Anyone up for a differential? May be heart-related?

[JodyDFB]

I didn't know where else to post this.  I'm wondering if anyone else has had similar symptoms AND found a cause?  I don't know what the cause is yet, but doctors are currently thinking "heart".  I've done a 24hr Holter monitor (awaiting the analysis), and am currently wearing a loop monitor for the next two weeks.

A month ago, I was perfectly normal.  For all intents and purposes, I was in perfect health.  I do have MVP, but was told (about 8 years ago, when it was discovered during a test for HCM, after my sister was diagnosed with the condition), it was nothing to worry about.  (I was told I do not have HCM.)  I also have occasional atrial flutter.

Other than the MVP, I was pretty healthy.  I am female, nearly 50-years-old, and have never had a serious health problem.  I eat a disturbingly-healthy diet, exercise every day, have never tried any illegal drugs, don't drink alcohol, and take no medications.  I was sailing along without a care in the world.

One day, I woke up and did some exercise, had a nice breakfast with my husband, and chilled on the couch afterwards, playing a game of solitaire on my iPad.  Out of the blue, I suddenly:

- felt like I was losing consciousness,
- my eyesight went blurry, I had difficulty focusing,
- my heart started pounding,
- I felt like I wasn't getting enough oxygen,
- my muscles started trembling,
- I went cold, then had whole body shivering, with
- nausea and
- diarrhea.  

My body was screaming at me that I'm about to die.  Obviously, I didn't die, and I have never actually lost consciousness.

Subsequent episodes have lasted 1-5 minutes.  I have had more than one episode in a day.  Individual symptoms can come and go all day.  However, I have had a few days, in the past two weeks, where I've felt nearly perfectly normal.

While I still have transient, individual symptoms, my last acute episode was two weeks ago.  As luck would have it, the day before, the day of, and even the day after, my 24hr Holter monitor, were days where I felt completely normal (for the first time since the episodes began).  Alas, I do still have individual symptoms, and managed to catch some of the heart pounding, heaviness, and general discomfort, on my loop monitor, last night.  

More info:

- vitals are all in normal ranges after episodes (and even during, if I have the presence of mind to check)
(BP typically under 100/under 70 with a high of maybe 130/100, HR 60-100bpm, temp. 35.9-37.4C)

- CBC mostly in normal ranges, a couple of slightly high or slightly low readings, but of little concern

- blood cultures negative

- ECG normal ("very good")

- no positional relevance (acute episodes occurred while sitting upright or lying on either side) (I rarely even have individual symptoms while standing.)

- not activity related (strenuous exercise does not elicit an acute episode or individual symptoms)

- and due to eyesight blurriness, had my eyes checked, and found no evidence of any disease whatsoever (and even with the continuing blurriness/difficulty focusng, my eyesight still tests 20/20)

- my scalp is often tingly/somewhat numb, especially across occiput

- I don't automatically associate transient pains with this problem, but do have occasional head pains, heart pains, and cold or hot sensations around my heart.  These last mere seconds, and are not recurrent in the same spot (with the exception of the hot/cold heart sensations).



I don't think I've missed any major symptoms, so if it's not there, it's probably not part of my problem.

There are sooooooooo many conditions which fit a few of these symptoms, but not all, or really even most of them.  I mean, I've never had limb numbness or paralysis.  My heart rate has not gone above 120bpm (I've never seen a reading above 100).  I don't have recurrent headaches.  Neither my HR nor BP have been especially low, either.  My temperature is always normal.  I've never fainted.

I have an echocardiogram scheduled when I return the loop monitor.  But, I fear, if all that turns up nothing specific, I'll be left to just live like this.  So far, I've been the one pushing for tests.  All the doctors I've seen seem either apathetic to my plight, or even as though they think I'm fabricating it all (given that my vitals are always fine when they check them).  It's irksome, to say the least, given how disruptive this problem has been to me.  I have a renewed appreciation for those who live with chronic health problems.  I took my excellent health way too much for granted.

I just started driving again, recently, with two episode-free weeks behind me.  But I still have the heart pounding that can even wake me in the middle of the night, the feeling I'm not getting enough oxygen, the blurry vision/difficulty focusing, random odd pains, just generally feeling "not right", with the worry a full-blown episode could occur at any time, since I don't know what's behind them, at all.

If anyone happens to have had a similar problem, and knows of a resolution (or treatment/prevention), I would dearly love to know about it.  I'm kind of left to diagnose my own problem, since doctors can't easily figure out what it is; my test have come back negative so far; and maybe because I seem perfectly healthy to them when I see them, when I'm not having symptoms, they don't take it seriously.  If the heart monitor results come back inconclusive, I'm not sure where I'll turn next.  Both a doctor friend of mine (who lives far away) and the optometrist I saw strongly recommended I fight for an MRI or CT scan, due to the scalp tingling, transient head pains, and blurry vision/difficulty focusing.  So, I'll try to do that, if this appears not to be heart related.

