To joanncm-
I literally had all those same issues you described. The difference is I'm from a very small community state and had an echo done. It was read and my tricuspid and aortic valve were leaking moderate plus with an ejection fraction of 66 to 68%. The fatigue was terrible three naps a day. I had had and put on six new meds over the last five years. Since December I just felt worse and worse and had more swelling in my feet my legs my stomach etc. My primary said I think you've outgrown the doctors in the state and sent me to the Cleveland clinic. The doctor listen to me first And then listen to my heart my lungs and examined me. He said we really need to get another echo which I was in agreement with. The great thing was they had gotten a new program for their ultrasounds and my echo came out completely different. It showed that I had mild leakage on the aortic and tricuspid valve it was normal for my age. My ejection fraction was 56 to 58% but that's still normal. And I had some mild pulmonary hypertension and that's probably why all the medication they were giving me we're not hitting my blood pressure because it was treating in the wrong area. I was able to get off 4 meds and cut one and a half. He started me on Spironolactone. I cannot tell you the absolute difference it has made I mean I am taking no naps I don't have any other symptoms I feel great and of course way better than I have in five years because I was not diagnose correctly. I'm not saying this to bash anybody what I am saying sometimes the second opinion really helps. You can't diagnose what isn't seen correctly. If you don't agree with your diagnosis or you have serious questions and you really need to be seen and get a second opinion. Many blessings hope it turns out better