and lung check-up were normal, but ECG showed inappropriate sinus tachycardia.
Let’s break down the possibilities: 1. Heart Issue - Your heart ultrasound (ECHO) being normal is reassuring—no structural heart disease. - Inappropriate sinus tachycardia (IST) is a rhythm problem where the heart beats faster than normal without a clear cause. It’s usually not dangerous but can be very uncomfortable. - Very high heart rates (like 240 bpm) are unusual for IST and may suggest episodes of another arrhythmia (like SVT), but if it was only once and during intense exercise, it could be a stress response. 2. Blood Disorder - Chronic iron deficiency (low ferritin) can cause fatigue, shortness of breath, and palpitations, especially if anemia develops. - Blood in stool (especially with a history of polyps and piles) can worsen iron deficiency. - If your hemoglobin is low, this could explain many of your symptoms.
3. Gut Issue - History of large inflammatory polyp, piles, and now blood in stool again points to ongoing gut issues. - Chronic blood loss from the gut (even small amounts) can cause iron deficiency anemia. - Reflux and gastric symptoms are common but usually don’t cause anemia unless there’s bleeding.
4. Other Possibilities - Nasal polyps and gut polyps together can rarely be seen in some genetic syndromes, but this is less likely if you don’t have other symptoms. - Sometimes, chronic inflammation (from gut or elsewhere) can also cause fatigue and affect heart rate.
What Should Be Done Next? Tests to Consider 1. Repeat CBC (Complete Blood Count): To check for anemia and platelet count. 2. Iron Studies: Ferritin, serum iron, TIBC, transferrin saturation. 3. Stool Occult Blood Test: To check for hidden blood loss. 4. Colonoscopy: Since you have blood in stool again and a history of polyps, a repeat colonoscopy is important. 5. ECG and 24-hour Holter Monitor: To document heart rhythm over a day and catch any abnormal fast rhythms. 6. Thyroid Function Tests: Overactive thyroid can cause fast heart rate. 7. Echocardiogram (if not done recently): To recheck heart structure and function. 8. Pulmonary Function Test (PFT): If shortness of breath is significant, even with a normal lung check-up.
Summary - Your symptoms are most likely a combination of chronic iron deficiency (from gut blood loss) and inappropriate sinus tachycardia. - The most important next step is to find the source of blood loss (repeat colonoscopy) and correct iron deficiency. - A 24-hour Holter monitor can help clarify your heart rhythm issue. - Keep your doctor updated about any new or worsening symptoms.
Thank you
Hello
Your reports strongly suggest chronic iron-deficiency anemia, and this alone can explain:
Shortness of breath (even at rest) Fast heartbeat / inappropriate sinus tachycardia Exercise intolerance Fatigue
Your CBC shows classic iron-deficiency pattern:
Low Hb (11) Low MCV, MCH, MCHC (microcytic anemia) High RDW Very low ferritin (5.9) → confirms iron deficiency
The likely cause is chronic blood loss from the gut (piles, previous polyp, current blood in stool).
A structurally normal heart + sinus tachycardia + anemia strongly points more toward a blood + gastrointestinal issue, not a primary heart disease.
What you should do:
1. Repeat CBC + Ferritin immediately 2. Iron studies (TIBC, transferrin saturation) 3. Repeat colonoscopy (since blood has returned after 5 years) 4. Stool occult blood test 5. ECG + 24-hour Holter monitor (to document tachycardia episodes) 6. Thyroid test (if not done recently)
Important:
A heart rate of 240 bpm during exercise is not normal — even with anemia. You should also be evaluated for SVT (supraventricular tachycardia) by a cardiologist.
In summary:
Most likely:
Chronic iron-deficiency anemia from GI blood loss secondary sinus tachycardia
But:
Recurrent blood in stool must not be ignored.
You need gastroenterology + cardiology review together.
I trust this helps Thank you
