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BBB Chest Pains - Not Heart Attack Symptoms

 
 
Reply Mon 28 Mar, 2011 12:19 pm
Last September, BBB had symptoms of pains in her jaw and then in her chest. I took her to Presbyterian's urgent care but the symptoms had subsided by then and even though they wanted to send her on to ER at their hospital, she refused.

This past weekend it happened again only the pains in her jaw, chest and back were more severe and lasted a lot longer. We again went to urgent care, they put her on oxygen and the pains eased a bit, but they sent her on to the ER by ambulance because she was still experiencing pains 30 minutes later. During the 10 hours in ER they gave her an extra dose of baby aspirin, pushed fluids via IV and did all the usual testing (blood, CT scan, x-ray, EKG, etc.) for heart problems and also blood clots. Nothing was found and she was sent home. She's back to her usual self. She's scheduled for a heart stress test on Wednesday to see if there is anything hidden that hasn't surfaced yet.

So, my question is can anyone think of anything else that could be causing the chest pains and accompanying pains in the jaw that may have been overlooked? She had a colonoscopy last week and everything has come back negative, so it probably isn't something intestinal or in the lower GI track. She's not on any new medications other than some prescribed OTC probiotic powders they are experimenting with in an effort to treat her chronic diarrhea.
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Type: Question • Score: 8 • Views: 9,490 • Replies: 40
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chai2
 
  1  
Reply Mon 28 Mar, 2011 12:29 pm
Stress?
0 Replies
 
firefly
 
  1  
Reply Mon 28 Mar, 2011 01:04 pm
@Butrflynet,
Actually, those can be symptoms of a heart attack, particularly in a female, but the tests done in the ER may not immediately reveal the problem.

Several years ago, my mother had the same sort of symptoms, but the ER tests did not suggest or confirm a heart attack. She was quite sure it was a heart attack, however, and she was admitted to the hospital as a precaution. Two or three days after admission, blood work confirmed an elevation in cardiac enzymes which indicated some damage to her heart muscle, indicative of a slight heart attack. However, at no time were there changes in her EKG. The cardiac enzyme elevation was considered more reliable in determining what had occurred. Slight heart attacks can be missed on ER evaluations.
You can read about cardiac enzymes here
http://www.americanheart.org/presenter.jhtml?identifier=4477

A few months prior to the above event, my mother had had a chemical stress test, rather than an exercise stress test, to evaluate her complaints of pressure in her chest. That test did indicate an area of some arterial occlusion, but my mother's doctor (an excellent cardiologist) questioned the test result, and did not think the situation required further action at that point. After her slight heart attack, the one noted above, she had angiography and angioplasty and a stent was inserted in the artery that had shown blockage on the earlier chemical test (the artery was 70% blocked). Whether that artery had been the area where her slight heart attack occurred was never determined, but she has had no recurrence of the same constellation of symptoms--jaw pain, shoulder and back pain, and chest pain--since that time (almost 8 years ago).

Hopefully, your mother's stress test will either shed more light on the problem, or rule it out as being of cardiac origin.

Gallbladder problems, and gallstones, can sometimes produce pains quite similar to a heart attack.
edgarblythe
 
  1  
Reply Mon 28 Mar, 2011 01:07 pm
Perhaps angina?
0 Replies
 
BumbleBeeBoogie
 
  1  
Reply Mon 28 Mar, 2011 01:22 pm
@firefly,
Firefly, thanks so much for your mother's information. I hope to know more after my Wednesday stress test. I'm a big mystery to everyone.

Today, Monday, I'm doing laundry and goofing off with Butrflynet and doggies Dolly and Madison.

BBB

0 Replies
 
djjd62
 
  1  
Reply Mon 28 Mar, 2011 01:38 pm
@Butrflynet,
a producer on a radio show i listen to had Pericarditis, said it felt just like a heart attack, it's an inflammation of the sac around the heart
http://en.wikipedia.org/wiki/Pericarditis
Butrflynet
 
  1  
Reply Mon 28 Mar, 2011 01:42 pm
@djjd62,
Yep, my dad was diagnosed with that while undergoing his double by-pass in the '80's.

I've been reading up on the blood enzymes and angina and have a list of questions for the doctor who will be doing the stress test on Wednesday.


BBB will undergo the medication stress test rather than the physical stress test so perhaps that will be more revealing.

Thank you all for the additional avenues to investigate.
0 Replies
 
ehBeth
 
  1  
Reply Mon 28 Mar, 2011 01:47 pm
@Butrflynet,
Has there been a dental/jaw work-up?
BumbleBeeBoogie
 
  1  
Reply Mon 28 Mar, 2011 01:48 pm
@djjd62,
djjd62, thanks for the info. I will pass the question along to my physician.

