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Old 03-12-2007, 07:09 AM   #1
JunieJay

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Can you spare some pixie dust?

Went to the hospital on Thursday with chest pain and shortness of breath. Was given every test possible - chest x-ray, EKG, CT scan of the heart and lungs, and just to be on the safe side, was admitted for 24 hours -- all normal. Doctor scheduled a stress test to rule out a heart condition, which is scheduled for next week.

Since my mother died (very young) of heart disease, and my father (very young) of lung cancer, to say I'm worried would be putting it mildly. I've tried to keep a stiff upper lip and not mention it here since I know people have real, diagnosed problems they are dealing with, and its a goo chance all of this could just be anxiety on my part. But I know I am among friends here, so I'm spilling anyway.

If you could spare some prayers and PD, I'm eternally grateful.
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Old 03-12-2007, 07:13 AM   #2
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Judi,

I will be hoping for the best for you!! You've always been very supportive of me and I only I hope I can do the same in return.

I'm glad you went to the hospital--so many people would ignore it. Hopefully it will turn out to be nothing but "anxiety" (which is really NO fun ) or something like acid reflux, which causes all sorts of similar cardiac symptoms.

I'll be thinking of you and PLEASE let us know how it goes.
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Old 03-12-2007, 07:38 AM   #3
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OMG Judi.....now you have me worried.. Please do let us know how the tests turn out. OK.. here's the thing here. I think you know this already, but, my Dad died young and my Mom relatively young, both of heart. So right now I have outlived my Dad by 10 years and am heading to the age of my Mom when she passed..

My reflux mimics a heart attack. I do not have heartburn...I have chest pain so make sure they rule out reflux too. I also get shortness of breath because when the pain starts I start to get nervous and my jaw gets tight too.. all those happen with heart issues..

Got you covered.. try not worry too much until you know what you are dealing with.. Big hugs to you....

One more thought.. remember when I was taken out of WDW in an ambulance from mass at the Luau.. do you remember that? It was reflux then too. Also, I had a stress test when I got home and passed it with flying colors.....Darn that reflux.
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Old 03-12-2007, 07:38 AM   #4
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I hope everything is OK. Christine is right-it's a great thiing that you are having it checked. Keep us posted.
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Old 03-12-2007, 07:40 AM   #5
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Quote:
Originally Posted by Mackey Mouse View Post
OMG Judi.....now you have me worried.. Please do let us know how the tests turn out. OK.. here's the thing here. I think you know this already, but, my Dad died young and my Mom relatively young, both of heart. So right now I have outlived my Dad by 10 years and am heading to the age of my Mom when she passed..

My reflux mimics a heart attack. I do not have heartburn...I have chest pain so make sure they rule out reflux too. I also get shortness of breath because when the pain starts I start to get nervous and my jaw gets tight too.. all those happen with heart issues..

Got your covered.. try not worry too much until you know what you are dealing with.. Big hugs to you....
Just wanted to add that my reflux often causes shortness of breath with me. In fact, I've been having that all weekend. I just feel like I can't get a deep breath. Then I end up "overbreathing." Anyway, an irritated esophagus can cause some stimulation of the cardiac nerves (according to my doctor). So, if you're heart comes out "clean", you may want to investigate the reflux aspect. Like Mackey Mouse, I *never* get heartburn.
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Old 03-12-2007, 08:08 AM   #6
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Quote:
Originally Posted by Christine View Post
Just wanted to add that my reflux often causes shortness of breath with me. In fact, I've been having that all weekend. I just feel like I can't get a deep breath. Then I end up "overbreathing." Anyway, an irritated esophagus can cause some stimulation of the cardiac nerves (according to my doctor). So, if you're heart comes out "clean", you may want to investigate the reflux aspect. Like Mackey Mouse, I *never* get heartburn.
Thats EXACTLY what it felt like Christine, like I couldn't get a deep breath. Its comforting to know others have this, even though I would not wish it on anyone.

