Dealing With Chest Pains!

[Gemma]

Hello everyone. I wanted to ask how people were able to deal with their chest pains. My pains are different all the time. Sometimes pressure, sometime shooting stabbing pain, sometimes electric shock shock pain. Lately its been an everyday thing for me. I am really scared. My cardio docs think I don't have any cardiac issues, but I am still really concerned. I had already done echo, stress test, echo stress test, 24 & 48 hrs monitors, 7 & 10 days even monitors, cardiac and pulmonary ctscans with calcium score test, numerous ekgs and cardiac blood enzymes done at ER visits for chest pains. Never found anything. I saw like 4 different cardiologists and all say I don't have cardiac problem and that pains are something else. I am still really scared and feel like they are missing on something.

I recently read about unstable angina, Pritzmentals and microvascular and read that tests that I did dont test for it. I take no meds for chest pains and never tried calcium Chanel blocker or anything else. I get scared I might have that and it can lead to heart attack. Past 2 weeks pains happen everyday thruout the day. I have been to ER 4 times in last couple of weeks. All cardiac work up at er is negative.

Does anyone know if I would have problem, would it show anywhere at least some abnormality. And what are the chances to have unstable angina if all tests are negative. This is so scary. Any advice would be great.

Thanks.

[KareBear]

How is your BP and heart rates? I'm sure you are scared, I know I have been thru this and I'm sure many others on here too. I dont know what has helped my chest pains exactly but since starting propranolol (beta blocker- the only one that has actually helped my tachycardia some) and since being on oxygen at home I no longer have the severe and scary chest pains. Sometimes I get mild ones but just a nagging pain, much milder.

I dont know much about the other cardiovascular issues you mentioned but if you asked your doctor for the specific tests, would he do them? I hope you find something that can help!

[millyaulait]

Do you suffer from anxiety? Your post comes across as very worried and anxious, which is completely understandable, but it's worth mentioning that anxiety / panic attacks can come across as very physical, often presenting the same symptoms as a heart attack or like chest pain.

It could also be muscular tension or inflammation, maybe even GERD (acid reflux), all of which can feel very much like heart pain and chest pain, but obviously aren't related to the heart at all.

If you have had all of these tests and they have come out negative then you should try to trust in that there is nothing wrong with your heart.

I also have frequent chest pains (along with lots of reassuring tests) but I am learning to live with it, I think the most important thing is staying calm and taking slow, deep breaths when they occur. Could you describe the pain in more detail, please? Maybe that would be useful in helping you further.

[Gemma]

Hi. The pains are different. Usually I feel squizing pain on the right side of the sternum. Also, sometimes when I take deep breath I feel stabing pain on the left of sternum. But mostly what I feel is squizing pain on the right. Also, feel uncomfort all across my chest and scared that something will happen. But the worst and most scariest feeling is the stabing sharp pain that comes out of nowhere and even though it only lasts couple of seconds it leave me very sore in the chest area. These pains feel like electric shock pains and are very severe and take my breath away. When they happen, I cant take a breath and sometimes end up with the panic attack. My pulse starts rushing up and I feel like I have a heart attack. I just had an episod like this last week and ended up In ER. All cardiac enzymes and ekg was normal. Also, when ambulance came over they did onspot 12 led ekg and it was normal.

I honestly dont know how to deal with them anymore. They were never as severe and got really worse last couple of weeks. I tappered off xanax 8 weeks ago, so thought maybe its still a withdrawal symptoms, but they were not as bad in the bigging of my withdrawals as they are now. I wrote on benzobuddies site and people said that 3th month of withdrawals is the worst, but nobody talks about having such severe chest pains.

I know anxiety plays a big part in it, but I really wanted to get off xanax because it was making me worse and was prescribed for the wrong reason for me in the biggining. I felt horrible during the withdrawals, had all possible symptoms. Now, I experience these chest pains.

My blood pressure is around 96-100 systolic and 55-65 diastolic. HR sitting is from 55-75, and standing usually elevated around 95-120 in the mornings, but later the day around 80-95 standing. Since I got off xanax, my resting heart rate lowered. Sometimes when I just watch TV it could go down to like 55, usually I feel lightheaded with that. I dont know if its bad or not. Cardiologist didnt say anything about it. Also, I started feeling upper back pain. Sometimes in the middle, other times where shoulder blades are. These symptoms scare me a lot. Lightheadness, chest pains, back pains, are all symptoms of heart atack, which is very scary. Even though I know I could have these pains due to my dysautonomia. Doctors think I have OI, but not POTS.

I wish I could just make peace with these pains and live with it.

[looneymom]

Hi Gemma,

Sorry you are having to deal with the chest pains. My son has had these episodes before and I have had to take him to the emergency room. At his last cardiologist visit, the doctor did an EKG and Echocardiogram. Everything was fine and he said chest pain can be part of the POTS condition. I've noticed that Tyler has these spells after a virus or some type of infection. Hope you are feeling better today. If these episodes continue, I would suggest that you go see a cardiologist.

