Hey guys, this is going to be a little long so please bear with me. I would *love
* to have some clue as to what's going on because so far my doctors haven't been able to make a diagnosis and I've been having some very worrisome symptoms.
Note that ALL of my symptoms have thus far occurred at rest, under non-stressful circumstances. I'm 28, 5'11", about 145 lbs. No medications and no lifestyle changes that would cause any of this. June-August
Early in the summer, I had began to develop some chest pain and discomforts. These were mostly quick jabs of sharp and sometimes shooting pain. Some severe, others that I brushed off. Almost always ending within a second or two. But the frequency of these pains and some of the feelings that I was getting were definitely not normal for me.
I went to my doc who did an EKG which was normal. He ordered me to get an echo in the coming weeks. Literally the day before the echo, I had some kind of cardiac episode. I was at work on my computer when all of a sudden I got this wave of upper chest panic and lightheadedness out of nowhere. It was so scary that I thought my heart had stopped. This "lightheadedness" wave lasted only about 5 seconds and it was immediately followed by a run of very fast heartbeats (estimated 130-140 bpm or more). These were beats that I was self-aware of, strong and hard in the center of my chest. I described these as palpitations, although I am using that term in a very general sense. These self-aware beats terminated in about 30 seconds.
Naturally, I freaked out and thought that I was dying, so I dialed 911 and had an ambulance pick me up from work. Because this was all so overwhelming for me, I sent myself into a panic attack. Elevated heart rate, super high blood pressure (systolic was in the 160's, I forget was diastolic was), extreme trembling, and even some numbness/pins and needles in my arms. My face was also very pale. They told me that I was panicking and depriving myself of oxygen so eventually I calmed down and everything went back to normal. They gave me a Xanax which helped a lot. They ran an EKG, chest x-ray, and bloodwork at the hospital. All normal. Of interest is that my potassium levels were low @ 2.9. Previous bloodwork around the same time period indicated borderline pottasium @ 3.5.
I was dismissed with the typical diagnosis of anxiety, but I guarantee that the anxiety was caused by the episode and not the other way around.
These episodes happened a few more times throughout August, and I made repeated visits to the ER for each of them. I started to get really depressed and had a lot of anticipatory anxiety because I never knew when another episode would occur.
So I decided to make some lifestyle changes:
- Took a week off from work to relax
- Cut out all caffeine and soda
- Increased fluid intake (much more water)
- Greatly increased pottasium intake (orange juice, bananas, etc...)
- Started taking a small amount of magnesium supplement
I also visited a cardiologist who put me on a heart monitor. And guess what? No more episodes up until now. I was on the monitor for nearly a month and not one episode! I should also mention that I had the echo performed and it was perfectly normal. I had more blood work which was good as well. Cholesterol 175, CRP very low, very low risk for heart disease. September 22nd - Present
I started to develop a chest tightness in sternum area, which sometimes extends or occurs on the left side of my chest. This is a very peculiar tightness. It's usually a concentrated knot-like feeling in the center of my chest or a feeling that something is physically in there that doesn't belong. Sometimes it feels deep. And while it's mostly in the sternum area, the tightness can sometimes occur on the left side of my chest. It can last for hours, or it can last for minutes. But every single day it's there and it's rare that my chest ever feels completely normal.
Position definitely seems to influence it. Arm position, leaning forward/backward, lying down or standing up all seem to influence it, whether providing relief or making it more tight. Sometimes a deep breath will aggravate it. When the tightness first started, I noticed that it was worst when lying down on my back with my hands/arms behind my head, and more relieving when sitting up and leaning forward.
Sometimes while standing up and walking I feel the knot in the center of my chest and it feels funny as I swing my arms back and forth. Also, sometimes there is a band of tightness extending from my sternum to the left side of my chest which gets tighter when I swing my arm back, and more relieving when I swing my arm forward.
Aside from changing position, I feel that massaging the area of tightness can provide some level of relief. Though once I stop it usually comes back seconds later.
Also of interest is that I get a popping sensation in the center of my chest every so often. It usually happens when I do something which stretches or tenses up the chest, such as standing up, walking, pulling my arm back, or bending backwards. The "pop" doesn't hurt but it's kind of a nasty feeling because I don't know if it's a palpitation or if it's muscle/cartilage/bone that's popping. Sometimes I notice that my heart speeds up after it happens.
