Heart/Vascular Issue Can't Figure Out

[dragonfire101]

Been having chest pain past year cant figure it out. Last year 10 months ago had chest pain felt like also irregular heart beat at times. I had ekg, labs and echo. Everything came back good echo unremarkable with ejection fraction 60%.

Couple months ago chest pain stress test came back good.

Past weekend tried start off taking some old fatburners just to see if can tolerate well too old at 38 for that, but just wanted see how they made me feel which after 2 days may have caused chest pain.

Woke up in middle night hot sweaty chest pain. Took aspirin went back to bed then 2 days later went to emergency room because still had some chest pain but not as bad, but went to work and stress seem make it worse.

EKG, blood pressure, blood work for enzymes and factors for heart attack all good, also complete metabolic panel came back good. Chest x ray good. Was sent home.
My blood pressure is always good.

Was sent home still have chest pain several days later.

Couple months back had MRA because eye doctor see blood vessels damage in one eye and high pressure and I had a episode were vision in both eyes went black several seconds. MRA good. Had clotting factors test that came back good. No sludgy blood.

Not sure what to do its crazy. Something is up?

 

[Bio]

Stewie and gotgame need to chime in here!

The only thing I can suggest is asking them to let you holter monitor for 24 to 48 hours and see if that shows the occurrence of any abnormalities. Aside from these episodes causing you stress, is there anything else going on that's causing you stress and/or anxiety?

Hopefully you get this figured out soon and it's nothing serious! I'm sure having piece of mind about this will be huge.

 

[dragonfire101]

Stewie and gotgame need to chime in here!

The only thing I can suggest is asking them to let you holter monitor for 24 to 48 hours and see if that shows the occurrence of any abnormalities. Aside from these episodes causing you stress, is there anything else going on that's causing you stress and/or anxiety?

Hopefully you get this figured out soon and it's nothing serious! I'm sure having piece of mind about this will be huge.

No nothing else causing stress. Thing is some episodes are on weekend when I not stressed and the fatburners triggered last event so make me feel there some preexisting issue or something going on to cause episode this severe.

 

[Slr722]

Get an echo cardiogram.

ITPP should help fix your heart. Stop taking everything but for trt dose of test (150-250mg/wk), this means if you're on gh you stop that as well.

 

[dragonfire101]

Get an echo cardiogram.

ITPP should help fix your heart. Stop taking everything but for trt dose of test (150-250mg/wk), this means if you're on gh you stop that as well.

I had echo when all this started 10months ago it was fine (unremarkable)and I'm not on anything but TRT dosages 150-200mg week for the past 10 + years and no GH and if I ever did use GH itswould have been 2iu day and I take a plethora of preventive supplements that support heart function and immune system.

 

[GreenEarth]

Is there anything is particular that has been causing stress or anxiety for you in the past year? I occasionally get chest pains and it always seems to be linked to anxiety/stress, I've also had a slew of tests run that all came back fine. Ever since the first time it happened, I've found that my body is a bit more sensitive to stimulants as well, particularly caffeine for whatever reason.

 

[myosaurus]

Sometimes a stiff neck can show as chest pains.

 

[john161]

yOU NEED TO RUN A SALIVARY CORTISOL TEST. tHE HOLTER WILL PICK UP IRREGULARITIES BETTER THAN STRESS TEST, BUT IT SOUNDS LIKE YOUR HAVING PANIC ATTACKS FROM CATECHOLAMINE DYSFUNCTION.

CAN ALSO RUN URINARY CATECHOLAMINE TEST, IF CAN GET DR TO DO HIS JOB RIGHT! YOU'LD BE SURPRISED HOW NOR EPI, DOP[AMNE, AND DHEA LEVELS CAN BE ALTERED IN THIS SPORT.

 

[dragonfire101]

yOU NEED TO RUN A SALIVARY CORTISOL TEST. tHE HOLTER WILL PICK UP IRREGULARITIES BETTER THAN STRESS TEST, BUT IT SOUNDS LIKE YOUR HAVING PANIC ATTACKS FROM CATECHOLAMINE DYSFUNCTION.

CAN ALSO RUN URINARY CATECHOLAMINE TEST, IF CAN GET DR TO DO HIS JOB RIGHT! YOU'LD BE SURPRISED HOW NOR EPI, DOP[AMNE, AND DHEA LEVELS CAN BE ALTERED IN THIS SPORT.

Ya not sure with catecholamines wouldn't blood pressure be up? Mine is fine. Im thinking Holter might be good idea.

 

[Stewie]

Is this happening moreso at night while sleeping or when you're at rest?

If so, I'm thinking possibly Prinzmetal angina or variant angina. The issue with ephidrine if in the event this is related to Prinzmental. Ephidrine being a vasopressor which will trigger a Prinzmental event. As will cool-cold weather.

You could try taking either L-Citrulline or drinking some beetroot juice and see if that helps?

 

[maldorf]

Only thing I could suggest is having a cath done, but that is rather invasive and the doctors would have to have good reason to call for one. The procedure isn't risky but they do have to perforate your greater saphenous vein in the leg, that or the femoral cant remember which they use. You could have some blockage in the heart vessels that isn't causing anything to show up in ekg or the echo. I think this is possible. I think it could be that the vessels are narrowed down enough that in times of physical stress when the demand on the heart is higher then the pain is induced.

Did you do a stress test where you are on a treadmill and they do an ekg during that? Perhaps a MUGA scan where they give you a shot of epinephrine to speed up the heart and cause stress?

Hopefully one of our inhouse medical professionals can chime in. To me Cardiac catheterization is the gold standard.

 

[gotgame]

Not sure.

have you every had any structural imaging of your coronaries such as a cath or cardiac CTA?

