Frequency And Mechanism Of Chest Pain?

[mkoven]

I just started with a new cardiologist today whom I basically like. He told me that he doesn't usually see chest pain in dysautonomia patients, which leads him to suspect/confirm vasospasm. I had to really insist that the triggers are autonomic. Sometimes I get lightheaded, but I'm just as likely to get chest pain. I've heard the theory that the pain comes from the fast heartbeat not leaving enough time for the heart to fill, but this happens when my rate is not particularly fast, and is brought on by the usual--standing/being upright. It does seem to correlate with wide postural swings in BP. It literally feels like my chest is being vaccuumed out from underneath.

Thoughts? I don't want to start worrying that something else is going on--esp anything dangerous. I've been tested up the wazoo--clean catheterization, essentially normal echo. The main findings are positive tilt.

[erikainorlando]

Don't know my dear. But I have had terrible chest pain. Now I have to say that it is usually coorelated with being upright or activity...EVEN if beta blockers ahve kept the hr down.

My has gotten somewhat better as I am using the real toprol rahter than the generic. Not sure why tho. I had one EP think it was arthritis...I told him I got it with the onset of POTS...so he then said it was POTS related but not sure why...

Erika

[janiedelite]

I get hypertensive on standing and have had chest pain since the summer of 2008. Usually it's associated with orthostatic or emotional stress, and is usually relieved by lying down. My cardiologist suspected that my elevated norepinephrine on standing was causing some vasospasm and started me on carvedilol, a beta1, 2, and alpha 1 blocker. My chest pain is so much better, BP more and heartrated more stable, I'm a bit more tired but not terribly.

[mountain girl]

I have never had it explained to me why, but I do experience chest heaviness is how I would describe it. I often feel short of breath then too. I experience it as some of the others have said, when I have been upright too long and need to lay down, or even mild stress. For me, laying down does not help immediately, but does help when I have rested maybe an hour or more. I also have Ativan, which does help. Good luck and try not to worry.

[Rene S.]

I definitely think that I experience vasospasms or variant angina or Prinzmetal's. Whatever terminology you want to use. It happens to me at night. starts out with a muscle spasm down the center of my chest with heaviness, radiates down my arms, horrible pain in my throat and jaw and I sweat. I pop a nitro and it usually dissapates, or I fall asleep. Tired of running to the ER when it happens. I'm still not feeling great after having one on Sat. night.

Betas make it worse. I have tried the CCB and they speed up my heart rate. The problem is that I've seen a few cardios who have no idea about our illness and insist that vasospasms are so rare and because I've had a clean cath that it wouldn't matter anyway. Grrr. Unless you are having one right in front of their eyes, they tell me it's esophogeal spasms or heartburn but I know it's not true.

Just wish I could get a proper diagnosis for it just by my description. Very frustrating.

I did try Coreg for a few days but it gave me horrible irregular heartbeats. Don't know what else is next. I'm supposed to see a Cardio next week who knows about POTS/dysautonomia so I'm keeping my fingers crossed.

I'm tired of having my chest pains dismissed just because my cath was clean and stress test was normal.

Rene