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Forum Name: Cardiology Symptoms

Question: MVP-pain spreading.


 Fatherseyes6 - Sat Feb 26, 2005 11:04 am

I have written a post once already about chest pains. Pains since I was 18 that only lasted for a few seconds to a couple days. Now I am now 32 , and on my 8th week of this. I am having a constant dull pressured pain, and sharp shooting electric pains (as quick as a bolt of lightening) throughout the day and night. (waking me out of my sleep) I have been put on Soma, cataflam, protonix, and xanax. It is from my family doctor, who believes I ave costo chondritis. I was diagnosed with MVP 2 years ago. I am now having cramping.in all my abdominal area, with the chest pain worsening. I had a stomach ultrasound done on Monday which showed a normal gallbladder,liver, and kidneys. Then a couple days later I had blood come up my throat and into my mouth, while taking a shower. 2 days later I went to do my echo, and stress test, in which, my ekg was abnormal, but the echo showed nothing , but MVP. ( But the tech swears she saw something, but the doctor called it shadows. I am hurting everyday, trying to function as regular is impossible, and has been for 8 weeks. progressively getting worse. Everything runs through my mind, I have saline breast implants, I wonder if scar tissue has built up behind them, I wonder if its intestinal, I wonder if its heart related. Its in no way or shape an anxiety issue with me, causing any of the physical part of this. Of course after so long, and being in pain, and seeing blood, and not being able to put a finger on an answer, I get very scared at times. Especially when I awake of of a deep sleep with this shooting horrible pain. I am trying not to take the drugs often, because they really do not alter the pains, and they are also addictive. I mostly take the protonix, but everynow and then I have to take the others. Some days I go to sleep (with xanax )hurting so bad that I wonder if I will wake up the next morning. Its starting not to scare me if I don't. Because I am suffering. I have also had blood in my stool over a course of a year. I have an appiontment for an colonoscopy, and endoscopy, but not until April. What am I supped to do with that? That is too far away. What could be causing such constant unrelenting pain in my chest? Why is it ok , for my ekg to be abnormal? I have such a swollen fist sensation of my left side of my chest, and sharp shootong electric pain acros thewhole thing, with palpitations, when I am at rest, and not even paying any attention. I can be in the happiest place, and relaxed and enjoying my time, and it will shoot this pain everytime, no matter what i am doing. I am at a loss of what to do or think. I am at a loss with my doctors, both my cardiologist, and intestinal doctors are on vacation right now. My drugs are not helping, and I am just at a mental and physical loss. Please tell me what to do? I need an honest, professional, and attentive opinion. PLEASE?
 Dr. Yasser Mokhtar - Mon Feb 28, 2005 7:48 pm

User avatar Dear Jenny,

To determine whether or not chest pain is caused by coronary disease, the major risk factors for coronary disease in the patient complaining of chest pain are assessed and the characteristics of the chest pain are looked at and the probability of this pain being caused by coronary disease is then determined.

Females of the child bearing age are naturally protected against coronary disease unless they have had major risk factors for long periods of time. You are a smoker, and this is only one major risk factor for coronary disease. Your chest pain sounds very atypical as compared to that of coronary disease. So, to begin with, your probability of this being due to coronary disease is low.

You had a stress echo, i am not sure whether it was an exercise stress (if it was an exercise stress test and you kept exercising till your heart rate reached its goal without you having typical chest pain, this is a very good sign that you don't have coronary disease) or a chemical stress. At any rate, it was negative by echo. ekgs are not the best tool to diagnose coronary disease, otherwise, other tools would have not been invented or used. ekgs specially in the females is even worse than males to diagnose coronary disease. Echoes are far better than ekgs because echo visualizes the heart in real time and any abnormality is immediately identified. What do you mean by an abnormal ekg? Coronary disease has a specific pattern on the ekg during the stress test and if it was not there even if the ekg looked abnormal (whatever that means), then the probability of this abnormality being secondary to coronary disease is low.

So, your clincal probability that this pain is due to coronary disease is low to begin with and your stress echo was negative, so i am confident that this pain is not due to coronary disease.

So, when you have your pain, don't think of the worst which is coronary disease, because you don't have it. If you are still very worried about this pain be due to coronary disease, then you might want to discuss having a coronary angiography with your cardiologist, this is the gold standard test to diagnose coronary disease. It is an invasive test and has its complications of course, but since your stress echo was negative, i am not sure that any cardiologist will be agreeable to that.

Your chest pain could be very well related to your mitral valve prolpase as mitral valve prolapse is notorious for having atypical chest pain. Did you try any medications for the pain? Beta blockers can be used in a trial to control the pain.

The character of the pain suggests that this pain could be due to back or spine problems. i would recommend that you have a neck x-ray or ct scan to exclude spine problems.

Blood coming out of your mouth is an alarming symptom, but the most common cause of having blood coming out of your mouth, is related to inflammation or infection, so you could have been having a bad bronchitis (specially that you are a smoker) or a bad case of sinusitis or sore throat even. i think you should mention this symptom to your doctor once available and if you have this symptom again, i would recommend you having a ct scan of the chest to make sure that there is no cause in the lungs that would cause this.

