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Forum Name: Cardiology Symptoms

Question: Unexplained heart problems...


 ECC - Thu Feb 17, 2005 3:18 pm

Hello,

I'm 33 years old and I'm a Persian Gulf Vet with Persian Gulf Syndrome and I started having some heart problems last January (2004). My problems started, literally overnight. Up until Jan of 04 I had low blood pressure and a low heart rate. I have noticed some fibrillation (fluttering and eratic heart beat, skipped beats, double beats, sometimes my heart will stop beating for a few seconds, etc.) over the last couple of years though. In January of last year my heart rate went through the roof. I have since been diagnosed with Tacycardia (heart rate well over 100 at a rest). My blood pressure also shot way up. There was also a significant increase in my fibrillation. This was also the same time I had my first anxiety attack. I also started having quite a bit of chest pain at this time. Last but not least, I started hearing my pulse in my left ear also at this time. I have been through EKG's, ECG's, several heart enzyme tests, a Thallium stress test (for the stress test my BP and HR went through the roof...they kept asking me if I was OK and I told them I felt fine. I was on the treadmill for 8-10 minutes going full speed and they finally slowed it down and let me off), a couple of Holter monitor tests, and an Upper GI X-ray after drinking ?ballium?, multiple chest X-rays...and I really cannot think of whatelse. I've been to the emergency room several times, thinking that I was having a heart attack. It's gotten to the point now, that I do not go anymore, b/c every time that I've been, there's supposedly been nothing wrong... According to my Doc, all of my tests checked out within normal ranges. I do have a mild case of esophogeal reflux disease. He said that my problems are probably the result of a Chemical imbalance of some kind. He said he saw no signs of heart disease. He said that all he could do was to treat my symptoms. I was on 50 mg of Atenolol to help with the tacycardia, fibrillation, and elevated BP. They just reduced that to 25 mg, b/c I am gaing quite a bit of weight, and the meds are slowing me down. I take .5 mg of clonazepam daily for the anxiety and 10 mg of cyclobenzaprine for my back...to help me sleep. With little or no exertion, my heart rate and BP are both still staying in normal ranges (132/77 P-78 ) but with significant exertion both are going up kind of high. I am also still having chest pains with exertion. Most of the time these pains are on the left side just below my pectoral muscle. These pains are usually very brief, and sharp stabbing pains. Occasionally they will be center or right, but most of the time they are on the left. To give an example, I just finished splitting some wood (30-40 minutes of moderate exercize) and I took it easy. I had several chest pains on the left side while splitting. My BP before I started was 131/74 P-68. Immediately afterwards it was 144/79 P-99. Thirteen minutes later it was 137/83 P-103 and 38 minutes after that it was 140/80 P-96...this while all at a rest. I took it real easy while splitting the wood...I was not working myself hard at all. I know these levels are not significantly high, but they get higher with more exertion...and the chest pains concern me quite a bit. I'm a contractor and I do hard physical labor for a living. The other day my BP was running 140/91 with a heart rate up to 100 and it was an easy day at work...just doing light trim work. I honestly believe that my heart problems are Persian Gulf related and all of my care has been through the VA center. What I want to know is: Does a normal person's BP go up high with exertion? What could possibly be the cause of my chest pains with exertion? I have not been having the problems with anxiety for quite a while now, so I do not believe my problems are related to this. All of my problems seemed to have started overnight. My chest pains have me the most concerned. They can be best described as being short, stabbing, sharp pains, just below and underneath my left pectoral muscle. Sometimes they will kind of wrap around the left side of my chest (under my left arm). I also suffer from shortness of breath, but this is definitely Persian Gulf related. The doc's at VA are very tight lipped and will not give me very much information. Any help or insight would be greatly appreciated! Thank you in advance.

I would also like to add that at night while sleeping, I can be laying completely flat on my back or stomach and my arms and hands will go completely numb and wake me up. They get so bad that I cannot move them at times...I think this must be related to circulation some how.?.?

