News  |  Journals  |  Conferences  |  Blogs  |  Articles  |  Forums  |  Twitter   
 

 Headlines:

 
 

Doctors Lounge - Cardiology Answers

"The information provided on www.doctorslounge.com is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her physician."

Back to Cardiology Answers List

Forum Name: Cardiology Diagnostics

Question: Pains in my chest and head


 robert uk - Fri Mar 18, 2005 7:50 pm

I am a 38 year old male living in the United Kingdom and recently nearly 2 weeks ago was went to the accident and emergency here in the UK with pains in my chest and head. After numerous blood tests they said that i may have a possible blood clot and so they did more tests over the next few days to rule it in or out which the VQ test came back as Low Probability, while i was having the VQ test i was getting bad chest pains again and they did an ECG at the Nuclear Department which the staff and the doctor said something about the ECG showing AF which i don't understand what AF means. The doctor at the time said to me he could not let me go anyway as my heart rate was high. Last year i was also in hospital with bleeding stomach ulcers, and whilst in started to get chest pains and my heart rate reached 190+ at times but they said to me it was a problem with low potassium and gave me some potassium drinks. Now over the past 10 or more years on different occasions i have ended up at the accident and emergency for chest pains but the only thing they always said is that i had tachycardia which is a fast heart rate i think and let me go each time. When i was released this time from hospital they gave me two medications named Cardicor and ramipril and never explained to me what the medication is for. The reason i am writing is that when i am admitted they never seem to get to the bottom of the problem and now this evening i am feeling a tightness and heavy in my chest again and pain up the right side of my neck but i am hesitant to go to the accident and emergency again as i feel they will just release me after a while with no real answers. Is there anyway you can put me in contact with someone in the UK or give me some information as i am at a loss on what to do next.

This is an update to the above text which i wrote a few days ago until i found somewhere like your website that i could ask for some advice. I was admitted to hospital again yesterday morning but released the same day later that night after being taken ill at the outpatient department that i was attending for a routine appointment for another condition not connected to all this what as been happening to me lately. I had not felt well since i was first released from hospital the first time which is explained above. I will outline what happened to me yesterday Thursday 17th March. It was around 10:30 am and i started to get severe chest pains and also felt terribly sickly and my heart was pounding and short of breath. The staff at the outpatient clinic phoned for an ambulance. When the paramedics arrived they first of all gave me oxygen as i could not get my breath and they also gave me a squirt of a spray under my tongue which they said would help with the pain until we reached hospital. The paramedics also did an ECG and the only thing i could hear them talking about it was that the ECG came back with a result of a VT which i tried to look up on the Internet but could not find much information on what that means. Anyway when i arrived at the Hospital assessment area they did numerous blood tests again and another ECG.A little later that afternoon the Doctor came back to me and wanted to do another chest Xray and also another VQ scan as again one of the blood test came back as positive for a chance of a blood clot which i already had both those test 2 weeks ago. The results of the VQ scan again came back again as low risk but the staff in the Nuclear department were very surprised they let me out of hospital the first time and thought i was still in hospital and they sent me for another follow up scan. The Doctor in the Nuclear department also told the staff i think he would be better off with a different kind of scan and the Staff Nurse and other staff were urging him to put a request in for it but then he said no to them because it was another doctor that arranged these same test again that i already had. I am not sure what the name of the test he said to them would be better as i had already had this one only 2 weeks earlier as i was still getting some chest pain and my heart pounding as they were doing the test again. They also squirted a spray again under my tongue during me having the VQ test again as i could not keep still with the pain in my chest whist breathing trough the mask.

Anyway a few hours later that evening the Doctor came back saying that the VQ test again came back as Low Probability of a PE. Now i was still feeling very sickly but the pain in my chest had lessoned somewhat, just leaving the sensation i have been getting now for over two weeks since i was first admitted which is a very heavy feeling over my chest like a weight on my chest. He said that i should just take the medicine i was given before which was Cardicor for my heart rate and ramipril for my very high blood pressure which he said was unusual for someone my age. He also said he thought the pains were muscular which i very much doubt, but he is the doctor and who am i to argue that point over to him. So here i am again at home and the sickness feeling and heaviness is still there and i have hardly eaten anything since coming out as soon as i have eaten a bit the nausea sickness feeling seems top get worse, the only pain in my chest i have been getting since i was out is every now and again i get a sharp pain in center of my chest which then takes my breath for a few moments and my heart pounding on and off all day and i keep burping every now and again.

