|
Post by Outspoken on Aug 2, 2016 0:05:32 GMT
So, I've been experiencing chest pains since Friday night (3 days). While they have always been in the same location, the intensity and feeling changes from time to time. My father dropped dead at 50 from a massive heart attack after he thought he had indigestion for a week. I do have high blood pressure, reflux and high cholesterol, for which I am medicated. I try to err on the side of caution.
I went to the ER Sunday night. I was given an EKG, had heart enzymes drawn twice. I was told they were all normal but they wanted me to go to the cardiology floor and have a stress test. So, I went to cardiology, had another EKG and stress test. My BP was high the whole time. The pain behaved the same way as it did at home. After the stress test, a cardiologist with poor bedside manners came to me while I was in a wheelchair in the hallway with other patients and said "You Passed your stress test. I don't think it's your heart. But, if you don't get better, give us a call (handed me his business card)." He turned and walked away. A hospital employee returned me to my room. My nurse said I was being discharged as soon as the paperwork came and the doctor came to see me. They served me a nice lunch. A doctor came and told me that a new anti-inflammatory that I had been prescribed by my PHP for tennis elbow wasn't a good mix with my reflux medicine and I shouldn't take it - or any anti inflammatory (Advil, aleve, ibuprofen). He feels like this is the cause of my pain. So, he INCREASES my reflux medicine, prescribes me Lortab for a week and discharges me.
I am home. Still experiencing pain off and on. And I'm still scared and not sure I believe what they said. It seems like either my PHP or my Pharmacist would have known if I could not take that medicine and I've never been told that before. I've taken Advil before.
So, now I sit here worrying that even though I passed their test, there is SOMETHING wrong with my heart. How likely is it that they are wrong?
I'm sorry this is so long and rambling. I think I just need to "talk" to keep myself from worrying silly!
|
|
|
Post by Delta Dawn on Aug 2, 2016 0:09:52 GMT
Vioxx was bad for heart problems in the past and they took that off the market. If you take Bextra or Celebrex that could be causing the heart problems. OR NOT. It can for a lot of people, though. Heart issues hit very close to home for you as they do for us. I hope your PCP can get to the bottom of this. I'm sorry.
|
|
|
Post by scrapmaven on Aug 2, 2016 0:16:00 GMT
I'm not a doctor, but I do know that anti-inflammatory meds and ibuprofen can exacerbate Reflux. I have reflux and I have also developed pericarditis (inflammation around the heart) a couple times. The symptoms were similar and it was hard to know which was which. It could very well be gerd, but if you're concerned then go back to your doctor or cardiologist of your choosing and follow up. Don't be afraid to call your doc and express your concerns.
ETA: Pericarditis was easy to find, showing up on a random EKG when I went to get the pain checked by my pcp. She sent me to the hospital and they did the other tests and confirmed her diagnosis. If you had it I would assume they would have found it on your first EKG.
|
|
Deleted
Posts: 0
Jun 2, 2024 2:13:34 GMT
|
Post by Deleted on Aug 2, 2016 0:17:31 GMT
I would call your primary now.
|
|
|
Post by Outspoken on Aug 2, 2016 0:20:23 GMT
I'm not a doctor, but I do know that anti-inflammatory meds and ibuprofen can exacerbate Reflux. I have reflux and I have also developed pericarditis (inflammation around the heart) a couple times. The symptoms were similar and it was hard to know which was which. It could very well be gerd, but if you're concerned then go back to your doctor or cardiologist of your choosing and follow up. Don't be afraid to call your doc and express your concerns. ETA: Pericarditis was easy to find, showing up on a random EKG when I went to get the pain checked by my pcp. She sent me to the hospital and they did the other tests and confirmed her diagnosis. If you had it I would assume they would have found it on your first EKG. Thank you! I have an appointment with my PCP next week. I appreciate you sharing your experience!
|
|
|
Post by Eddie-n-Harley on Aug 2, 2016 0:41:04 GMT
If your pharmacy is still open, why not give them a call and have a quick chat with the pharmacist? Perhaps they can tell you why they didn't flag that medication interaction for you.
|
|
scrapngranny
Pearl Clutcher
Only slightly senile
Posts: 4,765
Jun 25, 2014 23:21:30 GMT
|
Post by scrapngranny on Aug 2, 2016 0:51:36 GMT
My DH had chest pains and it was his gallbladder. When I took him to the ER they immediately ran all the heart stuff, twice and ruled out his heart. They kept investigating and finally diagnosed it as his gallbladder, he had surgery and that took care of the problem.