Marsha, I totally remember this happening to you. I sent you a PM before reading your reply. I was thinking of it when I was in the ER, but I couldn't remember what the actual diagnosis turned out to be.

I have never had stomach problems, or heartburn, so I ruled out reflux. Interesting to know it doesn't always present as such.

Thanks ladies for your prayers.
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Old 03-12-2007, 11:23 AM   #7
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I was diagnosed with gerd...but I hardly ever have the acid shoot up into my throat. My problem is always the air or gas in my throat and chest. I can have good days then out of the blue I feel like I cannot breathe deep enough or yawn. Sometimes like the wind has been knocked out of me. It's weird...like the chicken/egg thing, I don't know if it's the anxiety that causes the gas or the gas that causes the anxiety. I've even been awakened in the middle of a deep sleep and can't breath. Very scary! I've found that when I belch it helps somewhat. I sound like a beer drinking, pizza eating college kid! I'm glad you are having the heart thing checked out though. But I know this can mimmick heart problems. I also get the heart flutters when I have the breathing problem. I have had enough to know that it isn't my heart and I am not going to die. I wish you the best!
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Old 03-12-2007, 12:11 PM   #8
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Here's some PD, I hope you feel better.

Did they start you on a PPI? What brought on the symptoms in the first place? What took them away? Were there any changes on your ECG with your pain? Aside from your family history (which is a really important risk factor), do you have any other risk factors for heart disease? Do you smoke? Are your cholesterol and BP within normal limits? Are you normally active, or sedentary? (You don't have to answer here, just food for thought and some of the things your care team will look at.)

Just so you know, a stress test can give some indication of whether or not you have heart disease, but it's not definitive. The only way to know for sure if you have coronary artery disease is to actually view the coronary arteries via angiogram. This is not to say you need an angiogram (it's reserved for people who are considered high risk like someone who's had previous CAD, changes on ECG or a positive stress test). But it is to say that even if your stress test is normal, don't discount your symptoms as many people do. If you continue to have symtoms, continue to go back. The whole picture needs to be looked at each time.

We know that women often chalk up their cardiac symptoms to stomach problems. That combined with medical personnel attributing women's symptoms to either GI or anxiety puts women at risk, so you the patient needs to be that much more diligent about believing in and advocating for yourself.

In the meantime, if you are taking something like a PPI for your stomach, it should help narrow things down a bit if your symtoms recur. It's always a good idea to lower as many cardiac risk factors as you have control of, especially when you have a family history of heart disease.

Good luck. I hope I didn't scare you, just want to educate. Chances are good it's ok if you were thoroughly checked out, but it's good information to know in light of your family history. If you were my patient in the hospital during your stay, this is the type of conversation we would have had, but it would been more in depth, and you would defiitely be able to explain back to me 1) what angina is; 2) what causes it; 3) how to treat it and 4) how to lower your risk factors. Again, not to scare. Knowledge is power.

From WebMD: http://www.webmd.com/heart-disease/t...Topic-Overview
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Old 03-12-2007, 12:12 PM   #9
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Quote:
Originally Posted by thompson princesses View Post
I was diagnosed with gerd...but I hardly ever have the acid shoot up into my throat. My problem is always the air or gas in my throat and chest. I can have good days then out of the blue I feel like I cannot breathe deep enough or yawn. Sometimes like the wind has been knocked out of me. It's weird...like the chicken/egg thing, I don't know if it's the anxiety that causes the gas or the gas that causes the anxiety. I've even been awakened in the middle of a deep sleep and can't breath. Very scary! I've found that when I belch it helps somewhat. I sound like a beer drinking, pizza eating college kid! I'm glad you are having the heart thing checked out though. But I know this can mimmick heart problems. I also get the heart flutters when I have the breathing problem. I have had enough to know that it isn't my heart and I am not going to die. I wish you the best!

