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Forum Name: Cardiology Symptoms

Question: Chest pain worries narcoleptic patient


 Vo2x - Fri Apr 20, 2007 8:38 pm

First, let me say Hello and thank you for reading my post. I appreciate the time you have taken to read what I have to say.

I am a 23 year old male who has been diagnosed with narcolepsy, asthma and infectious arthritis (caused by a very bad strep infection). Otherwise I am pretty healthy.

My family has a history of heart and vascular diseases on both sides of the family as well as diabetes (father), cancers (both grandfathers, father, grandmother and cousin), lupus (aunt) and allergies (ranging from mild to severely life threatening). My grandmother had her first CVA when she was about 35 and continued to ischemic strokes until she died at age 45. My brother has high blood pressure which is quite often as high as 237/180, even on medication. Mother has hypertension and my father did, too.

I am currently taking 300mg Provigil po qd, 50mcg Flonase po qd and Allegra 180mg po qd. For pain management I use ibuprofen 800mg prn po OR 650mg aspirin/195mg salicylamide prn po, but generally try to avoid NSAIDs unless necessary.

My primary concern is that I have narcolepsy, and besides Provigil, I have been on stimulants of all kinds for many years. 3 years ago, I suffered a massive strep infection (asymptomatic to full onset in less than 10 hours) which required short term hospitalization. Altogether, I have had 27 strep infections over 7 year period. After treatment for the last infection, I have not had any infections, but I was left with permanent joint pain. I was told to be watchful of heart related problems from the infection.

The problem I have is I have been getting sudden chest pain (on my left side, only in the area of the heart) in the last 8 months, which goes away within seconds or moments. It is a very deep, sharp pain which definitely feels internal and occurs sometimes when I stand up, move around, am physically active or sometimes when at rest.

At times this is accompanied by a pulsating feeling in my neck, around the area of the common carotid. It generally feels like it is a force traveling upwards, lasting a few seconds, and then subsides. I can feel the throbbing if I touch my neck when this happens.

Sometimes my pain radiates to my shoulder or armpit or shoulder blade, but is brief. I have gotten light headed at times when this happened esp. when standing up.

I had 2 EKGs, both normal, but pain was not present in either. I just wanted to know if this is something I should check out or if it is benign.

Thanks.
 Vo2x - Fri Apr 20, 2007 8:42 pm

I just thought I would point out the Flonase is 50mcg IN qd =]
 Vo2x - Wed Apr 25, 2007 10:06 pm

I guess I should assume it is benign...?
 John Kenyon, CNA - Thu Apr 26, 2007 12:09 pm

User avatar Hello Vo2x - While sudden, transient, sharp pains are almost never associated with heart disease, this sort of symptom is probably very difficult to ignore, and since it has more components than just the fleeting pain itself it must cause some anxiety for you.

It sounds as though there is some structure or perhaps nerve pathway which is highly sensitive. It could be subsequent to one of your many infections. At any rate, it is a bother at the least. Does ibuprofin seem to relieve the episodes? This would argue for some sort of small inflammation somewhere. Since it occurs upon standing it is probably neuromuscular. Since it is sometimes accompanied by a pulsation in the neck (do you ever feel this when the pain has not occurred?) it could be that you have the usual occasional premature heartbeat, but that this is triggering the pain indirectly (some people describe premature ventricular contractions as "painful"). It is also possible that since the pain is sudden and fleeting it is also startling, and that might cause an actual momentary increase in cardiac output, which would be detectable as a pulsation in the neck if one were quick enough to check for it.

While in all likelihood quite benign, if this continues to happen it will become one more thing to deal with. If it can be minimized medically it would be to your advantage, as you have quite enough to deal with as it is.

At the very least I would mention it to my doctor. There may be some simple explanation or, better yet, a simple solution.

Good luck to you.

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