Is there a relation between blood and chest pain and the answer is yes but not in the clinical setting that you are describing. A condition called pulmonary embolism can cause but this is not what you have as your symptoms do not fit the symptoms and signs of pulmonary embolism.

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

Yasser Mokhtar, M.D.
 Fatherseyes6 - Tue Mar 01, 2005 9:00 am

First let me start out by thanking you very much for taking the time to speak with me, and looking at my post. Thankyou!! Yes I had an excercise stress test. An echo first, then the treadmill, and then an echo again as soon as I stepped of the treadmill. But I did not complete the test. I had a bad shooting pain at 148 heart rate, which is when my ekg pattern showed something ( at that exact moment) They had wanted to see my rate get to 160, but we did not make it, as they said stop, and i got down, and did the echo. Which was blocked on the right side by my breat implant, which made it difficult to get a side view. The technician and the doctor disagreed over the results (right in front of me) He ended up looking at it for 10 minutes, and calling it shadows. But I did not get a discussion with that doctor, he is not my cardiologist, mine was on vacation. so they said they would get the results to him, and I have an appointment, when he comes back . Mitral valve prolapse can cause pain across your chest? See, I never knew that, no one ever really explained anything about MVP to me before. Just basically what it is, and thats it. When I bleed in my mouth, I really had no signs of infection in the nose or throat, or any bronchitis symptoms. It just sort of leaked up like reflux does, except it did not burn. I wasn't coughing or gagging or anything. Which was quite scary. I would love to get my lungs looked at . My father died 4 years ago, at age 64, of COPD ,and asbestos .His systems eventually shut down. I disguss this chest pain with my doctor, he automatically diagnosed me with cost chrondritis, with out any testing, just by our discussion. He said he has had it for years himself. So, he gave me all those pills I mentioned, that really do not help the pain, but do help some of the anxiety I get when I"M hurting. I do not want to find something terribly wrong with myself, but I want to stop this pain. Its been day after day, and all night long. Never in all my years, has it lasted this long,Or been this painful, and consistent, the maximum has been 2 days..a long time ago. At age 22. Now I am counting the months. I have stopped my job, and been house bound, majority of the days. It was always just a minute or 2 of instant pain , and then it would disappear , as quick as it came. But not this time. Its taking me to new levels, with side systems of blood, and severe joint pain, shortness of breath, and constant chest pain. Not knowing which avenues to explore, and everyhting is such a slow process to be seen. I just want to say thankyou for your time once again.... Thankyou...Jenny
 Dr. Yasser Mokhtar - Tue Mar 01, 2005 9:44 am

User avatar Dear Jenny,

Thank you very much for the update.

First of all, please, stop smoking.

i am still convinced that your chest pain is not due to coronary disease, the pain that you had during your stress is not typical and i am still not sure about the ekg abnormality but if it was typical of coronary disease, the doctor would have said that, regarding the echo, i think it is going to be really difficult to interpret the results with your breast implants.

Breast implants have lots of complications including leakage of the fluid within the implant, and this leak will cause symptoms in some patients specially if the patient is allergic to this substance. i would recommend that you call your surgeon and ask to be seen for this chest pain, there is no doubt that he/she will add a valuable opinion about whether or not this chest pain and all your other symptoms might be due to the breast implant and what are the possible solutions if they are due the implant.

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

Yasser Mokhtar, M.D.
 Fatherseyes6 - Sun Mar 06, 2005 9:31 am

Hello again, I went to the plastic surgeon who said its not my implants, But I am not sure, as he did no test or anythng what so ever. I saw my family doctor who is now taking me a little more seriously because of the blood issue. He sent me to get a chest CT scan, yesterday. (with the iodine injection) So I will hear about the rseults this Thursday, when I go back to see him. But I have a big question for you! My doctor (the family one) Has given me beta-blockers to take in the mean time. They are called Coreg-Carvedilol. I read that they reduce blood pressure, and mine is always around 98 over 60. I am always pretty low. Do you think , I should be taking this, and why do you think that he thinks I should? Taking new things makes me nervous, because I am already on soma, and xanax. No one has put a finger on the heart , and chest pain I feel. So I was wondering in your opinion can these beta blockers effect me in a negative way? In conjunction with the other pills I am taking? My biggest question is....Do you believe its a good idea, and what exactly do thet do? Thankyou , Jenny.
 Dr. Yasser Mokhtar - Sun Mar 06, 2005 4:01 pm

User avatar Dear Jenny,

Thank you very much for the update.

Hopefully, the ct scan of the chest will show if there is any leak or inflammation surrounding the breast implants.

The coreg is most probably given for the chest pain. Since you have mitral valve prolpase, this chest pain could be caused by mitral valve prolapse, and the beta blockers group of medications (to which coreg belongs) are used to control chest pain originating from mitral valve prolapse.

Coreg can be given in a very small dose so it will not affect your blood pressure at all or will cause a very small change.

There is no interaction between coreg and soma or xanax.

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

Yasser Mokhtar, M.D.

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