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carotho 09-03-2003 12:53 PM

Help! - Strange left sided chest pain incidents
This is a long tale so I hope someone has the patience to read it and perhaps get something out of it or have some advice for me --

Yesterday I experienced something new, although it was slightly similar to an event of about a year ago.

First, by way of (extensive) background, I should say that I have had heart palpitations for about 5 years (I'm mid-fifties now and female) and the cardiologist (electropsyiologist) says that I have an arrythmia, but that it is "benign" and that I should avoid stress. Uh huh...

I saw that doc after a bad palp attack at work a few years back (I always feel them at the throat area, which is somewhat atypical), after which I ran to the internist's office and had an EKG which revealed very rapid (yeah, I was panic-stricken) but normal heartbeat. I then was given low-dose Atenolol (which I still take) and Xanax for anxiety (which I also still take).

Because the palps continued, I wore a portable cardiac "event" monitor (similar to Holter) for over three weeks and it revealed the "benign arrythmia" but nothing else.

Just about a year ago I drove myself to the emergency room after work one day, convinced I was having a heart attack due to nearly two days of perceived pain/burning in the sternum area. They hooked me up to some things and took a few tests. 2 1/2 hours later I was back home, having been told there was no evidence of heart damage but that I might want to get a stress-echocardiogram as a follow-up, since women evidently have weird heart symptoms sometimes.

Had the stress-echo a few weeks later and the stress test nearly killed me (I was too chunky, had gotten virtually no exercise so was out of shape). Stress-echo result revealed just that -- "really out of shape." I was told to lose a few pounds and walk more and avoid stress. That's all --

So...I set about to walk every day and eat less, etc.

Lost about 8-10 pounds by Feb. and was happy with that.

Had a colonoscopy (all clear, no polyps or anything) in May because the doc said I was "five years overdue."

By June I noticed digestive problems continued increasing since fall of '02 and finaly had a major, severe, abdominal pain attack that lasted over two hours, so went to the GI doc and he ordered abdominal ultrasound. All organs viewed were OK except Gallbladder. Multiple gallstones were revealed, to the delight of the GI doc (I'm not kidding, he was gleeful when he called), so I had the HIDA scan to test GB "function."

It's functioning fine, but docs still want me to have the GB out now and I am stalling, thinking I should feel a lot sicker before subjecting myself to a major procedure like that since many, many people have digestive problems as a result of the surgery! Consensus is that the major pain attack in June was caused by a stone that was attempting to escape from the GB.

Back to the chest pain -- one afternoon during the past year, while standing up and reading at a Barnes & Noble bookstore, I experienced excruciating left sided chest pain for a few moments when I was finished reading and putting the book back.

Now, for much of that reading time I'd had my heavy shoulder bag slung over my left shoulder (as I usually do) so thought THAT was the cause of the pains and dismissed them. I should mention that taking breaths increased the pain/discomfort to a signficant degree.

Just yesterday, at least a year later, at a different Barnes & Noble (maybe I should stay out of B&N stores!) across from my office (which I walked to), I was standing up, as usual, perusing a magazine, page by page, and read a few paragraphs here and there. I was not carrying anything heavy this time; in fact, I carried nothing with me. I probably stood there reading for about 8-10 minutes without moving. This is something I do frequently, but thus far have only had the two big pain incidents.

As I put the magazine back on the shelf yesterday, I was nearly overcome by chest pain that started for one split second in the center and right-side of abdomen, then moved immediately across and up into the entire left chest area, into the left shoulder (front and back) and entire left arm. I immediately panicked and started walking to get out of the store, thinking the movement would help. Once again, taking semi-deep breaths (or any breaths) re-created the pain in a major way.

This was not little brief stabbing pains that I have had in upper chest on occasion for years. Those are not thought to be of any significance at all, from everything I have heard and read.

Out on the sidewalk and heading back to work, probably no more than two or three minutes later, the "pain" disappeared as quickly as it began. As usual, I walked upstairs to the second floor with no problem. I did not feel any further discomfort at all yesterday (or thus far today).

My question is this: what is it? I have read about Angina, but am not sure it sounds like what I experienced during either left-sided chest pain event. And doesn't angina usually hit when or immediately after someone is exercising, walking, taking in cold air, etc? Stress can bring on angina, too, but standing still reading a magazine without a care in the world doesn't seem to fit at all.

I have read about pleurisy, pericarditis, etc., and how they cause pain that is worsened by taking relatively deep breaths. But how can one have either affliction for just a couple of minutes??? I have read that heart pain does not react, i.e., worsen in connection with the breathing process. Does anyone know anything about this?

I have also read that gallbladder, or pancreas, etc., problems can cause chest pain, as can muscle strains, nerve problems, etc. Then there's something called "idiopathic chest pain" which I guess means "we just don't know WHAT causes it."

I find it to be a stretch, but has anyone experienced chest pains relative to gallbladder? Gallbladder is on the right side, in upper abdomen, and is known to cause right-sided, and under-the-shoulder blade pain, but everything I have experienced is LEFT-sided, except for the small uper-right abdominal twinges I get off and on that I KNOW are from the GB.

I'd go to the doctor once more to describe the incident but am so sick of all of this "doctoring" and so tired of coinsurance payments that I hoped someone one out there could relate to this weird chest pain scenario and make suggestions/comments. I don't THINK I have heart trouble, especially based on my history, but as I am definitely an anxiety/panic/worry prone person, I always consider the possibilities and seem to dwell on the worst.

