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peachychou123

Worsening of POTS symptoms with new chest pain?

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I have painful reflux often but the only time I can remember getting non-reflux related chest pain is a few years ago when I was forced to stay upright for hours - much longer than my comfort level. Also another time when I was out walking in the snow. 

Recently after having a virus my tachycardia and dizziness has worsened. On Friday I had been up for about 2 hours and suddenly got a very tight constrictive type pain in my chest, back shoulders and left arm. It was terrifying if I'm honest and incredibly uncomfortable. It lasted about 45 minutes. I ended up going to the emergency room but by that time it had lessened. They did an EKG and checked my cardiac enzymes. Thankfully everything came back normal and I was told to take paracetamol and propranolol (beta blockers for anxiety) and sent home. On Saturday, I was up for a few hours and I got the pain again. I laid down for about 30 minutes and it subsided. It feels almost like some kind of angina pain.

No pain on Sunday or yesterday but tonight it's back. These episodes are very painful and VERY scary. I'm on beta blockers since Sunday but they don't seem to be helping in fact I've heard these can worsen angina or coronary spasms. I have a meeting with a cardiologist but it won't be for a few weeks or even months. Is it possible I'm having some kind of artery spasm? I don't want to take risks. I'm curious if nitro helps these pains but I'm only 25 and on beta blockers so I don't know how likely they will be to try it. Honestly being diagnosed with angina would be scary but it's definitely preferable to HA or something else! I'm so stressed out these days and these chest pains are just terrifying me. Also leaning forward seems to hurt more? I'm pretty freaked out in case they missed something as technically I've still not had an ECG during one of these episodes. 

 

 

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Sorry for your ordeal.  I think it is somewhat reassuring that the hospital sent you home, but it probably wouldn't hurt to follow up and get a checkup with your doctor.  That is much better than having to go to the ER again,

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Thank you. It subsided again after laying flat. So now I'm wondering if it could be angina or connected to lack of blood flow after being upright too long? Hmm. I need to ask my doctor about this.

I'm definitely thankful my labs came back okay on Friday but to have this pain frequently is rather disconcerting. I am going through a pretty bad POTS flare-up atm and have been getting lots of adrenaline dumps, extra dizziness etc. My anxiety always makes me jump to conclusions. If it gets worse I'll definitely go back to the doctor. I'm trying to relax but these pains make it hard!

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@peachychou123 - I have POTS and angina, I always get chest pains when my POTS flares. It is definitely a very concerning and bothersome pain but my heart cath and sterss tests were not showing anything concerning. Please know that chest pain is a common symptom for POTS - most of us have it. If your tests continuously show nothing bad and your pain comes and goes you may just have the ususal POTS chest pain. DO follow up with your cardiologist but also be assured that it is a "normal" symptom of POTS. 

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I get chest pain as a symptom but it is more of an aching pressure. It usually indicates I am doing too much and I need my next dose of midodrine. But you should always let your doctors know of a new symptom so they can check things out to make sure everything is OK. After my echocardiogram I felt much better anxiety wise about my heart symptoms because I got to watch the screen and see with my own eyes that everything was functioning. Plus if my symptoms get better after laying down for 30 minutes or so, then I know it is my POTS. 

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If it is a new chest pain I would go to the doctor whether or not it gets worse.  The doctor can run more thorough tests than the hospital. It's not worth worrying/being scared.

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12 hours ago, StayAtHomeMom said:

I get chest pain as a symptom but it is more of an aching pressure. It usually indicates I am doing too much and I need my next dose of midodrine. But you should always let your doctors know of a new symptom so they can check things out to make sure everything is OK. After my echocardiogram I felt much better anxiety wise about my heart symptoms because I got to watch the screen and see with my own eyes that everything was functioning. Plus if my symptoms get better after laying down for 30 minutes or so, then I know it is my POTS. 

That sounds similar to mine. It's like an aching squeezing pain. I'm hoping the cardiologist will offer a stress test asap because like yours it worsens when I'm doing too much. 

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16 hours ago, Pistol said:

@peachychou123 - I have POTS and angina, I always get chest pains when my POTS flares. It is definitely a very concerning and bothersome pain but my heart cath and sterss tests were not showing anything concerning. Please know that chest pain is a common symptom for POTS - most of us have it. If your tests continuously show nothing bad and your pain comes and goes you may just have the ususal POTS chest pain. DO follow up with your cardiologist but also be assured that it is a "normal" symptom of POTS. 

My body has been stressed since this virus. Like I said I've been in a weird POTS hole and am experiencing unpleasant symptoms I haven't had before. I had tachy for days at rest and it's still higher than usual when walking anywhere. And I feel constantly dizzy now even when just sitting up. And now the chest pains. It's all rather new and unsettling. I'm hoping it's just weird POTS stuff because I went to the ER on Thursday and Friday and they couldn't find anything aside from some sinus tachycardia. But because these symptoms are new onset and I haven't worked out what's normal for me yet there's always heightened anxiety and a sense of 'what if'. But thank you for sharing your own experiences because my anxiety is not helping matters.

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12 hours ago, yogini said:

If it is a new chest pain I would go to the doctor whether or not it gets worse.  The doctor can run more thorough tests than the hospital. It's not worth worrying/being scared.