I hope you find answers soon.
|
|
|
Post by Linda on Aug 2, 2016 0:53:47 GMT
((((Hugs))) and prayers
|
|
Deleted
Posts: 0
Jun 2, 2024 2:13:34 GMT
|
Post by Deleted on Aug 2, 2016 0:58:20 GMT
glad you're seeing your pcp. Look for a doc you trust and don't give up until you're satisfied with the answers you get. And best wishes!
|
|
theshyone
Pearl Clutcher
Posts: 3,411
Jun 26, 2014 12:50:12 GMT
|
Post by theshyone on Aug 2, 2016 1:10:36 GMT
I do know that from being in a number of heart groups with many other women that heart attack signs are missed more women in women than men. Most usually don't get the chance to get as much diagnostics as you did. They are shoved out the door being told its anxiety or reflux. You got some pretty standard tests.
If pain doesn't go away be persistent, very persistent. Hugs.
|
|
|
Post by mcscrapper on Aug 2, 2016 1:24:29 GMT
I might be able to shed a little bit of light here.... I'm an ER nurse getting my masters and I am currently doing a rotation through the big cardiology group in town. We do stress tests every Friday. My last rotation was with the GI group. Loved that rotation for some reason. Hopefully, I've learned a little bit along the way.
From what you are describing, you have had every test we would have done for you. I would also want to see your current medication list. A lot of NSAIDs and other meds like Mobic can actually cause some non-cardiac chest pain especially if taken with some of the more commonly prescribed meds for reflux. GERD is a huge offender of chest pains. Any type of erosion on the esophagus can cause you to have some inflammation right there in your sternal area.
I would question if you had an echo. The stress test, however, is a GREAT diagnostic and your insurance may not pay for an echo if your initial stress test was found to be negative.
Let me know if you have another other questions.
meredith
|
|
|
Post by Outspoken on Aug 2, 2016 1:37:24 GMT
I might be able to shed a little bit of light here.... I'm an ER nurse getting my masters and I am currently doing a rotation through the big cardiology group in town. We do stress tests every Friday. My last rotation was with the GI group. Loved that rotation for some reason. Hopefully, I've learned a little bit along the way. From what you are describing, you have had every test we would have done for you. I would also want to see your current medication list. A lot of NSAIDs and other meds like Mobic can actually cause some non-cardiac chest pain especially if taken with some of the more commonly prescribed meds for reflux. GERD is a huge offender of chest pains. Any type of erosion on the esophagus can cause you to have some inflammation right there in your sternal area. I would question if you had an echo. The stress test, however, is a GREAT diagnostic and your insurance may not pay for an echo if your initial stress test was found to be negative. Let me know if you have another other questions. meredith Thank you! You are so sweet! I did not have an echo. And, I bet my insurance would frown on it if it were unnecessary. It very well could be a GERD offender. But, the location (under left breast and radiates under arm) just seems weird to me to be GERD. But, I am NOT a doctor or medical professional. I will give it the week they told me to give it and ask my PCP next week.
|
|
|
Post by christine58 on Aug 2, 2016 1:49:00 GMT
GERD effects everyone differently and I'm betting that is what this is. Also have them check your thyroid. A friend thought she was having really really bad GERD or a heart attack and it was her thyroid.
|
|
|
Post by mikklynn on Aug 2, 2016 15:07:45 GMT
I had a similar experience after my PCP increased my Lipitor. She was pretty sure it was GERD, but sent me for the heart tests to be certain. Mine felt like heartburn with a knife in my back.
I reduced the Lipitor, continued on Zantac and got better.
