Questions posted in the
Heart Forum have been answered by doctors from The Cleveland Clinic Foundation.
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Subject: Atypical chest pain I am a 55 y/o female with a strong family history of diabetes but am unaffected at this time. I also have hypothyroidism treated with .15 Synthroid with a TSH of 2.09. I was evaluated for atypical chest pain and have had an echo showing R and L atrial enlargement and L ventricular hypertrophy. Recently I have had an increase in episodes of atypical chest pain which usually starts in my R jaw and may or may not proceed to my mid-chest. I become diaphoretic, my BP generally goes above 170/90 (my normal is about 135/80) and my EKG shows no ectopy. Nitro helped during this last episode which lasted more than 20 minutes. Usually I just stop what I'm doing and ride it out knowing it will eventually subside. When I was first diagnosed with hypothyroidism (Hashimoto's thyroiditis) I was having these pains at least once a month preceded by a week or so of increasing fluid build-up where I felt SOB. An echo at that time showed MVP but once I was medicated appropriately the episodes decreased to no more than once or twice a year. My echo no longer shows prolapse and a thallium exercise treadmill was essentially normal. I still precede these episodes with the build-up of fluid, feeling more and more SOB until the chest pain occurs. I have diuresed heavily afterwards with no diuretics. My Internal Medicine doctor is at a loss and told me to try some research on my own. My labs are essentially normal except for an LDH of 1250 and an AST of 49 which is a change. Chest X-ray is WNL except for a linear density in the left base which is unchanged. I told my doctor I'm just low on naturietic (?sp). He just laughed. He offered me a return visit to the cardiologist and if that evaluation is normal then a work-up with an EGD, etc. I have a mildly progressive decreased exercise tolerance in the last year or so but am otherwise essentially healthy, working daily at my nursing job and maintaining my home. I would appreciate any other suggestions you might have for follow-up. |
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