Nucs tests are terrible in many ways and can be normal up until something like 75% stenosis on some people. Maybe you have some narrowing of diag or OM somewhere thats not enough to show up on EKG or nucs. Maybe you have a long segment myocardial bridge and thats causes the chest pain when you get tachy from the stims. Depending on the severity of it it may not show up on most tests.


I dunno bro im just putting some things out there, not much i can suggest other then that. I mean i suppose next time it happens you could try popping some nitro real quick and see if that relieves it. If so id think its coronary in etiology.

As stewie said it could be some vasospasm from the stims who knows. personally id lay off the stims. If this keeps happening the only other thing id suggest is getting some structural imaging done and if thats clean im gonna tell you do not worry about it and to lay off the stims/t3 etc.

 

[gotgame]

Only thing I could suggest is having a cath done, but that is rather invasive and the doctors would have to have good reason to call for one. The procedure isn't risky but they do have to perforate your greater saphenous vein in the leg, that or the femoral cant remember which they use. You could have some blockage in the heart vessels that isn't causing anything to show up in ekg or the echo. I think this is possible. I think it could be that the vessels are narrowed down enough that in times of physical stress when the demand on the heart is higher then the pain is induced.

Did you do a stress test where you are on a treadmill and they do an ekg during that? Perhaps a MUGA scan where they give you a shot of epinephrine to speed up the heart and cause stress?

Hopefully one of our inhouse medical professionals can chime in. To me Cardiac catheterization is the gold standard.

that is certainly true for athero ( despite sometimes missing some ostial lesions from position of catheter). In this situation cta might be better as you can easily see the course of the coronaries. In the cath lab you cant always tel if something has a malignant course, its also hard to see a bridge as your not really visualizing the myocardium.

I do call the cath the truth machine. Ill call stuff sometimes that im not sure in terms of stenosis because when compared to CTA, cardiac cath has much better spatial resolution which is better suited then the contrast resolution of cta.

 

[dragonfire101]

Is this happening moreso at night while sleeping or when you're at rest?

If so, I'm thinking possibly Prinzmetal angina or variant angina. The issue with ephidrine if in the event this is related to Prinzmental. Ephidrine being a vasopressor which will trigger a Prinzmental event. As will cool-cold weather.

You could try taking either L-Citrulline or drinking some beetroot juice and see if that helps?

That's funny you said that I ordered a product yesterday it has
Beet Root Powder (root), Hawthorn Berry Extract (berry), L-Citrulline, Sodium Nitrite

not sure about the sodium nitrite though? I told the doctor it was some type of angina from what I read but wanted to know what is causing it is the issue and what im scared of?

 

[Stewie]

As much as I don't like using wiki as a reference-citations. This is pretty accurate on describing Prinzmental angina.
https://en.m.wikipedia.org/wiki/Prinzmetal's_angina

 

[dragonfire101]

Not sure.

have you every had any structural imaging of your coronaries such as a cath or cardiac CTA?

Nucs tests are terrible in many ways and can be normal up until something like 75% stenosis on some people. Maybe you have some narrowing of diag or OM somewhere thats not enough to show up on EKG or nucs. Maybe you have a long segment myocardial bridge and thats causes the chest pain when you get tachy from the stims. Depending on the severity of it it may not show up on most tests.


I dunno bro im just putting some things out there, not much i can suggest other then that. I mean i suppose next time it happens you could try popping some nitro real quick and see if that relieves it. If so id think its coronary in etiology.

As stewie said it could be some vasospasm from the stims who knows. personally id lay off the stims. If this keeps happening the only other thing id suggest is getting some structural imaging done and if thats clean im gonna tell you do not worry about it and to lay off the stims/t3 etc.

I have thyroid disease and on amour thyroid 120mg daily.

I only took the stims as a test to see if I could trigger and event which it did. I haven't been taking any in years and years. It took a day and half to trigger an event. I was going to stop at 3 days if nothing happened.
day one, 2 caps in afternoon then day , 2 caps am and then 2 caps afternoon and the event appeared to happened that evening after I went to sleep and woke up.

The caps were a 370mg complex of caffeine, synephine alkanoid, octopamine alkanoid and DMAA.

Never had any cath-angio or CTA just what I listed. my insurance is good so should pay for any test if doctor can justify it. Will CTA pick up narrowing of OM Cx somewhere?

CTA is sam thing as MSCT? I really probably prefer this before cath-angio.

 

[ALLEX]

I've seen all kinds of weird symptoms from an inflamed or swollen xiphoid process.

 

[ALLEX]

I have thyroid disease and on amour thyroid 120mg daily.

My ex wife had Graves and it causes all kinds of symptoms. She complained about chest pain and it was later diagnosed as panic disorder and agoraphobia.

 

[dragonfire101]

As much as I don't like using wiki as a reference-citations. This is pretty accurate on describing Prinzmental angina.
https://en.m.wikipedia.org/wiki/Prinzmetal's_angina

Actually this is what it sounds like to me plus "Two-thirds of patients have concurrent atherosclerosis of a major coronary artery, but this is often mild or not in proportion to the degree of symptoms."

This wouldn't surprise me if I had mild atherosclerosis of a major coronary artery since past two years haven't done any cardio and ben eating like crap since back and neck surgery and car accidents and lawsuit have me doing crap for exercise.

Im about to go vegetarian for next 6 months blast GW501516? and blast a NO formula with my other heart supplements?

 

[maldorf]

I would want a cath done, but that's me. I don't know how likely your doctor is to do one though if you ask for one. Its not too bad of a procedure, but youll need to go off the new drug youre on to prevent clots. They will have you take lovenox shots for about 3 days or so before the procedure and then you can go back on the drug youre taking after the procedure is finished.