This may seem strange to be posting in infectious diseases with a subject of myopericarditis, but please bear with me.
My husband is 26 and until three weeks ago was fit, active and healthy. He is now a complete wreck sleeping 20+ hours a day, depressed and it seems susceptible to the least little infection.
I would live to give a full background, and some of this may or may not be relevant,
We spent Christmas 2010/11 in England and for 10 out of 14 days of the trip my husband was in bed with the flu. We joked that, of course as soon as he takes time of work for a holiday he gets sick. He never gets sick and hasn't had a day of work until recently. At Christmas he had a low grade fever, sore throat, runny nose and aches and pains. We used over-the-counter meds and after about 10 days he was feeling better and returned to work when he was dur to after our holiday. He was feeling more tired than usual, and having early nights, but we felt this was down to recovering from the flu.
On Valentines day 2011 he was diagnosed with strep. Again, he'd taken these few days of work and we were going away. His doctor prescribed antibiotics and he recovered from the strep pretty quickly, and was back to work in less than a week.
Then, on the 6th March he mentioned having back pain. By the evening he said it had moved into his chest and his hand felt weird. We went to emergency thinking we were over reacting (I pretty much forced him to go) and though an initial assessment showed fever and high blood pressure he wasn't treated as urgent because he was 26 and in previous good health.
Jump 8 hours later when we finally saw a doctor to be told there were cardiac markers in his blood that pointed to a heart attack (my stomach hit the floor). The doctor said because of his age/health they were not convinced with was a heart attack and would keep him in to pin point the cause.
A chest x-ray and CT showed no clot in his lungs and an echogram showed pericarditis. Dr ordered an angio to be sure there was nothing else going on and we were told that he had myopericarditis, caused by a virus (blood cultures negative so Dr explained "virus" means they don;t know what caused it). We were told it was heart disease but on a scale of 1 to 10 it was less than a 1. He was prescribed rest, high dosage asprin and told to go back to work when he was feeling better with no life-style changes. Doctor actually said this was the best possible diagnosis. We thought he would come home, watch TV for a few days on the couch and be back at work.
How wrong we were.
Also note, one of the lymph nodes in the back of his beck swelled while in hospital and we are told to see our GP if it hasn't gone in a week.
So a week in hospital and he is discharged. He is still having low grade fevers and his resting heart rate is averaging at 123, but we're told this is normal and he'll be fine in a few days.
For the next 7 days he is sleeping 20+ hours a day. I am forcing him awake to eat and take his meds. Walking to the bathroom drains him and he can't hold a conversation.
I take him to his GP who runs bloods and tells us to limit his sleep to 12 hours a day for fear of blood clots. This is impossible as he just can't stay awake. He's spiking a fever a couple of times a fay and has terrible night sweats.
Depression is kicking in no matter what I do and he is paranoid about his heart and constantly says he can feel it beating in his chest. GP says all sounds fine with his heart but his BP is low and his heart rate is high (around 100 resting).
This last Friday (still waiting for blood results) he starts with an awful infected throat. His fever is up to 40.1, you can smell his breath from a mile away and he can barely talk. Dr tentatively diagnoses strep again and does a swab and prescribed antibiotics (he's allergic to penicillin).
Two into the antibiotics and he he's physically and mentally exhausted. The pain in his throat is waking him every half an hour, his chest is ruttley and his heart is racing. GP sends him to emerg for intravenous antibiotics and heart assessment.
So today, hospital record a fever of 39.3 and a resting HR of between 125 ad 130. ECG is fine. They run bloods and a throat swab and give in intravenous antibiotics. They confirm Mono and send him home with a steroid shot saying they is nothing they can do for him. They send a referral to his cardiologist regarding the lack of improvement with his heart symptoms and tell him to rest and drink plenty of fluids.
They said pericarditis can cause prolonged fatigue and increased heart rate and he needed to rest and to continue with his high dosage aspirin (1.3g 4Xdaily).
I didn't mention the nausea. He's sick most days, usually in a morning and always takes gravol + zantac with his ASA.
The hospital couldn't tell us if the mono caused the myopericarditis or if the myopericarditis reduced his immune system causing the mono. They couldn't tell us if the earlier strep was the cause of anything, or the flu at Christmas.
We have to wait for his full bloods from his GP (Tomorrow we hope) and if his cardiologist will bring his follow up appointment forward (from the 15th April).
I am wondering is anyone has any ideas here. Is there anything I am missing that I should be asking the doctors? Should I be limiting his sleep and forcing him to stay awake? Any markers in his bloods I should be specifically looking for.
Hi, this doesn't sound like fun at all; I really hope things start improving soon. I'm wondering, how did the hospital confirm mono? Did he have a positive monospot or EBV titers blood test? I know you're probably swimming in questions, but it would help to know what, if anything, has been proven. Also, if it's any comfort, I was 23 (and physically active) when I came down with mono, and it still really threw me for a loop. I honestly didn't know I could get so sick! However, with that said, it does sound like you should cover all your bases dealing with the possible heart issues. Also, does he have any history of anxiety? If so, that can unfortunately make things even worse. Don't hesitate to ask any more questions!
This sounds a lot like what happened to my husband over the last few weeks, small illnesses followed by myopericarditis diagnosed after they thought he had a heart attack. 41 yoa, normally healthy, a firefighter/paramedic. They sent him for a cardiac catheterization in the hospital based on his EKG and found no blockages. Echocardiogram showed fluid and inflammation around his heart. Three weeks later and he is always tired and nauseated. He sleeps a lot and never feels well.
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