Doctors Lounge - Cardiology Answers
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Forum Name: Cardiology Symptoms
|thester6474 - Fri Aug 08, 2008 8:47 pm|
First all, let me state that I am a 25 year old female from Southeastern Georgia. Since this past October, I have been experiencing extreme burning sensations in my chest along with Tachycardia. Scared of the possible outcome, I have not informed my PCP of the chest pain, I just wrote it off as either being a symptom of either my Fibromyalgia or the anxiety attacks (have not mentioned this to my doctor either) I now have. On a good day my pulse is between 110 and 120, and on has been known at times to be over 120. I was diagnosed with Lyme Disease in January of this year, after an entire year of being ill. My Primary Care Physican for the last few months has noticed a weird rattling in my chest. My doctor now has decided that he wants me to have a complete physical, labs, pap smear, etc. Is it possible that Lyme Disease could have caused some damage to my heart? I have not experienced any shortness of breath, just pain in my back and chest.
I have the following conditions as well: Myoclonus, Hypermobility Syndrome, Degenerative Disc Disease, , Intractible Migraines, mild focal kyphosis of the cervical spine, mild loss of intervertebral disc signal intensity suggesting mild early degenerative disc desiccation, mild central canal stenosis secondary to mild annular bulging. I also have been diagnosed with osteopenia and scoliosis, Neuropathy.
Medications include: Provigil 200 mg, Naproxen 2 500 mg tablets, Nortriptyline 3 25 mg caplets, Zanaflex 8 3 mg tablets, Lasix 60 mg, Potassium, Compazine, Phenergan, Corgard and Tranxene.
Symptoms include burning pain in muscles, electrical like sensations, Headaches, extreme fatigue, arthritis, difficulty concentrating, stiffness
|John Kenyon, CNA - Tue Aug 26, 2008 10:02 pm|
First of all, yes, Lyme disease can, potentially, cause heart problems, and that is one good reason to begin to trust your healthcare provider to care for your problems. While this is probably not what has happened it is possible. The pain you describe sounds like nerve pain which would be consistent with peripheral neuropathy, and is probably not related to the elevated heart rate.
Overall, given the broad scope of orthopedic problems and other related nerve issues, it sounds as though you may also have Ehlers-Danlos disease, Type 3, which also can potentially cause some less serious heart problems.
I think most of your new symptoms are likely due to Lyme disease, which must be treated aggressively, but some of them may be due to what would appear to be connective tissue disease, which can occasionally throw a new symptom into the mix just to make things more confusing.
But first you must be willing to trust your doctor and understand that fear of a positive finding won't help make that problem get better; only by telling your doctor exactly what is troubling you can you hope to feel better and stay healthy.
I hope this is helpful and please do follow up with us here.
|thester6474 - Tue Aug 26, 2008 11:39 pm|
Hi, thanks for answerng my forum in such a timely manner. Before I get startedasking the necessary questions, I am going to fill you in my group of Phoysicians. I currently see 9 doctors, all treating me different things. Not saying that I do not trust my other doctors, but I my favorite. He is my PCP. This doctor has stood my side for a long while W ould Ehlers-Danlos disease be closely related to Hypermobility Syndrome? My current diagnoses include the following so far: Kyphosis, Scoliosis, early Mild Disc Degenerative Disease, Mild Spinal Stenosis, Mild Central Canal Stenosis secondary to Mild Annular Bulging, Fibromyalgia, Neuropathy -- diagnosed by my Rheumatologist, Myoclonus -- diagnosed by my Rheumatologist, Hypermobility Syndrome, Lyme Disease, Common Migraines with Intractable Migraines, slight anemia, B-12 Deficiency, Tension Headaches, Displacement of Lumbar Intervertable Disc, Neurasthenia (???), a nasal pharyngeal mass, and arthritis.
I looked online and saw that I could possibly be suffering from Ehlers-Danlos. My Rheumatologist noticed during my appointment in December that my skin had thickened a great deal. (This appointment was a 1 month follow-up.)
