Looking for answers

[jolene88]

Hi, I know this is a forum for paediatric cardiologists but was hoping you may have some advice about some symptoms My mother has been experiencing. My Mum is 46, not over weight, does not smoke or drink and is quiet active on a regular basis.
Recently she was admitted to hospital after a stress test showed a left bundle branch blockage which she was sent for after experiencing severe central chest pain with a radiating sharp pain that lasts about a minute or two on average a couple of times a day and nearly always on exertion. She is also experiencing chest tightness/heaviness almost all the time but sometimes will have episodes where she feels she is being crushed and then begins to experience left side weakness in her arm as well as pain when the pain in her chest begins.

Whilst in hospital they performed a resting ECG which appeared within normal range and an angiogram that showed no arterial blockages, The treating cardiologist said he was "Perplexed" as he had assumed it was most likely to be a blockage. she was discharged on Nitroglycerin and aspirin and was told a pulmonary function test would be booked on D/C.
Since she has been home (nearly two weeks now) She has put on 2 kilos in just over a week despite not having a very big appetite which mainly seems to be showing in her stomach and she says she feels very bloated. She does also suffer from Reflux and has been on Somac for this for a while now but is still experiencing burning reflux daily.
The concern since she has been home from hospital is that the chest pain is becoming more frequent and most concerning is that it is brought on by simple everyday tasks such as climbing a few steps or taking the garbage out to the bin or taking a shower (which we have now put a chair in for her to sit on whilst taking a shower)

Our GP has ordered an echocardiogram for tomorrow but am wondering if you have any ideas?
Thanks for taking the time to read this and appreciate anything you have to offer.

[jolene88]

Hi Thanks for your reply.
First of all I feel it very important to let you know I should have stated a few things more clearly... As far as her not sleeping, well she never has been a great sleeper but now that the fatigue is so overwhelming and she actually WANTS to sleep she is finding it difficult with the the aching. Also I understand that there are some people who would "Secretly enjoy the concern others may have for them when unwell" but obviously this can be quiet a touchy subject for some as i can tell you right now that My mother in no way has ever so much complained about more than a head ache! she is in the Social work profession and her youngest child is 15 so is still VERY much needed. Also she nursed our step dad for 16 months who eventually died from pancreatic cancer 3 years ago so i am highly doubtful that My mum is simply complaining of bogus symptoms because she enjoys the concern we show! we are a very close family and there is just no chance that this is what is happening, and I know it was not personal but given the kind of woman my mother is I am quiet offended lol.
Our GP has diagnosed her with having Gall stones (3 in fact) after the results from her abdominal Ultrasound came back but said that given her bloods are showing signs (that have nothing to do with the Gall bladder) she needs to still have further testing regarding her heart, and yes her Angiogram was normal which only says she has no blocked arteries and the results actually said "Minor disease only" the resting ECG was normal as they had predicted it would be though since she had been on bed rest for more than 5 days straight and given she only gets this pain on exertion is understandable. Her bloods have shown some concern apparently and has now been referred to the hospital on Monday for a repeat Stress test with Ultrasound of the heart at the same time so as to see what the heart is actually doing during these episodes, so I must say to you this is hardly "Everything showing up normal" If our GP feels there is cause for concern and the Gastroenterologist feels it is important for Cardio to follow up and do more tests then that is enough for us to assume there is something going on that should not be, and also when the LBBB was found she had been on the walking machine for all of 2 and a half minutes before her heart rate climbed from 56 to 178! everyone in the cardiovascular unit told us this WAS concerning, The problem we are having is that yes it is not fitting in the Normal findings and this is why the treating Cardiologist was "Perplexed" in saying this though he has not told her nothing is wrong and to go home like nothing happened, she has been kept off work for the last month now and told that until a diagnosis can be found she needs to limit her physical activity and return to Emergency as soon as she experiences any crushing sensation resulting from the chest pain. and just so you know she rarely complains! It is us her children who are noticing the difference in her and she will still try to soldier on. All I was trying to do on here was to find out if anyone might have had any other suggestions for things that were going on. I know how hard it can be sometimes I was sick for nearly two years and because I ended up being diagnoses with 3 different illness's noone could figure out what was wrong with me at first because all the symptoms together just didn't match up but when separated it was quiet obvious what was going on, I know and my whole family knows the kind of person my Mother is and we all know (Including our longstanding GP) that she is not a well woman right now what ever it is causing it. She is booked in pulmonary testing next week as well to look at her lung function and also the stress test with ultrasound so I guess we will see what that shows up. I will look forward to letting you know when they have figured out what is wrong with her as I appreciate that sometimes people make up their symptoms because they enjoy the attention but this is just not our mother. I know that our GP will do everything she can as well especially if she concerned enough to call her on a weekend to see how she is. I wish you knew My mum because you too would know that between January and now something is just not right!

