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Forum Name: Valvular Heart Diseases

Question: Rhuematiod arthritis and MVP


 wvbound83 - Sat Jul 09, 2005 5:35 am

I'am 44 yrs old an when I was 18 I was diagnosed with MVP at the time I had no real problems except one fainting. I also have rhuematiod arthrtis which I've had since I was 17. In the past I was on Celebrex an Vioxx for quit sometime. In 2003 I started experiancing chest pain as if my heart is being squeezed,pain to the touch in the middle of the chest,dizziness,shortness of breath the pain will sometimes go around to the my back as well and upper my neck,fatigue very very sever. When these attacks occure they only last for 1-2 mins. I'm awakened at night with this problem as well there is no burning with any of these symptoms. My family doc did have me taking a baby aspirin daily?
This past yr my BP has been on many diffrent occassions been high. In 2003 I had a stress test where you lie on a table an pictures or xrays are taken of the heart it showed something shadowy once that test was over the very next day I was in the hospital undergoing a heart catherzation the results of that were they showed some probable artery problem nothing sever soon after I went to see my cardiologist whom said everything was ok :roll: . The chest pain an all the symptoms I mentioned above are back moreso then ever should I be concerned an go back to the cardiologist? Both my parents have heart related problems such as high blood pressure,heart disease,heart attack,

Thank you ,
wvbound83
 Dr. Yasser Mokhtar - Wed Aug 10, 2005 9:37 am

User avatar Dear wvbound83,

Rheumatoid arthritis even though it mainly affects the joints, yet it can affect other organs of the body as well. Of the organs that might be affected are the heart and the lungs. Chest pain has many causes. The ones that most doctors would like to make sure that patients don't have when they come complaining of chest pain are usually related to the heart (such as a heart attack) and to the lung if they think the symptoms might be suggestive (such as a blood clot of the lung, called pulmonary embolism).

You had a coronary angiography which is the gold standard for diagnosis of coronary disease, and from what you said, sounds like it was negative. Looks like you are wondering about having "some probable artery problem, nothing severe" and what it really means. i have not seen the results of your coronary angiogram but what this usually means is that you have very minor narrowing in your coronaries and these narrowings are so mild they can not give rise to any of the symptoms of chest pains that you have been having. These narrowings are not uncommon in patients who are at a certain age.

Besides coronary disease, rheumatoid arthritis can affect the heart in other ways that can give rise to chest pain as well such as inflammation of the membranes surrounding the heart, a condition known as pericarditis and inflammation of the muscle of the heart, a condition known as myocarditis.

Sometimes, rheumtoid arthritis will affect the small vessels of the heart (not the big coronary arteries that are seen on the angiogram) causing them to be inflammed and giving you chest pain similar to the one of heart attack.

By the way, what did the coronary angiography show regarding your mitral valve prolapse?

Chest pain can be caused by lung problems (that can be caused by rheumatoid arthritis) as well. Like the heart, if the membranes surrounding the lungs become affected by rheumatoid arthritis and inflammed, this will give rise to chest pain. Rheumatoid arthritis affects the lungs in a lot of other different manners as well. i suggest that you have a ct scan of the chest to have your lungs evaluated if not already done.

One of the causes of chest pain in any patient can be neck spine arthritis. In cases of rheumatoid arthritis, the neck spine is very frequently affected by the rheumatoid arthritis itself. So, if you were not evaluated for neck spine arthritis whether or not it is caused by rheumatoid arthritis, i suggest that you be.

The way that you described your pain, with pain to touch, makes me think that this pain might be related to affection of the skin/subcutaneous tissues (tissues underlying the skin)/muscles affection by rheumatoid arthritis.

You should be talking to your rheumatologist about these symptoms to see whether he/she thinks that these symptoms might be related to your rheumatoid arthritis and whether or not they warrant treatment with other medications such as prednisone or other newer agents.

Chest pain can be caused by acid reflux disease/heart burn or other stomach problem especially if you are taking lots of pain relievers for your arthritis.

If your blood pressure is high, it needs to be treated.

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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