MVP or GERD induced Asthma

[double"l"]

AS long as I could remember I have always had to yawn to get a good breath at certain times. I had heart palpitations and was diagonosed with MVP in my thirties. Took Tinormin for a while until with exercise and diet I was better.  Have had flare ups upon occasion when the irregularities would be worse  but not activity limiting. Twenty years ago I was diagonosed with an ulcer.  I have had a carafate prescription that I take maybe for a few days three times a year.  I do have an uncomfortable feeling in my chest regularly that seems to be worse when my stomach is empty but then again not activity limiting. I have been an active "super" Mom. Able to climb gourges and mountains by day and fix an elaborate meal for twenty by night. A year ago my palpitations got worse and my shortness of breathing (yawning) and fatigue was much worse. I being in my early fifties felt it would be a good idea to make sure I was not having some other more serious problem. I had an echocardiogram
and stress test and various blood work. I was healthy with no evidence of MVP. But I still felt heart blips and blurps regularly.  My blood was work up was excellent.  A week ago I started feeling short of breath and was yawning and stretching and inhaling deeply constantly just to feel like I had a good breath. I was fatigued and lightheaded and was having what I thought was horrible MVP systems.  Everytime my chest would
blip or flip or roll over I would feel it all the way up into my head just like a wave and then I would have to yawn or stand up and breathe as deeply as I could to catch my breath. After two days of this I went to my dr. and was put in hospital for
echocardiogram, tests for pulmonary embolism, ecg, isotrope test for pulmonary and circulatory function, blood work up, and a telemetry to record heart beat function. Plus chest x-rays.
Everything was normal and no one can tell me  what the sensation is in my chest that feels like a heartbeat or extreme pulse that sends a wave up to my head. There is no evidence of any irregular heartbeat. I went to a pul. specialist and he said there was a little evidence of damage but not enough to think truly ashtma but he put me on Advair twice a day anyway.  I got the impression from him that he thinks I am just having a prolonged panic attack and am making myself hyperventilate. I am very uncomfortable still but a bit better. I have my own business and am having a terrible time trying to talk to clients while yawning every five minutes and struggling for air to come through.  Oh yes, my blood oxygen was 100% and 99%. My chest feels like someone is squeezing it and my back hurts so bad from trying to stretch to breathe. I can't sleep for waking up every five seconds gasping for air. I am not having a prolonged panic attack.  Something is wrong with me. Where do I go from here?

[Kevin Pho, MD]

You have clearly had a pretty comprehensive evaluation for your symptoms in the hospital.  Most of the major diseases would have been ruled out with the tests you have mentioned.  

By the isotope test - I assume that means a persantine MIBI - which would evaluate for coronary artery disease.

One consideration would be an evaluate for diaphragmatic dysfunction - which can sometimes cause breathing difficulties.  Most cases can be diagnosed with chest x-ray, but in some cases you may want to consider a fluroscopic test to evaluate for any dysfunction in the diaphragm muscle.  

Regarding the heart "blips", you may want to consider an event monitor - which can record your heart rhythm during an episode for a more accurate reading.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[medic29]

Hi!  I can relate to you very much so, both as the "super mom" (taking care of the house, the kids, the husband, the diners, etc!) and with the symtpoms that you are feeling.  I also feel like someone is squeezing my chest in a way, and my back will feel so sore!  I also have the "waves" that seem to originate in my chest area, and the funny and scary heart beats!  One time I counted a full three seconds in between beats and then when it did beat, wow! what a wallup it did!  It hurt!  My heart does flips and rolls and wierd stuff a lot.  

I have to say that you must be comforted by the fact that all these very detailed tests have come back normal and with good results!  Maybe you should look a little more into the panic attack and panic disorder probability.  These attacks very much cause the shortness of breath, wierd wave feelings, racing heart, chills and flushes, fear of impending doom or that something is just wrong, and all kinds of nasty autonomic nervous system problems.  They are extremely scary, sometimes more like terror, sometimes more managable.  There is a lot of good information on the internet about this disorder and it is very treatable.  Hope all gets better for you!