I also see that type 6, consists of a mixture of Kyphosis and Scolios. Is it possible that could be causing some of the problems as well? Considering that over the last 18 months, I have seen a total of 9 doctors. Each of which prescribes a different medicine along with the diagnoses
|thester6474 - Wed Aug 27, 2008 6:04 am|
Would Ehlers-Danlos disease be closely related to Hypermobility Syndrome? My current diagnoses include the following so far: Kyphosis, Scoliosis, early Mild Disc Degenerative Disease, Mild Spinal Stenosis, Mild Central Canal Stenosis secondary to Mild Annular Bulging, Fibromyalgia, Neuropathy -- diagnosed by my Rheumatologist, Myoclonus -- diagnosed by my Rheumatologist, Hypermobility Syndrome, Lyme Disease, Common Migraines with Intractable Migraines, slight anemia, B-12 Deficiency, Tension Headaches, Displacement of Lumbar Intervertable Disc, Neurasthenia (???), a nasal pharyngeal mass, and arthritis. I have looked up Neurasthenia countless times, but each site has totally different symptoms and treatments. I also see that it is not used that often in the present day, maybe because different doctors’ believe it encompasses different symptoms. In your opinion what is it?
I looked online and saw that I could possibly be suffering from Ehlers-Danlos. My Rheumatologist noticed during my appointment in December that my skin had thickened a great deal. (This appointment was a one month follow-up.)
I also see that type 6, consists of a mixture of Kyphosis and Scoliosis. Is it possible that could be causing some of the problems as well? Considering that over the last 18 months, I have seen a total of 9 doctors, and have been diagnosed with both by two separate doctors’. Each of which are probably unaware of both diagnoses.
I have one doctor however that I trust thoroughly. He is my Primary Care. Do you think that it would be in my best interest to ask my PCP to follow up with the clinical tests for Ehlers-Danlos Syndrome.
|John Kenyon, CNA - Wed Aug 27, 2008 11:28 am|
Hello again and you're very welcome -
A couple types of E-D are certainly marked by hypermobility syndrome as well as degenerative connective tissue problems, usually in the joints and spinal column. So it seems something that should be ruled in or out, if only to simplify the management and avoid confusion.
If you are most comfortable with your PCP there's no reason why he couldn't function as your "quarterback" doctor to coordinate care with the others who you see. It may even be possible to reduce the number of them eventually.
There are often combinations of types of E-D and of other connective tissue diseases as well. It's not unusual for them to overlap. Knowing what's going on more specifically could really help the management of your symptoms and make you feel less like a patient and more like someone who simply has a somewhat different sort of physical makeup.
Best of luck to you. Please keep us updated.
|thester6474 - Fri Sep 26, 2008 9:06 pm|
How would a person be tested in order to rule out Ehler Danlos, and which specialist would be more informed with this type of disorder?
|John Kenyon, CNA - Tue Sep 30, 2008 12:14 pm|
Hello again -
The diagnosis of E-D is done in two parts: first, the signs and symptoms part, in which each type of the disease is distinguised by certain signs, symptoms and abnormalities manifested in a given patient. This allows classification and projection of the prognosis (which, with the exception of Type IV, vascular, is generally good, although with certain sometimes chronic problems that are not life-threatening. The second part is laboratory testing for specific genetic and collagen abnormalities: the vascular form of E-D (type IV) and for arthrochalasia (E-D type VIIA and VIIB) and dermatosparaxis (type VIIC), biochemical studies can detect alterations in collagen molecules in cultured skin fibroblasts. Molecular testing for Types IV and VII is also available. The rest are diagnosed specifically based upon the physical findings as above.
The determination of what type, the genetic origin, and the likelihood of passing on a non-working pair of genes or just one gene, is all very complex and can and should be included in genetic counseling of anyone who is diagnosed with a type of this disease.
The type of specialist most commonly involved in the long-term management of E-D is a rheumatologist, although dermatolagists sometimes become involved and someone specializing in genetic defects is often of great usefulness as well.
I hope this answers your question.
|thester6474 - Tue Nov 11, 2008 7:43 pm|
On Saturday I noticed these bruises on my upper and lower legs, they are about 2 cm and painless. They are either purple or red in color, and appear in clusters (majority of which are on the backside). Like I stated in my earlier post I have a burning pain in my chest as well as tachycardia (normally above 115).