What do you cardiac experts out there think??? I'd appreciate any and all comments. Thanks!

cutup 09-03-2003 03:38 PM

[And doesn't angina usually hit when or immediately after someone is exercising, walking, taking in cold air, etc?]-

Angina is not always brought on by activity. I had it while sitting down reading a book. I don't think it was stress related. I believe it was due to artery spasm. Even sitting down eating a heavy meal can bring on angina.

[I have read that heart pain does not react, i.e., worsen in connection with the breathing process. Does anyone know anything about this?]

I have heard that said before too. My pain did not seem to worsen with taking a breath.

[I have also read that gallbladder, or pancreas, etc., problems can cause chest pain
I find it to be a stretch, but has anyone experienced chest pains relative to gallbladder?]

Absolutely, and it is very similiar to the pain you feel from heart blockage except mine was on the right side chest shoulder and upper back.

It is frustrating going back and forth to the doctor and not feeling secure that they've diagnosed you correctly. One way to find out if it is your gallbladder is to have the surgery. I've had it done and have experienced no digestive problems.

I'm certainly not a cardiac expert. I have personal experience and a little bit of what I've learned to go on. It's just hard to say whether it's your heart or not. Would you describe yourself as being short of breath during these 2 incidents? Also, at times I could walk up a flight of stairs with no prob other times I would be short of breath.

It isn't time that heals all wounds, it's what you do with that time. Dr. Phil

carotho 09-03-2003 04:47 PM

Thanks, Cut-up, for your response!

I have not been short of breath at all before, during or after these two chest pain incidents (that were nearly a year apart, at the least.

The only time I am slightly out of breath is if I hurry up my 1 1/2 stories' worth of stairs to my apt., lugging heavy bags of groceries and a gallon of water.

The extra pain when taking a semi-deep breath, during both incidents, is the real puzzler, because it sounds more like pleurisy or pericarditis, which I think is ridiculous. Like I said, how could one of those afflictions go away after a couple of minutes?

I agree about the coronary artery spasm possibility. From what I've just read about that, sometimes it's potentially dangerous, other times not, but it can be chronic and easily treatable if it can be diagnosed, which is also not always easy.

You're right, of course, that I should have the gallbladder out and see what happens. Especially with yesterday's pain event, because there had been no preceding neck/back strain from the heavy shoulder purse like during the first pain event, AND the fact that I did feel a sharp pain at mid-right upper abdomen just before the chest part kicked in, I tend to think referred gallbladder pain. I'd hate to think that was the cause, but plugging in chest pain on Google pulls up a host of sites and most of them suggest digestive organ problems (like GB) in addition to cardiac stuff.

Glad to hear, though, that you have had no problems as a result of the GB surgery. I suppose it's true that those with major problems are the ones who write messages on these boards, the rest of you are satisfied so why write?

I have such weird symptoms of everything imaginable all the time that I never know what's going on. Some of them are definitely related to stress/anxiety/panic, I know that for certain. The cardiologist I saw several times wrote that I presented with "a constellation of symptoms" back when I reported the palps. He's not lying; in reading what I wrote on their questionnaire after the fact, I had to laugh out loud. I sound like a lunatic!

I'm supposed to be going to Maui for a few days the end of this month, so will probably plan the GB surgery for sometime in October or early November unless there's a major incident beforehand.

My internist says "no problem" with going to Maui first -- they've got a good hospital and she agreed with me that in an emergency, recuperating from GB surgery on Maui wouldn't be all bad :)

It's true that we must gather as much info as possible about our own health, and cannot totally rely on the doctors -- we must work WITH them but not accept everything they say as gospel. Thanks to the internet we have so much more info at our disposal now. Docs don't like it but I think it's very helpful.

Thanks again --

cutup 09-03-2003 05:36 PM

The gallbladder surgery is much easier to recover from than before too. I can't remember exactly but I think I was back to work in about 2 weeks. Watch your intake of fats until then. Fat can trigger some pretty painful events. My father ended up with pancreatitis because of his diseased gall bladder. Have fun in Maui!
Just to be cautious about the heart deal take one of those online tests to do a risk assessment. It is not always an accurate predictor because I was at moderate risk, but it can help you prevent heart disease by knowing your risks and modifying the ones that you can.

zip2play 01-26-2004 04:36 AM

Re: Help! - Strange left sided chest pain incidents
I'll throw my vote to NON-ANGINA pain.

Two or three strong contenders:
1. Costochondritis (inflammation of rib joints...always hurts to breathe deeply)
2. Gall Bladder pain referral....often towards the shoulder area (usually right I believe) but it can reflect into the solar plexus nearby and pop up in the most God forsaken places.
3...small cahnce if irritable bowel pain reflection

I'm not fond of GB surgery for the masses (unlike most gleeful and very wealthy surgeons) and I've been keeping gallstones at bay for DECADES with annual or semi-annual liver flushes. They work beautifully and cost near $$Zero$$ with minimal discomfort and no need to leave the house.
Check the web for Hulda Clark's methods (and many variants)...all involve a day of fat free and then a HUGE dose of fat and sour...the bladder pushes with all it's might and expels stones. (You can always do the doors closed.)

I had a period of getting waves of pain every few minutes that would subside for a couple before kicking in again after EVERY fatty breakfast with sausage, bacon (uncrisp) or SPAM (yummm). The flush was an instant CURE that lasted 2 years! You can even find your stones afterward (not for the faint of heart:D)
Reminds me, GB pain is ALWAYS exacerbated with a fatty "insult"....try a half pound of UNCRISP, greasy bacon with eggs tomorrow and a piece of toast with as much butter as it can 1/2 hour you'll diagnose your bladder condition.

Good Luck, Carol!

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