I have suffered from periodic episodes of extreme exhaustion for 30 years old patient(my present age is 60). It was blamed on Hepatitis C, until I completed treatment recently achieving sustained viral response (cure). I don’t expect a diagnosis here, and I will see my cardiologist, plus other doctors if necessary, but I would like to preview some questions, which might help me refine questions for my doctor.

I am fairly fit for my age. Height 5'9". Weight 135 pounds. My body looks like a fit 30 year old, but sometimes I feel like 90 and near death. My diet is basically whole, natural foods, low cholesterol, almost no sugar, plenty of vegetable, but also some fish and poultry.

Blood pressure between 120/60 to 135/70 - at the lower end when I am exercising routinely. I take no meds (except for the Sovaldi/GS5816 for the Hep C, concluding 6 months ago). The only remarkable blood test out of range that I know of is blood platelets at 100.

In a nutshell, it seems like sometimes my heart functions smoothly and other times it is inefficient. I have had normal ECG, echocardiogram, stress test, and echo stress, during the course of this history (all within the past 4 years). I reportedly show a right branch bundle block on my ECG, although the doctor said it was nothing to be concerned about at this point (then being when symptoms of fatigue were assumed to be hepatitis C). My question is: Would RBBB symptoms be consistent with the manifestation as follows. For about half the time (sometimes more, sometimes less), I am able to function with enough energy for moderate activity. If I am physically active (e.g. cleaning or small construction), I wear out after 3-4 hours, and three days of that will completely exhaust me. However, I can walk vigorously, even run, on a treadmill for an hour, and that regenerates me (as long as that is my only significant exertion in the day). Working in heat is particularly exhausting (I live in Tucson, with temperatures up to 115 degrees - but others seem to manage better than I). The matter is, when I collapse into exhaustion, I become so weak, I can hardly get out of bed, or even sit up (feeble, but I don’t get dizzy). I feel my heart weak - dangerously weak, it seems. Even digestion and mental acuity is slow. This may last for days, at worst even weeks. At some point I begin to gain strength. Many times I have had a strange sensation that I feel a sudden jolt in my chest, and it seems as though suddenly, my heart is functioning smoothly. I usually find improvement steadily from that point, but sometimes it falls back, and I recover soon after. This could be imagination, but it has occurred many times, and the sudden effect is most interesting. This is why I wonder if there is an electrical “reconnection”. Alternately, I wonder if there could be a chemical threshhold (e.g. hormonal) that is reached at this point. But to the cardiac question, can RBBB turn on and off like this? Does it present symptoms this way? Can I have such a contrast of performance with RBBB, or does RBBB present as a constant condition?

Please respond with any insights you think are relevant.