Same here!!!!
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Old 03-12-2007, 01:11 PM   #10
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Pea n me, thanks for your candor. I'm the type of person who wants as much as information as I can get. I don't like to live in denial, I find that a lot scarier than being armed iwth information.

About me: I'm 44, a former smoker (quit almost 5 years, smoked for 15 years, 1/2 pack a day at most). My blood pressure is 120/80, or at least it was in the hospital. I've never had a problem with high blood pressure. My blood was drawn several times in the hospital, and I asked the doctor if cholesterol was a concern, she said no. I need to get a copy of the records to see the exact number though. I know years ago that I did have slightly elevated cholesterol levels.

Fortunately, my family history of heart disease is not the kind that is hereditary. My mother had a defective heart valve, brought on by rhemuatic fever that she got when she was just a small child. I mentioned that history not because I was concerned that she passed it on, but because I remember all the trials and setbacks she experienced over the years including 2 open heart surgeries.

I am not sedentary, but not exactly fit either. Somehwere in between. I walk to work 5 days per week, a 20 minute walk each way. When I’m diligent I also use the treadmill and do strength training, but I haven’t been diligent in a number of months. If nothing else, this is certainly a wakeup call to change those habits. I eat pretty well balanced meals but snack more than I should and could stand to lose 20 lbs. My BMI however is in the normal range – high end of normal, but still normal.

Are you a doctor, or a nurse? The question that I wished I had asked someone was this: if I were having angina attacks IN the hospital (which the pain I had was there with me the entire time, and is STILL with me, in my back, between my shoulder blades, and not really pain, per se….more like tension in my muscles), wouldn’t it have showed up wacky on the ECG? This is what I don’t understand about agina. I know agina is usually brought on by exercise, but I have this when I’m laying down. It doesn’t wake me up in the middle of the night, but I feel it as soon as I wake up. Is angina typically constant?

TIA!

Last edited by JunieJay; 03-12-2007 at 01:34 PM.
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Old 03-12-2007, 02:07 PM   #11
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Quote:
Originally Posted by JunieJay
The question that I wished I had asked someone was this: if I were having angina attacks IN the hospital (which the pain I had was there with me the entire time, and is STILL with me, in my back, between my shoulder blades, and not really pain, per se….more like tension in my muscles), wouldn’t it have showed up wacky on the ECG? This is what I don’t understand about agina. I know agina is usually brought on by exercise, but I have this when I’m laying down. It doesn’t wake me up in the middle of the night, but I feel it as soon as I wake up. Is angina typically constant?
Angina is caused by a disruption of blood flow through the coronary arteries which feed oxygen to the heart muscle itself. Blockages (or spasm) cause decreased blood flow, therefore you get pain. It's actually a nice warning system that Mother Nature provided us (though not everyone gets it, and for some, it's not classic pain in the chest.) Angina and it's related distruption to blood flow usually does cause changes on an ECG. You can actually tell which vessel is causing the problem based on which lead you see changes in.

A heart attack goes one step further. There is actual tissue damage as a result of the lack of oxygen. The damaged tissue gives off enzymes which show up in the blood, and you can see on the ECG changes that indicate heart attack. That's what they were looking for - called "ruling out" MI (myocardial infarction, ie heart attack) - when they drew your blood so frequently. So it's good you had no enzymes show up. I presume you had no ECG changes either, also good.

Stable angina is brought on by exercise. It's predictable. It's a supply and demand situation. Your body's demanding more oxygen which the coronary arteries can't supply. Stop the demand, and the pain should stop.

Unstable angina is more worrisome. It comes about at rest and requires more treatment. The underlying problem needs to be fixed so the angina does not progress to a heart attack. If you were having unstable angina, you would have had other physical findings as well and most certainly would have been brought to the cath lab.

Once cardiac causes have been ruled out, they begin to look at other things that could be causing the pain. It's never simple, and no two patients are ever exactly alike in either their symptoms or their treatment. Because the GI system is right near the heart, it's sometimes difficult to differentiate between the two. That's why they do a stress test to see what happens on your ECG during exercise, and often they'll send you home on a PPI to see if that helps while you wait for the stress test. If the stress test is ok, you may get a referral to a GI specialist.