I just don't know what to do next as if i feel the same again..I will feel such a fool to go to the emergency department or call for an ambulance as i feel nothing will be done and this will just go on and on with no end in sight.

Sorry for explaining this how i have but i just don't know who to turn to next.

Thanks for listening

Best Wishes
Robert
 Rhonda P, CEP - Fri Mar 18, 2005 11:53 pm

User avatar I will tell you that even if you need to leave the UK to find a good Cardiologist, you need to do this. Your life is in danger if everything you are saying is correct. You are in danger of a possible HEART ATTACK, STROKE and/or DEATH and you are way to young to have a heart in this condition. This is a personal question, are you an intravenous drug user? Something has beat your heart up for it to be acting this way. It may have been injured or attacked by a virus or possibly you inherited this but a Cardiologist can help you out, I'm talking NOW, you don't have time to waste, you are be in extreme danger as we speak. You can blow a blood clot and die or stroke at any moment, especially when your heart starts fluttering. Did they tell you to take an aspirin a day or anything like that?

My educated guess would be that you are having atrial fibrillation causing possible clots to form and ventricular flutters but are they being cardioverted by electricity? You may need a pacemaker put in place. When you complain of chest pain they spray nitroglyerine under your tongue to dialate the cardiac vessels so the heart can breath and they should put you on oxygen at this time also.

AF - Atrial fibrillation - In it the heart's two small upper chambers (the atria) quiver instead of beating effectively. Blood isn't pumped completely out of them, so it may pool and clot in the bottom of each chamber. If a piece of a blood clot in the atria leaves the heart and becomes lodged in an artery in the brain, a stroke results.
VF - ventricular flutter is a ventricular rate of 150-300 bpm and requires defibrillation or cardioversion (where they shock you) usually to get out of it.

This link is the the American Heart Association in the USA but it can explain AF, VF and other cardiac stuff, look around on their websites. Maybe you could even contact someone for a good Cardiologist reference. Just PLEASE don't drop this, I feel very insecure with your treatments as you have explained it.

http://www.americanheart.org and go to warning signs
 robert uk - Sat Mar 19, 2005 9:35 am

Hello AZ Paramedic

Thank you so much for the information in your reply.
To answer your questions about drugs..I have never taken any form of drug in my life and the only thing i can think of is that a lot of my relatives and close family have had heart problems. My uncle had an heart attack but had bypass to put that right, my grandmother and grandfather died of heart related problems. MY mother has a heart murmur from birth and high blood pressure. I think the link to my problem how i am at the moment must be inherited. I forgot to mention that while i was on the assessment ward I had some kind of attack which i am not sure what it was....I went very hot and sweaty all of a sudden and very sickly but just before that happened i had a big pain in my chest and then it left me short of breath and gasping again, i did notice on the machine that was attached to my finger which i glanced at during having this problem was my oxygen was 72 , not sure what that means and my heart rate i kept seeing it go from 130 to 240 then down to 80 then up to over 250 all over the place. I called over for a nurse who came to me and said she would get the Doctor but he never came as i think he must of been with another patient and only came over after that episode had died down and to tell me he needed to do a VQ test again because a blood result again like 2 weeks before came back positive that there was a chance of a blood clot, But as i said in my other post again the result came back low probability. I really wished that the other Doctor at the Nuclear scanning department would of insisted on that other test he said would of been better because i had only had the VQ test 2 weeks earlier and with him working in that area i thought maybe he mentioned this other test because he felt a better result would come of it to at least find out what is going on with me.

When i was sent in the first time just over 2 weeks ago, it was head pain very sharp that i had from early morning and lasted all day and into the early hours of the next day, The following day i started with chest pains and the heaviness , weight feeling over my chest and so went to the emergency department. The sharp pains i still get in my head..not like a headache but when they come are just sharp pains and also i get a very heavy feeling in my head similar to what i get in my chest, like a weight is pressing down.