[grendslori]

Hello, I can feel your concern with your mother. Weight gain such as she had had is probably not due to heart issues in light that she has had so much testing done on her heart and everything seems fine. A LBBB really isn't that big of a deal, many people have this problem and don't even know it; it certainly doesn't cause the symptoms that you are describing. The description of  symptoms you are describing would be for a patient in a terminal state of congestive heart failure and there is NO way that would, or could, have been missed by even a resident cardiology student, let alone a qualified cardiologist. Has anyone checked out her kidney function? Thyroid? There is one other thing you must consider here, as hard as it may be, could your mother be (secretly) enjoying the concern you have for her; could she be seriously depressed? Sometimes when there are changes, including  hormonal, women can start to become depressed, especially at a time when the children are now grown up and moving on with their own lives; sometimes a mother can feel alone and not needed.  Many of the things you have written on here, don't add up and that is why the doctors are a bit baffled by your mother. If your mother isn't sleeping well, she is going to look wiped out, that is normal for anyone. Pain on the left side is probably muscle or cartiledge related. You have to think that if your mother has had EKGs, Stress Testing, Echo and Angiogram done as well as hospital monitoring done and all of that has turned out fine, then her problem is not heart related. Even weight gain is only SOMETIMES related to heart problems; in some people (myself included) water retention can be upwards of 30+ pounds and there is nothing wrong with either their heart or kidneys. Have your mother see a kidney specialist.

[jolene88]

Hi, Thanks so much for replying to my question.
My Mum had her Echo and apparently it is also clear.... So we are quite stumped because she is definitely getting worse not better and even our GP is still concerned enough to say to her that if the crushing pain returns in her chest along with the pain she is to go straight to Emergency.
We have been doing alot of reading on the subject and everything so far is saying that LBBB is definitely an indicator that something is not quiet right with the heart. We are thinking of requesting a Halter monitor, simply so that she has the monitor on to record what is happening to her heart when exertion induces the pain because whilst in hospital on the heart monitor things seemed fine but that was because she was on bed rest the WHOLE admission and primarily the pain is induced upon exertion, but lately exertion for her can simpky be taking a warm shower, walking up a few steps (the pain when it comes literally puts her on the ground) and she is starting to look more and more wiped out. She is not sleeping well and is very achy during the night through her left side. I am so concerned as this is just not typical for my Mum she has been a relatively healthy woman who has never been in hospital apart from having her children and for now all of a sudden to watch her go through this pain and weakness is terrible it is like she is becoming a very elderly lady day by day and the deterioration in her ability to carry out simple tasks is very concerning, This is a woman who has always been quiet capable of multi tasking and usually very active but is now reduced to struggling to climb the few steps to her bedroom and sitting on a chair to have a shower. enough is enough and I wish someone would just look for more than a blockage which is all her cardiologist at the hospital seemed concerned with. something is not right and I am scared we will lose our Mother while we fight for them to do more tests, they only have to look at her to know she is changing before their eyes. I just wish I knew what else it could be or related to.....

[ireneo]

That's nice that she has no obvious blockages but are they going to address the left bundle branch block which is electrical, not a vessel disease? She could have arrhythmias going on even with clear arteries. Perhaps the echo will show how things are with her valves, ejection fraction and general heart size.

As for the weight gain, it may be fluid retention. Until she finds out what's going on, she should do her best to avoid sodium. Not just putting salt on her food but avoiding canned soups, pre-packaged meals, cheese, soy sauce, lunch meats, etc. All she has to do is look at the package and see sodium content listed. You'd be surprised how much is added even though we can't seem to taste it.

I hope she gets some answers soon. Something isn't right.