Rachel

[Gemma]

Hi, looneymom, its nice to hear from you. I actually just saw cardiologist like couple of weeks ago. He thinks I am totally fine and also says that my dysautonomia might be causing this. But I am still scared. I have them everyday now and cant keep on going to ER every time I have it because its everyday. I wish it goes away soon.

[Chaos]

Sorry you are having so much chest pain Gemma. My daughter who also has POTS has been having daily chest pain the last several weeks as well. Our POTS neuro says it's very common with dysautonomia...so common that they told us not to bother taking her in to see anyone about it. Of course she talked at length to his nurse before they made that recommendation, but based on her symptoms they felt the pain was consistent with what they frequently see associated with POTS/dysautonomia.

She has found that when the pain gets bad she tries to stay active to distract herself. The doc has recommended that she watch her activity level in general as well as her amount of sleep/hydration/salt etc. He seems to think if those things are out of balance she'll be having more pain. She tends to be one who is trying to avoid acknowledging that she has the condition and is still trying to live her life at 200 mph. She has noticed that there seems to be some correlation with her lack of sleep etc.

Here is another thread http://forums.dinet.org/index.php?/topic/22372-chest-pain-micro-vascular-angina-new-cardio-has-interesting-observations-at-last/ where chest pain is discussed, along with the possibility that in fact there is microvascular angina occurring in POTS. It makes sense, but don't think your average cardiologist, let alone an ER doc, is going to have a clue about it.

[castronovo112587]

Gemma, I too get a lot of random chest pains all different and have been to ER several times and cardiologist with full cardio work up. I get the shootKing and stabbing pains as well and sometimes just a constant pain in my chest and shoulder. Have you noticed the pain to be associated with movement? And can you press on your chest to recreate the pain? They say if you can then its almost always muscular skelatel (do not know if I spelt that right) and costochondritis which is the inflammation of cartlidge between joints and cause the pain to be sharp and shooting at times as well as just a constant pain. Medic girl, it's so weired how we are all different when I was on propranolol all my symptoms had started while I was in it and were wayyyyy worse and I wonder if it is what helped cause/trigger my pots.

[Gemma]

Hi Rosey. I do feel some discomfort when press on chest area, but not that much. What do you do for the pain? I just hope its nothing serious.

[E246]

Hi Gemma,

I have just responded to your email.

Just thought i would post as well for anyone else.

Chest pain was my biggest problem and like you Gemma i had lots of different types of pain and no one seemed to take it seriously but it was debilitating.

I have now been diagnosed with microvascular angina by two cardios. This diagnosis has helped me deal with the pain and also has meant that i have found medication to help.

It has been likened to spasm in the micro vascular vessels.

I tried bisphoromal (sp?) but it just gave me a terrible headache. I now take a small dose -20mg - 2 or 3 times a day and this along with restarting HRT has brought my symptoms under control.

Gemma - i also ended up in A&E regularly and nobody believed it was anything other than anxiety. But when your heart beats in strange ways it makes you feel fundamentally not very well and out of sorts. I felt very unsafe and scared because i knew something was wrong. However i now feel confident that someone knows what is wrong and that my heart is working ok. I eat very healthily and try and exercise as much as i can to keep my heart strong.

Is there any cardio that might discuss the possibility of micro vascular angina. I do remember raising it in A&E but the doctors there are not specialists.

I am really interested to see if anyone else has any further info on this as i am still not sure how MVA and POTS fit together. I have not found a doctor who know much about both of these.

Good luck.

[Gemma]

Hi emma. Thanks for reply. Did doctors say its dangerous? And how long did you have pain before you got diagnosed. The mri that they did was able to confirm the diagnosis? And was it stress test mri, or just regular cardiac mri. Also what is HRT?

Thank you.

[Gemma]

And what is bisphoromal? Cant find it online. Thanks.

[castronovo112587]

I never have taken anything for the chest pain bc I do not deal well with any medicine. I went to er several times and cardiologists and when they saaod all was OK structurally with heart I just kind of deal with it. Last week pain got pretty bad one night and woke up the next day OK. If you do feel tenderness on your chest when pressing on it I'm sure a good deal of your chest pain can be due to chostochondritis. Look it up and it can get very persistent and painful I know from experience. Don't forget that pots causes chest pain as one of the symptoms.

[E246]

Yes had spelling wrong - it is a beta blocker.

[Gemma]

Ok, so I spoke to my electrophysiologist and he said he really doesn't believe its microvascular or pritzmentals angina based on the symptoms I described to him. But he can try me on calcium chanel blocker, I think Verapamil. He gave me 2.5 mg and said to start with half of that. He is concerned that my BP will drop and wouldnt want me to take it but I guess because I am insisting he is willing to try it.

Today, I saw my regular cardiologist who just recently took my case from my old cardiologist because he is more familiar with dysautonomia and has some patients with that. He really doesn't like the idea of me taking calcium chanel blockers and thinks that they will make me feel like passing out. He also says that he has patients with microvascular angina and they present differently then my symptoms. Also, he said it would have shown at least somewhere on some tests as abnormality. The stress echo he said would have shown at least some decrease in blood supply to the heart. Also, this variant type of angina often showed either elevation or depression of something on EKG and mine probably 20 or so EKGs didn't show any of that. He is repeating my echo just to make sure there is no inflammation of the sac around heart. Also, he said they do not do cardiac stress mri, but if I find a place who does it, he has no problem referring me there to do it.