Like i said in my other post I just wished they could of got to the bottom of what is wrong so at least i know it can be treated and to stop all these symptoms i have been getting for over two weeks now. I forgot to mention that they also had been giving me Heparin injections whilst i was in hospital the first time in my stomach and then again this Thursday last week they also gave me a injection earlier that afternoon of it, but then released me as i explained.

If my VQ scan came back twice of the low probability of a blood clot but the blood test they do to see if there is a chance of a blood clot comes back positive does this mean i have no blood clots and the problem is related just to my heart. The reason i can't understand it is why has the blood test they did each time i was admitted come back that they needed to do a VQ scan because the blood test was positive?

Thank you for your advice and the link you gave me, it has helped me a lot, and I will take a look on that website to see if i can find a cardiologist that will at least get me sorted on medication or something to stop me feeling how i am. If there was one thing i wish that could just go it would be the heaviness over my chest which is so hard to describe what it feels like and the pounding sensation of my heart....and also the sickness which i am not sure is related to al this or not, but i have had this sickly feeling since Thursday and it's not gone yet.

Best Wishes
Robert
 Rhonda P, CEP - Sat Mar 19, 2005 10:34 am

User avatar If you can get a copy of one of your ECG strips that show you AF or VF attacks or what is happening when you are feeling your chest pain that would help the Cardiologist or next treating Physician. The Heparin injections will keep you from clotting, thats a good thing. Have you ever had Strept Throat or any type of virus that may have attacked your heart? I feel that you are in a life threatening emergency here and I can't stress it enough to find a Cardiologist and see them as soon as possible. Do you have one around you? The weight you feel in your chest is your heart having a hard time pumping and "breathing". I'm going to see if I can get a Cardiologist to write you in the meantime, see if you can contact one.
 robert uk - Sat Mar 19, 2005 10:46 am

Hello
Thanks again for getting back to me..I have been trying to contact a cardiologist in the UK but have had no reply yet. I would not know really how to get the copies of the ECG that they took, but they must have them in my hospital records. The heparin i was pleased in one way that they gave me an injection because i was thinking that at least it will help if i have got a clot even thought those two VQ scans came back low probability..but i am not on the injections at home they only gave me them till they released me from hospital again. Thank you for going to so much trouble to help me and try to find a cardiologist to contact me. If he needs my phone number or email just tell me how i can give them to him, by email or something. The only other symptoms i have at the moment is dizziness and also sometimes a dull ache up my neck.

Robert
 Rhonda P, CEP - Sat Mar 19, 2005 11:05 am

User avatar the VQ is the tests they do to see if you have Pulmonary Embolisms. Your atrial flutters or fibrillations are causing clots to form in the top portions of your heart and when you finally get a good heartbeat out it pushes little pieces of clot out into your lungs from the artia that have formed, or at least thats what they are looking for with the VQ tests. I have written a note to a Doctor on here to review our conversation and write to you, I am also going to see if I can contact a Cardiologist for you.
 robert uk - Sat Mar 19, 2005 11:08 am

Thanks so much for all your help, it's very much appreciated.
 Rhonda P, CEP - Sat Mar 19, 2005 11:14 am

User avatar Try this website and see what you find

Dr D R Holdright
42 Wimpole Street,
London
W1G 8YF

Tel: +44 (0)20 7486 7416
Fax: +44 (0)20 7487 2569

http://www.cardiologist.uk.com/frames.htm
 robert uk - Sat Mar 19, 2005 11:16 am

Thank you, I am going to look at that site now.
 Rhonda P, CEP - Sat Mar 19, 2005 11:34 am

User avatar please, if you can, let me know how everything turns out for you and what your final diagnoses is. I don't want to bother you with it but if you have a moment. Thank you so much, I will pray for you.
 robert uk - Sat Mar 19, 2005 11:45 am

Thank you Web-Medic,
I sure will let you know on how things go for me, you have been so very helpful. I have contacted that Doctor from that website and am just hoping now i get a reply.