Good luck!
|
|
|
Post by Patter on Aug 2, 2016 15:14:05 GMT
I definitely would NOT accept what you were told. My daughter was hospitalized in two different hospitals in two different states and said her congenital heat problem had not changed and that she was fine. We would NOT accept that answer because we knew she was not fine. We also had several rude doctors along the way. Our GP is AMAZING and fights for us. He got her a referral at Duke, and after 3 weeks of various heart tests, they found something severe. She ended up with open heart surgery in February and March of this year. She has been amazing ever since! This is not the only time things like this have happened in our family. We have really had to get 2+ opinions before getting to the root cause and effective treatment. You know you body best. Find someone that will help and listen and truly get to the bottom of what is going on. Sometimes that means getting more specialists involved and looking at other body systems too. Hugs!
|
|
|
Post by mcscrapper on Aug 2, 2016 16:39:01 GMT
Forgot to add.....
You can ask your cardiologist for a cardiac calcium score test. It is a very simple test to measure any calcified plaques in your coronaries. It is a very simple CT scan but it is not covered by most insurance companies. In our facility the cost is about $200 or less but is a great indicator of coronary disease. You could also have a TEE but that is used mostly for patients with known disease - specifically in the aorta where the "regular" echo isn't as clear for some structures. The echo, however, is pretty specific. It is mostly used, again, for known heart disease or to determine progressing disease.
The most definitive cardiac / vessel test is a cardiac catheterization. Most MDs won't even do this if no disease is seen on EKG, stress test, echo, etc.
The pain under the breast going around to the back sounds more like costrochondritis. This is cartilage inflammation at the sternum and rib connection. We also call that "chest wall pain."
Just some other data points for you. Hope you are feeling better.
meredith
|
|
|
Post by Zee on Aug 2, 2016 17:11:14 GMT
Cardiac nurse here It sounds to me like they followed the normal and expected procedures for someone presenting with your symptoms.
For me, I would be OK with what they did so far as long as you're not experiencing pains that worsen or are aggravated by activity. That would warrant further workup IMO. Stress tests can have false negatives, but in light of your EKG and enzymes being normal I'd tend to agree that maybe your medications are partly to blame. That is not a routine reaction do there is no reason to fault your pharmacist for not warning you--but more research and studies are showing problems with reflux meds and interactions/side effects, so that may change. Most people take them without difficulty. That doesn't mean you're one of them, so try what the doctor advised.
As mcscrapper said, elimination of a cardiac cause often leaves costochondroitis (rib or chest wall pain) as a culprit, or GERD. Follow the cardio advice on changing your meds, and follow up with your PCP.
I don't think a echo is warranted just yet unless the symptoms don't resolve soon, and as mentioned it may be difficult to get it covered by insurance so I'd be OK waiting a couple weeks on that and seeing how you do. A cardiac cath (angiogram) is the only way to really tell for sure what's going on in there with your arteries, but that's not something you'd need right now for these symptoms and test results.
Another thing mcscrapper said that I totally agree with is seeing about one of those CT scans that helps identify calcified areas. It may give you peace of mind to get it done. There are free-standing clinics that offer those, do some research and find out what's available in your area. Generally the cost of that will be on you but they can tell you more about that than I can. I know they tend to keep the cost fairly affordable for most.
I'm glad you got in and got checked out, especially in light of your dad's history. Make sure your blood pressure issues ate being addressed by your PCP, if the high blood pressure is continuing to be an ongoing thing.
|
|
eastcoastpea
Prolific Pea
Posts: 9,252
Jun 27, 2014 13:05:28 GMT
|
Post by eastcoastpea on Aug 2, 2016 17:33:58 GMT
Hugs being sent. It sucks when you know that something is wrong and you don't know for sure what it is. I hope your symptoms lessen and that your next appointment answers your questions. Good luck.
