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Forum Name: Miscellaneous Cardiology Topics

Question: Periodic chest pain and fatigue with other symptoms


 Danie - Sun Nov 11, 2007 1:46 pm

I am a 35 year old female, who has had extensive cardiology tests and check ups over the last five years. The reason for these tests initially started about five years ago with palpitations and shortness of breath. The doctor then prescribed arrhythmol, which worked well. Along the way, my BP was taken, and found to be slightly elevated, so I am also taking Ramipril 2.5mg.
I have since come off the arrhythmol and only use it very occasionally when I feel that my heart is not maintaining a steady rhythm and I feel exhausted as a result. Then I go back on it for a period of 3-4 weeks and everything settles down again.
However since then, I have been back to see the doctor with intermittent chest pain,shortness of breath, and pain spreading across my neck down one or both arms. This is always followed by severe fatigue. On one occasion I visited casualty with a severe squeezing sensation in my left arm, accompanied by sweating and nausea. On each occasion, I have one episode of diarrhoea, which then goes away. ECGs have all come back clear, and I also have had a 24hr tape, which has shown a few ectopic beats, but clear otherwise. Along the way the tests have picked up a small hole in the heart, but I have been told this would not have caused my other symptoms.
On occasions I have dizziness, and faintness, where I feel everything go black, and then it clears again. I have not actually fainted.
My latest episode of this chest pain happened last weekend. I woke from sleep in the middle of the night, to a tightness in my chest, going through to my back, shortness of breath, and pain in both legs.This lasted about an hour. The pain in my legs was relieved slightly when I sat upright for a while. Since then I have had small twinges of chest and arm pain which have lasted for a few minutes and gone away again with rest. Accompanying this has been an unbelievable fatigue, where I have been exhausted with the effort of sitting up. Even the smallest task at the moment means that I break out in a sweat and my legs get shaky again. I have also had soreness all over, with joint pain. However, this is achy in kind, and is bearable.
I am impatient to be back at work again, but know that I would not presently have the strength to do my job. The last episode of this nature, kept me off work for a week. I have been off for a week and a half so far. As all the tests (chest x-ray, heart scan, bloods etc) are coming back clear, my GP is inclined to think it is not my heart, and has ordered further blood tests for rheumatoid arthritis, and inflammatories.
From past experience I know it will take me about three months before I have a reasonable quality of life again, where I can engage in something other than work, rest, sleep.
Sorry for the extensive length of this post, but my symptoms are so varied, even I have trouble keeping up with them.
I would appreciate any ideas or feedback, because if this next set of bloods come back clear, as I suspect they may, I don't know where to turn next.
 Dr. Chan Lowe - Thu Jan 24, 2008 4:42 pm

User avatar Hi Danie,

Initially, your symptoms do sound cardiac related but it sounds like you've had quite an extensive cardiac workup that has not shown any problems. Because of this, I am inclined to agree with your doctor that this probably isn't cardiac related.

I'm not sure exactly what is causing this but my suggestion would be to next see a pulmonologist for evaluation of your lungs. Occasionally, lung problems can present very much like cardiac issues.

If this doesn't turn out to be the source, seeing a rheumatologist is reasonable. A neurologist may also be of some help.

Sorry I can't give you much more of an answer.

Best wishes.

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