unexplained chest pain

[levi33]

I've had constant chest pain, lightheadedness, and fatigue ever since I had a one time cocaine use over a year ago. I had never used illegal drugs before, or since, so I'm not sure if I snorted too much or if it was laced with something else. Everyday activities and little exertion have worsened my condition. Vasodilators such as nitroglycerin, cardizem, and zestril that I've taken have worsened my condition severely. Aspirin has made me feel worse. Being in the heat on a hot day has really made me much worse. My chest pain and lightheadedness are much worse when I'm sitting up or standing. I've noticed the appearance of veins in my arms and legs and swelled veins in my wrists and feet (especially when I'm standing). My chest pain is in the center of my chest and over my heart. It is a heavy pain and sometimes with very sharp pains in my chest and back. I was misdiagnosed with anxiety and took xanax ad zoloft which also made me worse. Xrays have showed normal. Ekgs have showed normal. Two echotests have shown nothing. Chest catscan has shown nothing. Stress test has shown nothing but it increased my chest pain severely. I'm currently so fatigued when I'm standing and the chest pain and lightheadedness are so bad that I'm bedridden. I know that I damaged some part of my cardiovascular system. I'm 33 years old with no family heart history. My blood pressure has been elevated ever since this started.

[-T-]

Levi - Im really stumped on what this could be. Since you have high blood pressure that could be caused by an underlying problem which hasn't been found or diagnosed yet. Also you are on a lot of medication or have been taking a lot. It really isn't a good idea to take one medication containing a form of Paracetamol and taking painkillers or another medication also containing Paracetamol. However, I dont think this would be causing the symptoms you have described.

It really doesn't sound like Anxiety attacks. Your symptoms are to wide spread for that.

One thing I would do, is read all the leaflets on EVERY medication you are using and see if any of the symptoms you have mentioned are caused by the medication. It is possible you are allergic to something in the medications, but then again, I dont think this would be causing the symptoms you are experiencing.

But, I would definitely read all the leaflets and ask or tell your doctors, if you find some of your symptoms on the leaflets, that you want to change meds. Have you been tested for Mono? Ebv? I was just thinking this, as in chronic cases of Mono you can experience some of the symptoms you have mentioned. Ask the Doctor to do U&E, FBC, Mono spot test and the EBV test.

Just reading your post again, the appearance of veins in your arms and legs and swelled veins could be a sign that you have thrombosis which can either be heretidary or caused by some medication. I would have this checked out!

Its good the chest scans have showed nothing and are normal. It probably isn't your heart then.
The stress test could actually be an indication of Anxiety now that I think about it since it showed stress elevates your chest pain. But thats to be expected. Have you been tested for Angina? You might want to consider being tested for this as it can make you feel pretty dizzy and also give you pretty bad chest pain.

Good Luck and sorry I couldn't be more help.

P.S: Chest pain and dizzyness could also be lung related. If you are breathless quite often or have severe asthma then this can give you chest pain and dizzyness. The blood pressure I would look into though and the chest pain.

[zip2play]

levi,

You have a LOT of anxiety going on and of course I doubt that the cocaine +whatever else was snorted has anything at all to do with your condition.

Normally I'd be dismissive BUT the one thing that bothers me is that the chest pain increased markedly during the stress test. Was the stress test done with nuclear markers (injection) with a scan done immediately afterward (and probably before) to determine if any areas of your heart were being deprived of proper blood flow?
If the answer is no, why not arrange such a test?

Or, if you are pretty certain that it's not anxiety arrange for an angiogram...but that's a test you don't want to rush right in to though.

Do you regularly have pain and short windedness on exertion that's followed by rapid improvement with 5 monites rest? That's a snap STABLE angina diagnosis. If you have that regularly, I'd say angiography is warranted.

UNSTABLE angina (pain without exercise) has more elusive symptomatology and can be slippery to pin down without good testing.



Who prescribed the following:

Vasodilators such as nitroglycerin, cardizem, and zestril that I've taken have worsened my condition severely.

and for what condition? Nitroglycerine would only be prescribed for angina...who suspected that?
If nitro made your condition worse, then that points AWAY from angina...and back to mystery-land.