Edited to better describe my chest pains and to provide some additonal information.
 ECC - Thu Feb 24, 2005 1:35 pm

I'm still searching for an answer. I just spent about an hour splitting wood again today and I had a few sharp pains in the center of my chest...kind of felt like they were in my breast bone. They were sharp and brief. About an hour after splitting the wood by BP was up to 140/85 P-80. Should physical exercize cause my BP to rise??? Is this normal? I know it's not significantly high, but I've been told that any time your lower BP number is 85 or, you are doing permanent damage to the organs in your body. I'm also looking for an answer as to what could be causing the chest pains. They are always stabbing, brief pains...but they worry me...and 95% of the time they come with exertion. I would greatly appreciate any insight that the doctors could give me. I do not have health insurance, so my medical care is very limited. Thank you again!
 Dr. Yasser Mokhtar - Thu Feb 24, 2005 7:11 pm

User avatar Dear Eric,

First of all, i am not familiar with pursian gulf war syndrome, so i will not be commenting on it and whether or not the symptoms that you have are related to it in any way.

From what you said, i think that you don't have coronary disease. i think that the chest pain that you are suffering from is most probably related to localized muscular causes in the chest wall. This being said, however, i have a bias, any patient who has chest pain that proves not to be due coronary disease, i would like them to have a neck x-ray/ct scan to rule out cervical spine problems. If the pain that you are describing as sometimes goes around the back under your arm is always in the same place (when it comes to the skin), then this could be due to shingles infection in the past even if you did not have an obvious one with pain and rash.

Regarding the tachycardia and the increase in heart rate whether at rest or with exercise and the sudden start in the symptoms, if not already done, i would like to suggest to have a thyroid function test done. There are some rare diseases that can cause sudden increase in blood pressure, heart rate and even a panic attack like sensation that some times are not looked for by physicians because they are so rare and it is a hassle sometimes to diagnose them properly. These diseases include a disease called pheochromocytoma (tumour that secretes adrnaline into the blood) and another one called carcinoid symdrome (another tumour that secretes a substance called serotonin in the blood).

Usually, systolic blood pressure (the above number goes up progressively until it reaches 160 (in young patients) - 200 (in elderly patients). The lower number does not significantly change or may be minimally decreases.

After exercise, heart rate and blood pressure should go back to their original values. If the patient is of the athletic type, blood pressure and heart rate changes will go back to their original values faster.

From the blood pressure that you have, you might have high blood pressure, but the diagnosis of high blood pressure relies on having 3 high readings on 3 different occasions within the same week (meaning 3 different days) with the patient relaxed and not after exercise.

Atenolol is a medication that can control the blood pressure but if it is not controlling your blood pressure then you might want to discuss it with your doctor to increase the dose.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.
 ECC - Thu Feb 24, 2005 7:32 pm

Thank you very much for the reply Doctor! I do have a bad back and neck from a car wreck a few years ago...so there could be some problems there. I will look further into this. I also had a very brief and mild case of shingles last year (this popped up at the same time I had a strep infection in a sweat gland). They operated on the gland and the shingles appeared shortly after that. The shingles were not located in the same area of my body as the chest pains though. I believe they did a thyroid test on me, but I will check into that too. I have been diagnosed with high blood pressure...it was significantly higher before being put on BP meds. I went through 3 different kinds of meds before finding that Atenolol worked very well for me. They just recently reduced my dosage, b/c of weight gain and the fact that it was slowing my body down so much. The reduced dosage of 25 mg seems to be working for the most part. I am keeping a log to show my VA Dr when I go back in to see her next month. Thank you VERY much for your time and insight Doctor...it is greatly appreciated! :) 8) You've given me some hope that my chest pains may not be heart related. It can be very unnerving to think you could be on the verge of a heart attack with any type of physical exertion...especially when you are as active as I am. You doc's are doing a great thing here on this site!

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