Well, what a joke doctors are.... thanks for your your response. Anyway, I knew that something was definitely wrong and looked thought copies of my medical records which I have at home. I looked at results from an echocardiogram performed in September 2001. I noticed that I have left ventricular dysfunction and mild mitral valve regurgitation. This explains the 50% ejection fraction which is not normal. I WAS NOT TOLD OF THIS BY THE CARDIOLOGIST. Apparently the mitral valve regurgitation can stay mild or develop or turn into serious need for surgery or heart failure! The cardiologist is supposed to recommend regular echocardiogram at least one a year to monitor this. Instead I was discharged from the cardiology clinic!!!!! HOw do I know that the mitral regurgitation is not becoming acute if my GP does not recommend another echocardiogram? I simply do not trust doctors any longer. I live in the UK where we do have socialised medicine. Budgetary cuts are now affecting long term sufferers as well as those with private health care. Lack of resources, and medical specialist means that it is best to go abroad for medical treatment! You are right about the blue nail, this indicates lack of oxygen. It could be caused by many things though and unless GP willing to investigate, which she is not really interested in doing, well, I supposed I shall have to wait for an emergency to occur. I am thinking of changing my GP but might well end up with a worse physician that this one. Well, thanks for your views, very much appreciated. Kind regards and best wishes. Kooky/.