Can you tell me what FF means on ECG the first time i was at the nuclear department they also did an ECG there and i am sure they said it looks like FF but i don't understand the terms. There is no need to thank me i should be doing all the thanking for how helpful you have been to me.

Thanks again
Best Wishes
Robert
 Rhonda P, CEP - Sat Mar 19, 2005 12:15 pm

User avatar Well, don't quote me on this because I don't use that term but I believe they are talking about the first heart sound to first heart sound time interval (FF) or (FF) rate, on the ECG it is measured as the R-wave to R-wave rate (RR rate) or time interval. The R wave is the first tallest upward (positive) deflection on your ECG reading when the heart starts it's beat.
 robert uk - Sat Mar 19, 2005 12:23 pm

Thanks for that information. I will get back to you soon as i know anymore, and once the cardiologist contacts me. Thanks very much you have been a huge, huge help to me.
 robert uk - Sat Mar 19, 2005 2:13 pm

Just a little update..I have also been getting for a few hours a weird buzzing in my left ear and ache in my neck left side..like a deep buzzing noise. I have had a similar sensation in the past but that was when i feel i am about to pass out, this time it is a deeper buzzing. Also have you any idea what the constant burping i am having and if you think it is related to all this or something different.

Thank you
Robert
 Rhonda P, CEP - Sat Mar 19, 2005 2:28 pm

User avatar Your left carotid artery can have spasms causing neck pain may be due to your heart condition and can also cause the ear noise. There are so many things around that area, you can have dissecting areas, a stroke, things I can't think of that are happening. I just want you to hurry and get to a Cardiologist.

I have had many cardiac patients that burped and complained of needing to burp so I know that is definately part of your cardiac problem. Have you, by chance tried to call that cardiologist to see if they are in the office? It's probably night there isn't it. Maybe they have an emergency line you can contact them on for advise. I do have an email into one of the Doctors here for you and I know he is very knowledgeable in cardiology issues so watch for his response.

Can you tell I'm worried for you? :roll:
 robert uk - Sat Mar 19, 2005 4:57 pm

Hello
Thank you for thinking about me and your concern. Because i feel so poorly and the heaviness, sickness and chest pains i keep getting are not bating off, i am thinking of getting to the emergency hospital again in the morning if things are no better or if they get worse will go tonight instead of waiting for a referral to a cardiologist to come through. I just wished this heavy weight feeling would go. The only thing that is putting me off doing this again is i feel such a fool because this will be 3 times now in just over two weeks i have been admitted, but i just can't stand feeling how i am each time i come out without the problem being sorted for me. The other reason is that i feel they will just do all the same blood work again and it will come back fine except again for the clotting one which i am not sure what it is called but it seems to come back positive each time, then i just hope it wont be another repeat of the VQ scan as i have already had 2 in 2 weeks.

You see when your admitted i don't think it will be cardiologist who will be there, maybe just a Doctor who works in all areas. Have you any advice if it seems to be a repeat again of what test i need to tell if they have done or can it only be sorted with tests a cardiologist can ask for. Another thing i can't understand is if all my blood work is coming back okay for the test they are doing, could they be missing certain tests. The other thing is can i still have clots even if the VQ scan keeps coming back low probability. Thank you and for your kindness and help.
 Dr. Yasser Mokhtar - Mon Mar 21, 2005 12:19 am

User avatar Dear Robert,

To determine whether or not chest pain is caused by coronary disease, major risk factors for coronary disease and the characteristics of the chest pain (as compared to that caused by coronary disease) are looked at and then the probability that the chest pain is due to coronary disease is then determined.

You have one major risk factor for coronary disease and that is being a male. Otherwise you don't have any. Your chest pain is atypical. The probability that your chest pain be due to coronary disease is low.

The chest pain that you are getting is the way many people describe the palpitation feelings that they have, every time that you have palpitation or fast heart beat, you feel this pressure or pain. So, what you are feeling is not actual pain, it is the feeling of your heart beating fast (and may be even contracting stronger) and this gives this uncomfortable feeling in the chest that you describe as pain.