BBB
0 Replies
 
BumbleBeeBoogie
 
  1  
Reply Mon 28 Mar, 2011 01:50 pm
@ehBeth,
The physician was concerned about the jaw pain just before the chest pain and is testing re it.

BBB
dadpad
 
  1  
Reply Tue 29 Mar, 2011 05:54 pm
@ehBeth,
ehBeth wrote:

Has there been a dental/jaw work-up?

That was my thouht too. an abcess might be causing poison to enter the blood system
firefly
 
  1  
Reply Tue 29 Mar, 2011 06:26 pm
@BumbleBeeBoogie,
Jaw pain, particularly accompanied by chest pain, is not uncommon when there is insufficient oxygen supply to the heart, as is the case with a clot in an artery (heart attack), or a narrowing of the coronary arteries.

You might experience that same pain again during the chemical stress test you are going to have. My mother said it felt like she had an elephant on her chest during a brief period of her chemical stress test. When she actually had a heart attack, about two months later, she said the jaw and chest pain were worse than what she experienced during the stress test which is why she instinctively knew she was having a heart attack.

I hope all goes well with your stress test, BBB. Let us know what happens.
Butrflynet
 
  1  
Reply Tue 29 Mar, 2011 06:46 pm
@firefly,
The test is tomorrow morning - supposed to be for about 3 hours so won't have any news until after lunch time.

Thanks for the good wishes.
ossobuco
 
  1  
Reply Tue 29 Mar, 2011 07:23 pm
@Butrflynet,
Good wishes from me.
0 Replies
 
farmerman
 
  1  
Reply Tue 29 Mar, 2011 07:26 pm
@Butrflynet,
Ill bet its an intercostal cardial muscle thing going on. The rib musculature does weaken with age and this can cause pain in the chest area and can radiate to the arm, neck, even the ears. I had a major injury to my iCC muscles from an explosion and it soread my ribs a bit. 10 years after, I had what I thought was a heart attack. I hadda wear a bigass ACE bandage till the inflamation healed(Its an inflamation )
Butrflynet
 
  1  
Reply Tue 29 Mar, 2011 07:29 pm
@farmerman,
That is a possibility - she was diagnosed with a torn rotator cup about 10 years ago when she first moved here.
0 Replies
 
Butrflynet
 
  1  
Reply Tue 29 Mar, 2011 07:30 pm
@dadpad,
She hasn't had any complaints about soreness in her mouth. Is someone with full upper and lower dentures still susceptible to dental abcesses?
0 Replies
 
firefly
 
  2  
Reply Tue 29 Mar, 2011 07:56 pm
@Butrflynet,
My mother did not receive the results immediately after the test. The nuclear images had to be evaluated and both my mother and her cardiologist received the results within a few days. However, if BBB experiences chest pain or chest pressure during the drug administration portion of the test it's probably an indication of some coronary artery narrowing/stenosis.

I was in the room with my mother during her test. She was calm, I really wasn't. It bothered me to see my mother in physical distress during the drug administration and I was nervous to see her heart rate and blood pressure increase as much as they did. I was simply worried about her and about how much her body could tolerate. None of this lasts very long and everything then returns to normal. But I really felt as though I had been through a stress test of my own when it was over. That might just be me.
Butrflynet
 
  1  
Reply Tue 29 Mar, 2011 08:02 pm
@firefly,
Yeah, I'm not looking forward to witnessing it. I've seen her experiencing a high rate of rapid heart beat due to potassium deficiency several times already. In California, I had to take her to the ER a couple times for that.

These recent chest pains were entirely different. A couple of times it had her doubled over and clutching at her upper body as if it were a cramp or pulled muscle. She didn't experience the feeling of pressure on her chest.
firefly
 
  1  
Reply Tue 29 Mar, 2011 08:45 pm
@Butrflynet,
I wasn't prepared for the fact that the drug administration could produce significant chest pain, although the person doing the test explained that it might. I was disturbed by the sight of my mother in pain, and I was afraid she'd have a heart attack as a result of what was being done to her. That can happen, but it's very rare, and she was in the best possible place if that had happened. You're probably better prepared for the testing than I was at the time.

Oh, we've made many ER trips with my mother due to various electrolyte imbalances--potassium too high or hyponatremia (sodium too low due to sudden excess fluid retention)--as well as episodes of bradycardia or slow heartbeat (her heartbeat would drop to about 32 for two days, then return to normal all on its own). There were periods when these things would occur and recur, then they would finally just stop and never happen again. They never could figure out any underlying cause for any of these problems, and, other than immediate symptomatic treatment, they required no further care. So, BBB isn't the only one who presents diagnostic mysteries. Mothers like that help to keep doctors on their toes--and their daughters busy.Smile

Good luck tomorrow.
0 Replies
 
 

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