Since my last post, I have been diagnosed with Intractable Migraines, and prescribed Maxalt 10 mg tablets as needed on top of the Nortriptyline 75 mg. He also prescribed the Medrol Dos pak for the times when they come on as clusters, which is all of the time.
In the last month and a half, I have experienced a constant sore throat, this appeared shortly after the last bacterial infection I had. (I am an Educator in a Kindergarten class. My body is highly succeptable to disease. Last Sunday (Nov 1) I lost my voice and could barely speak over a whisper. This lasted for 8 days despite the use of Azithromycin 500 mg times 6 days. I have also noticed that my legs and ankles swell to the point where I can barely fit them in a sandal after infection, despite normal kidney function, what could cause this?
At my last appointment, my Rheumatologist decided that testing for Lupus might be necessary since my UA and labwork were abnormal.
My current Dx(es) are Fibromyalgia, Hypermobility Syndrome, Myoclonus, Neuropathy, Cervical Spinal Stenosis, Early Mild Disc Degenerative Disease, Early Mild Disc Desiccation, Kyphosis, Scoliosis, Osteopenia, B-12/Iron Deficiency, Anemia, Intractable Migraines, Tension Headaches, Anxiety Disorder, Chronic Rhinitis, Displacement of Lumbar Intervetable Disc without Myelopathy, Neurasthenia, and Partial Epilepsy.
My current Rx(es) are
Naproxen (2 -- 500 mg tablets daily)
Corgard (1 – 40 mg tablet daily)
Phenergan (1 – 25 mg tablet every 4 hours as needed for nausea)
Compazine (1 -- 10 mg daily for nausea associated with Migraines)
Nortriptyline (3 – 25 mg tablets at night )
Provigil (2 – 200 mg tablet daily )
Zanaflex 8 – 4 mg tablets daily)
Lasix (1 – 40 mg tablet daily)
Potassium (1 – 10 meq tablet twice daily)
Tranxene (1 – 3.75 mg three times daily as needed for anxiety)
Zyrtec (1 – 10 mg tablet daily)
Skelaxin (1 – 800 mg tablet three times daily)
Lortab (Hydrocodone /APAP) 1 (5 /500 mg) tablet every 4 hours as needed
Intramuscular B-12 Once Monthly
Maxalt (1 -- 10 mg tablet as needed)
Medrol Dos pack -- (only used when my migraines begin coming as clusters -- has me on a maintenance dose with refills available at pharmacy)
Lortab 1 -- (5/500 mg tablet needed for pain)
I have also been prescribed a TENS unit by Empi, Pool Therapy and complete Physical Therapy.
I have also been diagnosed with a condition called Neurasthenia,what is this? There is not much on this, I see though it is rarely used in modern medicine. Thanks so much for your help.
|John Kenyon, CNA - Thu Nov 13, 2008 9:51 pm|
The bruising or pettechiae on your legs does warrant further study, but probably in terms of blood work. You are on enough medications that it's possible one or more (or some combination) is causing a slight bleeding or bruising tendency. There are, of course, other possible reasons as well, but it should be fairly easy to determine what's wrong, if not precisely what's causing this.
The leg swelling may be related to the bruising, or it may be due to certain meds as well, and one that can do this is steroids (in this case the Medrol Dosepak). You might ask about that as well as a possible connection with the appearance of the bruises.
The term "neurasthenia" is an antique word no longer used in medical circles, primarily because it was generally applied to people who were thought to be weak or tired because of emotional disorder -- in the "all in your head" sense. It was once also a catch-all term for what was probably chronic fatigue syndrome and other not-yet-recognized disorders for which there was no diagnostic criteria. While an emotional cause for weakness or fatigue is not beyond the realm of possibility, both the diagnosis and treatment of somatic stress disorders is no longer so simple as to be dismissed with a single word. The use of it is slightly disturbing in this day and age.
I hope this is all helpful to you. Best of luck. Follow up with us as needed, and do keep us updated when you learn anything new.
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