But enough with the tightness. I also experience a variety of chest pains which I'm sure are related. They are usually quick 1-2 second jabs and jolts of pain. Some directly in the sternum area where the tightness usually occurs. It's a nasty pain, as if my sternum was bruised and somebody poked it with their finger. But it feels deeper at times, as if it's cardiac. Sometimes I get more generalized and a bit longer lasting aching in the center of my chest.
Sometimes I feel as though I have quick spasms or squeezing in my chest, some severe enough where it feels like a bolt of lightning shoots through my chest and releases a wave of adrenaline/nervousness throughout my upper chest. Again, these come and go within a second or two.
I recall lying down on my back a few times and getting this bad pain in the sternum area for like 10 seconds or so. What I did notice is that when this happens, I can press on my sternum and make the pain much worse.
I also get jabs and jolts on the left side of my chest. Some deep feeling, some which feel more on the surface. More rarely, there are times when talking/laughing/deep breathing causes an extremely sharp and/or shooting pain on my left side.
Also, sometimes in the middle of the night, I will wake up in a terrified state thinking that my heart and/or breathing stopped. I will actually grab my chest and have this feeling of panic as if I'm dying. This passes within a couple of seconds but then I have a hard time falling back asleep because I am so panicked and afraid that it will happen again. Luckily this is pretty rare. I still wake up in the middle of the night, but hardly ever with this feeling.
Now to the present. On Oct 18th I was at work. I had just come back from lunch and I was walking back to my desk. I had another band of tightness across my chest while walking again. Swinging my arms back made it tighter, and swinging them forward provided relief. What was different this time is that I had some tightness on the right side of my chest as well. I think this was the first time I felt it on the right. So I get back to my desk and sit down.
At this point I noticed that my vision was a bit hazy and that I didn't feel quite right. Like I was disconnected from myself. I felt for my pulse and I couldn't really find it so I started freaking out. I sat there for a minute, felt for my pulse again, and noticed a very strong pulse in my neck, like a bounding pulse. Not super fast but faster than normal and strong. Over the next few minutes I would go from feeling alright back to the hazy vision, slight lightheadedness, and a bad feeling of oncoming death. The thing that freaked me out most is that I would lose my pulse at times. But I was so tense with anxiety that maybe I was just tensing up and making it hard to find it? I don't know... I decided to play it safe and called over a coworker who called 911 for me. My coworker noted that I was pale.
As I was waiting for the EMTs I was already recovering. When they arrived they asked if I really wanted to go to the hospital because I was seemingly back to normal, just freaked the hell out. I went to the hospital anyway. In the ambulance my BP was high again in the 160's (systolic). The EMT calmed me down and because I had been through this before I started to relax and within 10 minutes I was in the 120's. Once at the hospital, they did EKGs, bloodwork, and yet another chest x-ray. All normal.
I had a more mild episode of this about a month prior. It was the same symptoms. Slight haziness of vision, lightheadedness, hard time finding pulse, and sometimes a strong bounding pulse. I actually had a bowel movement during this episode and I guess that stimulated the vagus nerve and returned me to normal pretty quickly, because I didn't feel the need to call 911 during this episode.
I can't help but think that all of this is related. The chest tightness, the pains I've been having, and these scary cardiac episodes.
After reading a whole bunch of stuff online, I am now deathly afraid of ventricular tachycardia. My cardiologist immediately said no when I mentioned it, but how would he really know? I know that SVT can cause similar episodes but then again, so can VT. So how do I know that I didn't have VT? Especially since I had a hard time finding my pulse. I mean I'm sure I had some kind of pulse because I was still conscious and breathing ok, but it still scares the hell out of me when I'm trying to feel that nice pronounced beat in my neck and it's just not there.
The plan from my cardiologist is:
1) Rule out GERD (which I highly doubt) - Take Zantac for two weeks and see if there's any improvement with chest tightness/discomfort.
2) Rule out pericarditis. Wouldn't this have shown up on my echo and/or one of my many chest x-rays? If the above doesn't work, he wants me to go on Motrin for two weeks to see if there's any relief.
3) Start looking further into arrhythmia's and determine what might be causing my episodes.
Any other ideas? Should I look into hiatial hernias? Pleurisy? Clots? I don't know what to do at this point. I'm so scared of going into cardiac arrest during one of my episodes, especially after reading about VT. Even though I have zero proof that it was VT or even SVT.
Any help would be much appreciated. Thank you guys so much!