|
|
|
Post by Outspoken on Aug 2, 2016 19:36:52 GMT
Forgot to add..... You can ask your cardiologist for a cardiac calcium score test. It is a very simple test to measure any calcified plaques in your coronaries. It is a very simple CT scan but it is not covered by most insurance companies. In our facility the cost is about $200 or less but is a great indicator of coronary disease. You could also have a TEE but that is used mostly for patients with known disease - specifically in the aorta where the "regular" echo isn't as clear for some structures. The echo, however, is pretty specific. It is mostly used, again, for known heart disease or to determine progressing disease. The most definitive cardiac / vessel test is a cardiac catheterization. Most MDs won't even do this if no disease is seen on EKG, stress test, echo, etc. The pain under the breast going around to the back sounds more like costrochondritis. This is cartilage inflammation at the sternum and rib connection. We also call that "chest wall pain." Just some other data points for you. Hope you are feeling better. meredith Thank you. Today I have added symptoms. Chills and slightly elevated fever. 99.8. Same chest pain. I called my PCP and they are aware of my visit to the hospital and are ready to act when I am. I I feel like I should be on an episode of House, MD!
|
|
|
Post by Outspoken on Aug 2, 2016 19:39:50 GMT
Cardiac nurse here It sounds to me like they followed the normal and expected procedures for someone presenting with your symptoms. For me, I would be OK with what they did so far as long as you're not experiencing pains that worsen or are aggravated by activity. That would warrant further workup IMO. Stress tests can have false negatives, but in light of your EKG and enzymes being normal I'd tend to agree that maybe your medications are partly to blame. That is not a routine reaction do there is no reason to fault your pharmacist for not warning you--but more research and studies are showing problems with reflux meds and interactions/side effects, so that may change. Most people take them without difficulty. That doesn't mean you're one of them, so try what the doctor advised. As mcscrapper said, elimination of a cardiac cause often leaves costochondroitis (rib or chest wall pain) as a culprit, or GERD. Follow the cardio advice on changing your meds, and follow up with your PCP. I don't think a echo is warranted just yet unless the symptoms don't resolve soon, and as mentioned it may be difficult to get it covered by insurance so I'd be OK waiting a couple weeks on that and seeing how you do. A cardiac cath (angiogram) is the only way to really tell for sure what's going on in there with your arteries, but that's not something you'd need right now for these symptoms and test results. Another thing mcscrapper said that I totally agree with is seeing about one of those CT scans that helps identify calcified areas. It may give you peace of mind to get it done. There are free-standing clinics that offer those, do some research and find out what's available in your area. Generally the cost of that will be on you but they can tell you more about that than I can. I know they tend to keep the cost fairly affordable for most. I'm glad you got in and got checked out, especially in light of your dad's history. Make sure your blood pressure issues ate being addressed by your PCP, if the high blood pressure is continuing to be an ongoing thing. A billion times - thank you. I appreciate all of this feedback. I have notified my PCP and made an appointment for next week (the time the cardiologist advised). But my doctor said if it worsens or I change my mind, just shout and he will see me.
|
|
|
Post by mcscrapper on Aug 2, 2016 19:43:23 GMT
[/quote]Thank you. Today I have added symptoms. Chills and slightly elevated fever. 99.8. Same chest pain.
I called my PCP and they are aware of my visit to the hospital and are ready to act when I am.
I I feel like I should be on an episode of House, MD![/quote]
Yikes! Any cough or chills or any other flu/cold like symptoms? I'm sure you got a cheat X-ray while being seen in the ER but I would definitely be more worrisome w the fever now. Do you have an appt w your PCP? If not, you need to see him/her.
|
|
|
Post by Outspoken on Aug 2, 2016 19:51:43 GMT
mcscrapperLatest temp is up to 101.7. I wonder if I have pneumonia! I did have a chest X-ray.
|
|
|
Post by Zee on Aug 2, 2016 19:56:14 GMT
With the chills and mild temp, just keep an eye on yourself and if you have any shortness of breath or weakness get checked out to make sure you don't have any virus that could cause heart damage. It's pretty rare for that scenario to fit with your symptoms, so no need to worry overly much about it, but just something to be aware of.
There isn't much to be done right now other than observe, chances are this will pass and you'll be better in a few days. But do check in with your doc if you're not feeling better in a few days.
Hope you are feeling better soon!
|
|
|
Post by Zee on Aug 2, 2016 19:58:40 GMT
Just saw your update, I'd call for an appt to be on the safe side since your temp is going up. They may want a repeat chest x Ray. Generally you can see your doc and get the order for the x Ray and do a walk in to radiology (not sure if that's the case where you are, but I've seen more of that lately and it could save you another trip to the ER).