Can I ask which thorough tests you mean? My doctor doesn't seem to want to investigate anything. They did my thyroid, kidney function, liver, infection levels, total blood count, troponin etc at the hospital and said everything came back okay. 

My doctor blames everything on anxiety and an overactive imagination tbh. When I told them I was lightheaded they threw some anti vertigo tablets at me despite the fact my sitting HR was 119 and I stressed to them it was a feeling of faintness NOT spinning or nausea. They wouldn't even properly acknowledge the fact I have POTS. I am lucky they even referred me. I'm hoping the cardiologist will listen to me. 

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@peachychou123 - you are experiencing the typical POTS dilemma: does the anxiety cause the tachycardia or does the tachycardia cause the anxiety? This is exactly why many of us get the anxiety thrown at us. It is true: a typical POTS patient has a completely normal heart despite all of the tachy/palpitations and there are studies that claim the "normal" POTS patient does not have elevated symptoms of anxiety. However: to distinguish between anxiety and POTS they do a TTT - and based on that they will make the differentiation. If you suspect POTS then you should ask your cardiologist to order a TTT. That is how POTS is currently diagnosed ( as well as symptoms and length of symptoms). 

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17 minutes ago, Pistol said:

@peachychou123 - you are experiencing the typical POTS dilemma: does the anxiety cause the tachycardia or does the tachycardia cause the anxiety? This is exactly why many of us get the anxiety thrown at us. It is true: a typical POTS patient has a completely normal heart despite all of the tachy/palpitations and there are studies that claim the "normal" POTS patient does not have elevated symptoms of anxiety. However: to distinguish between anxiety and POTS they do a TTT - and based on that they will make the differentiation. If you suspect POTS then you should ask your cardiologist to order a TTT. That is how POTS is currently diagnosed ( as well as symptoms and length of symptoms). 

I definitely have POTS because my resting HR has been normal but whenever I stood up it jumped to 120+. But ever since this flare-up my HR has been higher both ways. Can I ask when you get a virus or flare-up, does your HR return to normal as soon as it's cleared or do you find your flare-up of symptoms continues for a few weeks after?

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I have heard that if a positional change , like leaning forward, changes the severity is a good sign but definitely get it checked out. That is my plan!

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@peachychou123 - I have been somewhat controlled with meds and lifestyle adjustments to where I can tell when I get bad and get IV fluids to control my symptoms. If I did not have that option then I would be a complete mess - both physically and psychologically. ABSOLUTELY - when I get sick in ANY way my POTS flares and I will need fluids and bed rest. But I also know that if I get the bedrest WITHOUT the fluids I will not be able to function at ALL, even when the acute illness improves. My point is: if your current treatment is not enough to help you then you need better treatment. I understand that you have been to ER many times but ER only stabilized you until you can see your PCP - the PCP has to intervene and order treatments or testing. So - you need to bring your concerns to your treating physicians, and if they do not seem to satisfy your needs then you should find a doc who does. If you have been diagnosed with dysautonomia you will need to fins a specialist trained in that field. If you had rheumatoid arthritis you go to a rheumatologist: for stomach issues you would see a GI specialist and for a broken bone you would seek advice from an orthopedic …. the same it goes with dysautonomia! 

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8 hours ago, peachychou123 said:

That sounds similar to mine. It's like an aching squeezing pain. I'm hoping the cardiologist will offer a stress test asap because like yours it worsens when I'm doing too much. 

I recently drove to visit my mom and pick up my kids. I did it over two days for a total of 16 hours (it is a 12 hour drive if you don't stop every hour or two like me) and it took me til the second day to figure out why I was have chest discomfort in the early afternoon. Turns out it was my body saying I was doing too much and I needed my midodrine. Didn't really think of it at first because I was sitting. POTS symptoms can be... special. :D

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10 hours ago, peachychou123 said:

Can I ask which thorough tests you mean? My doctor doesn't seem to want to investigate anything. They did my thyroid, kidney function, liver, infection levels, total blood count, troponin etc at the hospital and said everything came back okay. 

My doctor blames everything on anxiety and an overactive imagination tbh. When I told them I was lightheaded they threw some anti vertigo tablets at me despite the fact my sitting HR was 119 and I stressed to them it was a feeling of faintness NOT spinning or nausea. They wouldn't even properly acknowledge the fact I have POTS. I am lucky they even referred me. I'm hoping the cardiologist will listen to me. 

I meant a full cardiac work up from a cardiologist- echocardiogram, stress test, etc

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I had the same thing happen to me over a year ago. It lasted around an hour and by the time i got to the er it went away although i still felt slightly faint and had a fast heart rate afterwards. I did all the tests as well as an echo. They found nothing wrong. I dont have pots btw but i have some form of mild dysautonomia. However I do know of people who have had reoccuring episodes. As far as im aware it is not dangerous but is very worrisome. Also i know what you mean about docs. Most docs are pieces of s***. Although not always their fault since they have a stressful job. Just keep looking until you find one who listens. Also unless completely necessary I would try to avoid all the drugs they give you as much as possible. Who knows what chemicals are in those things. Hope you are doing alright.

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