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Chest pain + feeling faint when running (Read 378 times)


Hip Hip Hooray

    Well, 4 hours later, I'm home and with no answers.

    Bloodwork and EKG were normal. They monitored me for about 3 hours, and no signs of anything amiss.   They tested my BP in various positions - lying down, sitting up, standing - and it stayed between 110-120/70-75 for all of them.

     

    Good luck!

     

    What is the ECG abnormality, do you know?

     

    I didn't catch what she thought it was on thursday, though I asked the ER doc why the difference between today's normal test and Thursday's not normal and he said maybe the cardiologist saw something minor that he didn't, or that it was different for some reason.  So a big I don't know all around!

     


    A Dance with Monkeys

      Glad today's evaluation was reassuring. It would be interesting to know what the doc saw.


      Hip Hip Hooray

        Thanks Trent, I'll let you all know what I find out.   Cardiologist is at a conference for the next week, so I'm just going to take a rest week and get on her schedule when she gets back and see what else we need to look at.

         

          Wow Oski, thanks for directing me to this thread. I have been noticing it but never opened, I would have if I knew you started it!

          I have no cardiology training, nor did I stay at a Holiday Inn Express last night, so I have no medical comments whatsoever. But I just hope all of this works out OK for you, so you can get back to your regularly scheduled injuries. You seem to keep coming up with new ways to put yourself on the bench...Sad

          Dave


          justrundan

            Oski- was a nuclear scan part of the stress test?  If the resting EKG is abnormal, that is often done.  As a 37 y/o woman your pre-test probability of abnormal stress test is low.  Do you have other risk factors?  Strong family history of early coronary artery disease? current or previous smoker?  really high cholesterol?  diabetes or high blood pressure?  without some of those, your risk is pretty low.  I would wonder about arrhythmia, a rapid heart rate that might drop your blood pressure.  You could ask about wearing a heart monitor while you run to see what your rhythm is if you can reproduce the symptoms.  Just my thoughts.  Good luck.

            Dan

             

             

             

             


            Hip Hip Hooray

              Oski- was a nuclear scan part of the stress test?  If the resting EKG is abnormal, that is often done.  As a 37 y/o woman your pre-test probability of abnormal stress test is low.  Do you have other risk factors?  Strong family history of early coronary artery disease? current or previous smoker?  really high cholesterol?  diabetes or high blood pressure?  without some of those, your risk is pretty low.  I would wonder about arrhythmia, a rapid heart rate that might drop your blood pressure.  You could ask about wearing a heart monitor while you run to see what your rhythm is if you can reproduce the symptoms.  Just my thoughts.  Good luck.

               

              It wasn't a nuclear stress test - but both the cardiologist and the attending in the ER today suggested that might be a next step.  I also would like to see if they can leave me on the treadmill for a little longer next time, since I usually start having problems in the 15-20 minute range, and the last stress tests were probably ~12 minutes or so in duration.

               

              As far as risk factors - my dad's side of men do have a history of heart disease, but not the women.  And I have no diabetes, great cholesterol, don't smoke, BP is 110/70ish usually.

               

              Dave - yeah, I am the unhealthiest "healthy" person you'll ever know, I swear.

               


              Hip Hip Hooray

                So I had my recheck today.  This is what I know (which isn't much):

                 

                - My stress test ECG showed an "inverted T wave".   That did not show up in other resting/sitting ECGs though.

                 

                - I have to wear a cardiac event monitor for 6 weeks.

                 

                - I have a table tilt test scheduled for the 12th.

                 

                - My bloodwork showed low TSH so they are starting me on low dose replacement therapy.  Do not know if this is related.  All other bloodwork was normal.

                 

                And so it goes.

                 

                cookiemonster


                Connoisseur of Cookies

                  Exercise induced EKG changes with a normal echo.  Now throw in the holter monitor.  New meds.  Tilt test pending.  Glad you're getting the follow up.

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                  "C" is for cookie.  That's good enough for me.


                  A Dance with Monkeys

                    Seems to me that Exercise induced EKG changes would be a one way ticket to a cardiac Cath. 


                    justrundan

                      T wave inversions very common in women on treadmill test; that's why they usually do those with nuclear scan.

                       

                      Hopefully the Holter monitor will show something; however, when running there will be so much artifact that may make it hard to interpret.

                       

                      Keep us updated!  Good luck.

                      Dan

                       

                       

                       

                       


                      Hip Hip Hooray

                        I believe that's what she said - that she sees that sometimes in women.   I haven't had chest pain in a week or so, either (then again, I haven't done anything more strenuous than walk to my car for two weeks).    


                        I have an 'event' monitor so what she wants me to do is "record" when I'm having an issue.  I will have to stop, stand still and then record so in theory they should be able to get a decent-ish take.  I have to call in results every 48 hours.

                         

                        I'm stressed wearing this monitor - it's like a constant reminder that "something's wrong".  Ugh.

                         

                        sbpbrent


                        Ludwig Classic Maple

                          Oski, I have heart stents and I've been through similar stuff.  I'm not a doctor, but it sounds like your problem might be "electrical" as opposed to "plumbing".  In either case, I would be cautious about a nuclear test.  I learned the hard way that those aren't worth much - for "plumbing" anyway.  An angiogram is the best test for "plumbing" issues.  An angiogram uses a nuclear tracer but it's not to be confused with the nuclear stress test.  For "electrical", a regular stress test can usually pick that stuff up.  I have a little of that too (slight arrhythmia under extreme stress), but it isn't serious.  My "plumbing" is what I need to watch more closely.

                           

                          In either case, I am hoping it all goes well.  I am running PR's in my 50's after a mild heart attack and 4 stents, so I can assure you, once you get to the bottom of your issue, it will get much better. Best of luck to you!   Smile

                          Marathon PR: 3:46:52, Denver R&R Marathon 2013

                          1/2 Marathon PR: 1:39:15, Heart Center Half, 2013

                           


                          Hip Hip Hooray

                            Oh - also - for my stress test I had no symptoms (and we ran through it twice).   I guess that's what's confounding things, the fact that it comes and goes and I don't have issues every workout?   She did mention that it could be a vasovagal response of some sort.

                             

                            I don't know.  My doc is well respected and I do feel like she's taking it seriously, so that is at least reassuring.

                             

                            (and thanks for the well wishes Smile )

                             


                            A Dance with Monkeys

                              T wave inversions very common in women on treadmill test

                               

                              I'm a simple guy. TWIs can be totally normal in this setting, for sure. They can also mean cardiac ischemia. There is only one way to get to the bottom of that question in a given patient.

                              cookiemonster


                              Connoisseur of Cookies

                                I'm with Trent on this one.  For whatever reason they decided to do a non-nuclear test presumably knowing that T-wave inversions are common in women on a treadmill test.  So why not do the cath at this point?  And certainly why not do the cath when they saw EKG changes on a treadmill test?  Or why not just schedule a nuclear stress now?

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                                "C" is for cookie.  That's good enough for me.

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