Keep us posted!
|
|
|
Post by mcscrapper on Aug 2, 2016 22:30:57 GMT
OutspokenTell me more about this pain. Is is just under your left breast? Is it a burning pain? Can you reproduce the pain when you touch that area? Are you having a cough? Any rashes? I'm almost leaning towards shingles. I know that sounds odd but hear me out..... several years ago I had a pt that presented very much like you are. We found nothing on chest x-ray, nothing on EKG, nothing on cardiac enzymes...nothing. Zippo. Zilch. A day or two goes by and the same pt shows up without any relief of symptoms but this time has a fever. We draw more labs. More nothing. We see this little tiny rash popping up and I'm like "this guy has shingles!!" Not saying this is what it is but my shingles started very similarly too except I didn't have chest pains to speak of. Mine felt more musculoskeletal but then I spiked a bit of a temp and then got the rash about 4 days later. After putting all the pieces together, it all added up to shingles. m
|
|
|
Post by holly on Aug 2, 2016 22:50:44 GMT
When my DH had shingles he had chest pain, he had a tiny little patch that I wouldn't have even called a rash. We were leaving for a cruise to Mexico two weeks later and the fact that he had chest pain, made him go to dr. His "rash " was on his shoulder blade.
|
|
|
Post by Outspoken on Aug 3, 2016 0:13:21 GMT
Outspoken Tell me more about this pain. Is is just under your left breast? Is it a burning pain? Can you reproduce the pain when you touch that area? Are you having a cough? Any rashes? I'm almost leaning towards shingles. I know that sounds odd but hear me out..... several years ago I had a pt that presented very much like you are. We found nothing on chest x-ray, nothing on EKG, nothing on cardiac enzymes...nothing. Zippo. Zilch. A day or two goes by and the same pt shows up without any relief of symptoms but this time has a fever. We draw more labs. More nothing. We see this little tiny rash popping up and I'm like "this guy has shingles!!" Not saying this is what it is but my shingles started very similarly too except I didn't have chest pains to speak of. Mine felt more musculoskeletal but then I spiked a bit of a temp and then got the rash about 4 days later. After putting all the pieces together, it all added up to shingles. m So, it is directly under my left breast (so, if I were to cut my breast off, not torso) and spreads under arm. It's like a dull ache sometimes and sometimes it's like a stinging sensation. It could be shingles that haven't surfaced yet. We also though Zika virus. I live in Florida and while I haven't been to any location that has known Zika virus, someone has to be first. I took 2 Tylenol and the fever decreased but did not break. In 3 hours time, it has gone from 101.6 to 100.3. My whole body aches - like the flu. But, I don't have a cough or runny nose. This is afternoon after I got the fever, my doctor's receptionist told me they would rather me go back to the ER. I don't want to because I think they will dismiss me as a fruitcake! But, if the pain worsens or if I start vomiting, I'll go somewhere!!!
|
|
|
Post by FLA SummerBaby on Aug 3, 2016 15:39:47 GMT
Sounds like you have gotten some good advice from our nurses here! Hope you get good answers soon.
|
|
|
Post by Outspoken on Aug 3, 2016 20:27:33 GMT
Zeemcscrapper Thank you both for being so kind and helpful. Last night I could tell my fever was breaking while trying to sleep. I was restless all night but not with chest pain. No fever today. Chest is "achy". Like a soreness. I am not nauseated and can eat as usual. That has been the case the whole time. Whatever this is - it is very weird.
|
|
|
Post by Zee on Aug 3, 2016 21:22:30 GMT
Zeemcscrapper Thank you both for being so kind and helpful. Last night I could tell my fever was breaking while trying to sleep. I was restless all night but not with chest pain. No fever today. Chest is "achy". Like a soreness. I am not nauseated and can eat as usual. That has been the case the whole time. Whatever this is - it is very weird. Thanks for checking in. I do wonder if this could be the start of shingles, like mcscrapper suggested? Hopefully just a mild virus that is running its course. Don't hesitate to go in if you start feeling bad again or if your temp rises like that again, or especially if you start to feel run-down or like you can't compete your usual activities. I hope you're back to normal soon!
|
|