Atrial fibrillation (af) is a condition in which the heart, instead of beating in a regular fashion, starts beating in an irregular fashion. This irregular rhythm could be fast or slow but the main characteristic is the irregularity of the rhythm. Atrial fibrillation has many reasons including but not limited to high blood pressure, hyperactive thyroid gland, electrolyte imbalance, heart problems such as valvular heart disease and lung problems such as developing pulmonary embolism or having chronic lung disease such as emphysema. In some instances, a cause is not found and in this case, atrial fibrillation is called lone atrial fibrillation.

Ventricular tachycardia (vt) is a condition in which the electrical impulses of the heart abnormally originate from the ventriles which are the 2 chambers that pump blood into the body (left) and the lungs (right) instead of originating from the atria which are the 2 chambers that receive blood from the body (right) and from the lungs (left). Ventricular tachycardia (in addition to the causes that are mentioned above as causes for atrial fibrillation) usually points to a heart problem. This heart problem can sometimes be a serious one.

i never heard of the term ff in ecg.

i am not sure why they keep doing vq scans everytime you go in to be checked and i am not sure what is the blood test that came back positive saying there might be a bloot clot (which makes them do a vq scan everytime). i think that the other test that the nuclear medicine doctor was referring to was spiral ct scan with contrast. This is a good test for detection of big central pulmonary emboli. The gold standard test is pulmonary angiography and may be this the test that the doctor was referring to but this test has some side effects. Low probability means that the probability that you have a blood clot when you have a low probability scan is very low. If you don't have any risk factor for pulmonary emboli and you have little or no symptoms to suggest the presence of a pulmonary embolus, then most probably, you don't have a pulmonary embolus.

It sounds that you have been having these episodes quite often and as Web-medic suggested, it is imperative that you be seen and evaluated by a cardiologist and if possible a cardiologist specialized in heart arrhythmias (called an electrophysiologist).

There is no need to feel stupid every time you think of going to emergency when you have these symptoms. Please, go. You are not stupid, you are a person whose needs have not been met and you need to be treated and that is why you have to go every time till you are treated.

i am not sure how the health system works in the United Kingdom, but do you have a primary care physician to whom you can go to for checkups and if anything wrong arises? If yes, i think you should talk to him about being referred to a cardiologist instead of waiting to be referred from the emergency department.

If not already done, i would suggest having blood tests for a complete blood count, electrolytes including calcium, magnesium and phosphorus, thyroid blood tests, echocardiograpy (ultrasound of the heart), Holter monitor (24 hours heart monitor) that will record your heart rhythm and rate over 24 hours and this is going to help to determine what kind of rhythm disturbance youb have.

Please, keep us updated on how everything turns out.

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

Yasser Mokhtar, M.D.
 Rhonda P, CEP - Thu Mar 24, 2005 1:52 am

User avatar Robert,

I hope all is well for you, please let us know how you're doing, it's been a while since you wrote in about how badly your chest was hurting and though you may go to the emergency department. Inquiring minds want to know :roll: plus we're all worried about you.

|

Check a doctor's response to similar questions

 

advertisement.gif (61x7 -- 0 bytes)
 

Are you a Doctor, Pharmacist, PA or a Nurse?

Join the Doctors Lounge online medical community

  • Editorial activities: Publish, peer review, edit online articles.

  • Ask a Doctor Teams: Respond to patient questions and discuss challenging presentations with other members.

Doctors Lounge Membership Application

 
     

 advertisement.gif (61x7 -- 0 bytes)

 

 

Tools & Services: Follow DoctorsLounge on Twitter Follow us on Twitter | RSS News | Newsletter | Contact us

 
Copyright © 2001-2010
Doctors Lounge.
All rights reserved.

Medical Reference:
Diseases | Symptoms
Drugs | Labs | Procedures
Software | Tutorials

Advertising
Links | Humor
Forum Archive
CME Articles

Privacy Statement
Terms & Conditions
Editorial Board
About us | Email

We subscribe to the HONcode principles of the HON Foundation. Click to verify.We subscribe to the HONcode principles.
Verify here