Hope this answered your question, if not, feel free to ask again. I am a longtime cardiac nurse in a major cardiac center. I've taken care of thousands of patients over the years with all kinds of cardiac problems. Thanks for clarifying about your mother. And you sound like you're in decent shape, too. You're correct about it being a wake up call. My patients always say the same thing. I usually tell them, even when they've had a heart attack, it's never too late to start taking better care of ourselves. And yes, I include myself in that, too, since my own father died of a heart attack at a relatively young age.
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Old 03-12-2007, 02:13 PM   #12
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Thank you. Sure wish you were my nurse, mine refused to give me any information whatsoever and yelled at me whenever she got the chance. Having only been in the hospital twice in my life (with C-sections for my kids), and having wonderful, caring nurses, the situation was daunting, to say the least.

What were the leads that were put on me during the observation period? Was that like a constant ECG? They called it a "heart monitor"...can you tell me specifically what they were monitoring? I know that might sound a bit dense, but I really wasn't sure at the time. I kept having that pain in my back and the shortness of breath, and I was thinking surely if it were an agina attack it would show up on that, no?

Thanks again.
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Old 03-12-2007, 03:06 PM   #13
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Quote:
Originally Posted by JunieJay
What were the leads that were put on me during the observation period? Was that like a constant ECG? They called it a "heart monitor"...can you tell me specifically what they were monitoring? I know that might sound a bit dense, but I really wasn't sure at the time. I kept having that pain in my back and the shortness of breath, and I was thinking surely if it were an agina attack it would show up on that, no?
You know, that's a really good question and reminder to me that sometimes people aren't sure about things but don't always ask. I try to balance giving enough information with giving too much information - people are usually feeling pretty overwhelmed when they're first admitted, especially when they're having pain or other issues.

It's a wireless heart monitoring system which allows us to watch your heart rythm and rate primarily. Sometimes during a cardiac event, arrythmias can occur, and generally when patients are having an angina episode, their heart rates increase. Sometimes what we see on the monitor will make us go check on the patient, who then says, well, yes, I've been having chest pain for a little while but didn't want to bother you. Or they may just be walking to the bathroom, LOL. Sometimes the monitor shows nothing at all, and that's important information as well. All pieces of the puzzle.

Quote:
Originally Posted by JunieJay
mine refused to give me any information whatsoever and yelled at me whenever she got the chance. Having only been in the hospital twice in my life (with C-sections for my kids), and having wonderful, caring nurses, the situation was daunting, to say the least.
I hate hearing that. Feel free to ask me anything if you think it will help. I don't have your specific information in front of me, but I can answer general questions.
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Old 03-12-2007, 05:44 PM   #14
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Judi....my thoughts and prayers are with you, daily, as you know

And I am thrilled that Linda (Pea-n-me) has chimed in here for you.
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Old 03-13-2007, 07:03 AM   #15
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First.. hugs to my friend Judi.. I am thinking of you. Also, I think walking to work, both ways, 20 minutes each way is good exercise... do they not say 40 minutes of cardio....(as I head to the gym for spinning class) I am thinking here from what you describe this might be reflux.....if it was angina, would it not go away eventually... My Mom suffered with angina and it would come and go??

Judi, do you have your gallbladder??? another pesky little organ that cause this kind of discomfort especially if the bile duct is blocked with stones..

I am not a nurse, and I thank God we have Pea-n-me here for a some really good medical advice....Thanks so much for being here and helping Judy and the rest of us.. I truly believe there is a special place for those nurses who are caring and helpful to people in need... I met some when DH was sick and they got us through a scary surgery and after treatment..

Judi, do keep us in the loop, try not to worry.. I know easy for me to say, I worry all the time.. hence the reflux attacks for me.. Hugs
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