Thanks, in advance, for your help.  :)

[grendslori]

After going back and rereading your post, I would probably push for the MRI/CAT scan. I'm surprised that the doctors have not ordered this before now. My daughter started having TIAs when she was ten, it left her with issues that were permanent. I guess that was one reason I wasn't thinking of TIAs as you wrote that these episodes come and go and they do not sound like they have a lasting affect. Request the MRI

[Occupant]

I am surprised that nobody mentioned it so far, but to me it sound - or rather reads - like TIA and you should have it checked out.

[grendslori]

I really don't have the time to sit down and read through all of these posts but a few things come to mind. One, ask to have a King of Hearts Monitor put on; you wear it for 30 days and you press a button when you have symptoms. You may have the gene for HCM which is generally always heriditary and have yet to develop the actual changes in your heart muscle walls. An MRI to be done? What good will that actually do you, other than to give you another bill? The walls are normal size according to the echo, the MRI isn't going to show you an arrhythmia problem, nor will the EKG unless it is happening as the test is being run. What an EKG WILL show you is if you have a possibility for developing an arrhythmia; if you have WPW, SSS, RBBB, LBBB, Long Q-T, those types of things. Get the 30 day monitor put on.

[skydnsr]

Several years ago, I had these spells where I would suddenly become nauseatingly dizzy.  It would come from out of nowhere.  Each time it happened, I would be completely incapacitated for an hour or more.  I was unable to stand up or walk.  Nothing relieved it -- not sitting down, not lying down, not closing my eyes, not keeping my eyes open.  One time it happened when I was out in the back yard, and I hardly was able to make it back into the house.  That was the worst one, because I had to try to walk after it hit me.  It happened a total of maybe four or five times, all within a span of about two months.  And then it never happened again, and I never found out what caused it.  I don't know what to say about it, except that I'm glad it stopped.  I hope your thing stops, too.

[JodyDFB]

Thanks for that.  :-)  

I really am open to considering anything plausible.  I don't know what's wrong with me...but something is.  it would be a lovely miracle if it would all just magically resolve itself.  But since that hasn't happened yet, I have to keep looking for an answer, either to treat/prevent or cure.

Of the few tests that've come back so far, the results show I'm normal or better than normal.  I've always worked hard to maintain my excellent health.  This (being unwell) is new to me.  And as I've said before, I almost don't know whether to hope a test comes back normal (thus reassuring me I'm healthy in that way), or abnormal (if it leads to a possible cause for my problem).

As I mentioned above, a curious possibility might be focal seizure.  What I forgot to mention is, many sources suggest they're most likely to occur when the individual is particularly relaxed.  My episodes (and virtually all my individual symptoms) occurred when I was extremely relaxed.  

Still, I'm waiting to do my echo. and cardio consult before I move on to possibly an MRI, EEG, or CT scan.

[JodyDFB]

I do appreciate the help...from everyone.  Thank you.  

(I will grant that since "anxiety" is a psychological problem which can manifest itself as physical symptoms, I probably won't be swayed away from the psychosomatic label.  And since there are questions, the answers to which tend to suggest anxiety as a likely cause, and with which I have ZERO in common, I doubt I'll ever get to the point of believing my symptoms are the result of stress.  I mean, to be fair, I did look at the medical information about anxiety, and literally laughed out loud at nearly every question.  - Are you constantly tense, worried, on edge?  Ummmm...noooo.  :-)  Do you frequently worry something bad will happen?  Hahaha...no.  What?!?  :P  - My point being, I have NOTHING in common with the typical anxiety sufferer.  So, before I imagine that I'm a unique anxiety case, I'll keep looking for the much-more-plausible physical cause.)

On a curious side note, a friend suggested focal seizure.  I considered it, but read that most sufferers can't talk or have involuntary movements during episodes.  That doesn't describe me.  (I'm here in the heart section because doctors are currently thinking "heart".)  Ironically, I just did a search for partial seizure, and this is what someone posted in the first question I read:

"I experience light-headedness - a 'fuzzy' feeling in my brain, visual disturbances (hard to focus on either something direct or in my peripheral vision), rapid heartbeat, muscle weakness and sometimes slight shaking."  She also describes a continuing "fuzzy" feeling in her head, beyond her "episodes".

I know.  I know.  It doesn't match exactly.  Nothing matches exactly.  But still fascinating.  There is some commonality there.  

I just had two of the "whoosh" sensations (as I call them...where it feels as though I'm about to lose consciousness), immediately preceded by sudden vision impairment (obvious difficulty focusing), about 30 min's apart.  So, while I haven't had a full-blown episode since the first two weeks of my problem (it's now been about 7 weeks since they began), I'm still experiencing various symptoms which are completely foreign to me.  I was being awakened in the middle of the night with heart pounding, for a while there.  I've had a couple of nights, now, where I've awakened to general discomfort and slight leg trembling; no heart pounding.  I'm confident enough to drive again....cautiously.  ;-)

I'm still searching, as I await the results of a few more tests.  On the plus side, I'm having fewer and fewer bad days.