I guess I will get the prescription and wait and see maybe pain subsides a little bit. I just hope I am not playing with the fire with this meds, but on the other hand so scared of the pains and feel like if I do take the meds maybe it will protect my heart in case I do have microvascular angina.

So this is my update on this topic.

[AllAboutPeace]

Hi Gemma,

I'm sorry you are going through this - I know it can be scary. Chest pain has been a big issue for me as well, especially two years ago when dysautonomia hit. It looks like you have had quite extensive cardiac testing, so that sounds reassuring (even though it may not feel comforting when you're in the midst if it...)

I've had several of the pains that you describe. My worst was a center of my chest pain that would last for about an hour at a time. It definitely felt like heart attack pain and I had constant pain in my back and shoulders. I had changes in my ECG's (inverted t-waves); irregular rhythms on hospital telemetry; a stress test which 'looked like' cardiomyopathy (later ruled out by echo); mitral valve regurgitation on echo; and BP crash after stress test. All of those things came on with pots and despite those new findings, they assured me I was fine. What I realized then was that I had to try to manage the pain somehow myself.

I don't know what your activity level is like, but have you tried having some good rest time to see if that will help or keeping a log of symptoms/activities to figure out what your triggers are? Is blood pooling an issue for you? That can definitely contribute to the hypoperfusion in your upper extremities. I have lots of blood pooling, so keeping my feet up when sitting made a big difference in the upper back pain; and my abdominal binder helps too. I put a game on my iPod that I would lay down and play to help to distract me/wait out the pain.

Chest pain is not a common symptom for me anymore.

It's great that you were able to have two consults with your EP and cardiologist, so you have a quick second opinion! The echo should hopefully give you some extra peace of mind as well.

Just curious, did you ever search up benzo withdrawal on this forum, or try to google dysautonomia (or Pots) & benzo withdrawal? Since you mentioned that you've heard from the benzo site that the third month can be the worst, but no one mentioned chest pain as a symptom - I wonder if a subset of people with Pots/dysautonomia do experience it as a withdrawal symptom??

I hope you are able to get some relief soon

[Gemma]

Hi thanks for reply. I actually did read on benzobuddies that third month could be the worst. I also think that due to dysautonomia and our sensitivity to everything might be making the symptoms of withdrawal 10 times worse.

Logically I understand that my heart is probably fine. I am 31 with no family history of heart disease and all cardiac tests normal. But still when i feel pain, its really hard to control myself.

[angelina]

Hi Gemma,

I noticed you are taking or have taken Rhodeola rosea. Are you still on it? When do you take it during the day and how much do you take? And finally, if you are still taking it, how long have you been on it? The reason why I ask is that this particular adaptogen increases norepinephrine, serotonin and dopamine. It acts as an inotropic drug on the heart, meaning it affects the contractions of the cardiac muscles. As with many supplements, you may want to seek out the advice of a Naturopathic doctor in order to make sure you are taking the correct herbs for your condition.

[Freaked]

Hi, just wanted say that you're not alone in scary chest pain. I've had them all my life when I run, and at other times ever since I got POTS. I've had basically the same tests as you and spent a huge amount of time in the ER. I don't know what to think about them. Twice since the POTS, the pains were followed by something that docs said sounded like SVT, a type of arrhythmia, but I wasn't wearing a monitor or anything at the time. I also worry about Prinzmetals or microvascular dysfunction, and I've made an appointment with a pain specialist to see if he knows of any non-cardiac causes of pain like mine (that occurs in the lower teeth/chin sometimes).

One thing I did notice though was benzodiazepine withdrawal seemed to make the pains worse. I was prescribed them before I was diagnosed with POTS in case they helped with my tachycardia (which they didn't). But from about two weeks after I stopped them, on two different occasions, I started getting daily pain that lasted for a few weeks. Chest pain is a common symptom of benzo withdrawal, and combined with dysautonomia it's probably worse. Also, it's not a hard and fast rule, but doctors always say that sharp pains are more often non-cardiac. Hope you feel better soon.

[Gemma]

Thank you all for replies. And thank you angelina for mentioning rhodiola rosea. I had no clue its effecting heart. I guess i will stop taking it and see if the pain, subsides. I am taking it for past 3-4 week and actually thats when pains increased. I also added magnesium to my diet at the same time, but i heard that should help the pains.

So can rhodiola actually do some damage?

Thank you.

[angelina]

I do not know if damage can occur because of R. rosea, but it is a good idea to stop especially if you are experiencing problems (but check with your doctor or pharmacist). I believe its initial use and study was with Russian fighter pilots. They found that it assisted them in keeping alert and focused during combat battles. Thus it was meant to be taken for a short "stress". It actually loses effectiveness when taken continuously over several months. R. rosea acts like a benzo and uses the same GABA receptors. So if you were experiencing problems with benzo, you may be duplicating your problem with Rhodiola.