[levi33]

I would like to say to T and zip2play that I appreciate your replies and insight. I need to emphasize that I don't have anxiety. I believe there are too many lazy doctors that, when faced with a difficult diagnosis, rely on anxiety as a means to an end. To disagree with zip2play, I know that the cocaine I snorted a year ago has everything to do with my condition. After snorting it my heart was beating way too fast for far too long. I really thought I was going to have a heart attack. Immediately after, I vomited several times, sweated profusely, and then passed out. I've had bad chest pain ever since then. I also had severe left arm pain for about two weeks after. I know I damaged something. I didn't see a doctor till two months later. My chest pain is constant. It is always there, even at rest. I was given nitroglycerin one time in Dec. '03 when I passed out and was taken to ER. My sisterinlaw told paramedics I was having chest pain. It made my pain much worse. I was prescribed cardizem in March '04 when doctor thought I may be having heart spasms. I only took it for 4 days because it was worsening my condition. I was prescribed zestril in July '04 for high blood pressure. I took it for 3 days and stopped, because again, it was making it worse. I live in Arizona and the heat has made it much worse. Heat also dilates blood vessels. My condition does improve after months and months of nothing but rest, but will worsen immediately after slight exertion, heat, sex, aspirin, and vasodilators. Other symptoms that I get are lightheadedness and fatigue (especially after sitting up or standing for a little while). I haven't noticed being shortwinded. I've noticed blood pooling in my hands and feet when vertical. The stress test that I took back in Dec. '03 was induced because I couldn't run on the treadmill. It showed heart was normal. I have also noticed that my heart rate increases above normal when standing. I have a couple of questions. If I have unstable angina, could it not show on an ekg or echo? If I have thrombosis (as T pointed out) could it occur in the chest. I've read about DVT but it occurs in the legs. If so,could thrombosis not show on an ekg or echo. I do admit that my problem is very difficult to diagnose but I know it's cardiovascular. Thanks for replies.

[-T-]

Hey Levi,

I'm sorry I was rambling off lots of ideas in my previous post. I'm just not sure what is wrong with you but I definitely believe something is. I totally understand about the doctors putting everything down to Anxiety. Myself, I suffer from severe chest pain which radiates down my left arm, pretty much whenever it likes and I went to my doctor about this. My heart was beating very fast and after 10minutes of this my doctor said I was hyperventilating! I was completely calm. I think doctors are pretty useless. They NEED telling what to do most of the time, lol.

The doctors should of investigated WHY you couldn't run on the treadmill just as they should of investigated why the GTN spray made your chest pains worse. If I was a doctor I certianly would of and not left one stone un-turned. But Im not so I wont go there.

I cant really say if Angina..unstable angina, will show up on an ECK/EKG or Echo. It did with my father but not with my grandmother. So I cant say 100% just that in some people it does and in others it doesn't.
However, I do know that Angiograms are pretty good at finding out whats wrong with you. A small camera is inserted into your groin which looks closely at your heart and can find any abnormalities. This test worked for my grandmother and also, for my dad. So I would recommend you having this test done. If you have a cardiologist tell him/her that you want the Angiogram. If you dont have one currently, be referred to one via your doctor.

As far as I know DVT does occur in the legs and I beleive its more common in those who have varicose veins. I dont think thrombosis shows on an EKG or Echo. The tests which are usually carried out in diagnosising DVT are blood tests to check the clotting properties of the blood, and unltrasound scan and also a dye can be injected into your veins then you will have a X-ray which will show up any abnormalities or DVT.

DVT, if you have one, usually travel to the lung but in my experience they have travelled to the heart. My grandmother had no idea she had a DVT, she had this pain in her leg then she went to lie down. Less than 10minutes later she was having a major heart attack. We were told she had DVT in her leg, a blood clot had formed and travelled up to her heart, causing her heart attack.

I dont want to worry you. Just trying to explain. But if you do think you might have a DVT then by all means, be examined for one.

What I said above are just ideas (in my previous post). I dont want to say you have something when its possible you have none of the things I have mentioned. Good Luck