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Possible Heart Problem?

I'm a 24 year old female, who, until November 2006 was in good health with the exception of kidney stones.

I started having left side chest pain and left shoulder pain and went to the ER, where they did an EKG which came out fine.

The pain continued and I started having bad muscle (sharp) pain all over, in my arms, jaw, ribs. I've also had tingling on the left side of my face, hands and feet

I have been to the ER twice since my original visit and they all did EKG's that supposedly came out fine.

I saw a Cardiologist who did an EKG and a Stress Test and Echocardiogram, all of which they said were normal.

My EKG says

Vent rate 89 bpm         Normal sinus rhythm with
                         sinus arrythmia
PR Interval 122ms        Biatrial enlargement
QRS duration 72ms        Low voltage QRS
QT/QTc 360/438           Abnormal ECG
P-R-T axes 73-72-43

When I asked about the biatrial enlargement, he said it could be because I have larger breasts or the way the leads were placed.

I want to believe these hospitals and doctor, but the symptoms are continuing, along with pain in arms, legs, shortness of breath and the feeling of something being in my throat, so it's very scary.

What could this be? Is it a heart problem or something else?

Any and all opinions are greatly appreciated.
19 Responses
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Avatar universal
Hey there!

I'm a Cardiac Echo Tech.  The physician is correct.  Lead placement is critical to a succesful 12-Lead EKG.  Many hospitals today have EKG machines which (in my opinion)display to much information or inaccurate information. The lead placement is most likely producing a "false positive" for biatrial enlargement.

If a patient had enlarged atriums, then they would also have enlarged ventricles.  You cannot have one without the other. Enlarged atriums are indicative of left sided or right sided (blood) congestion.  When heart pressures are off balance, blood has a tendency to "back-up".  Overtime, this causes the ventricles, then lastly, the atriums to enlarge or dilate.  

If your atriums were enlarged, it's a result of ventricular dilation/overload.  If this were the case then your EKG would have automatically shown an increased QRS complex in all views. (Meaning your ventricles are huge too.) Because this did not occur, nor did your Echo show anything remarkable with your atriums or ventricles, then don't worry.  It's not your heart.  Also, if there were problems with both the atriums and ventricles, there would also be measurable problems with your valves.  This didn't happen either.

People who have enlarged hearts have more problems then tingling fingers, tingling jaw, muscle spazams/pain.  They have pulmonary edema, enlarged abdomens, thick or swollen knees, difficulty breathing, lung conjestion, coughing, spitting up mucus.  These people most likely require several pillows at night to sleep, allowing them to continue breathing without going into congestive heart failure. This doesn't occur ever so often, this is a way of life.

I'd wonder if you work out often and are pulling a muscle, or possibly have pinched a nerve.  Auto accidents can cause this also.  I think you may have indicated you have had an auto accident.  

See a Chiropractor!  They will work wonders on you!  I promise!

Relax though, it's not your heart....
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Avatar universal
re: Labs, Bppv,

If you go on the site www.Dizzytimes.com it will give you an insight to labs, Inner ear problems

Hope this helps.

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Avatar universal
I don't work out. I haven't seen a rheumatologist yet.
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97628 tn?1204462033
That sounds even more like anxiety.
You might want to get a complete physical.
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97628 tn?1204462033
Have you been tested for lyme disease and that whole panel of things ?
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Avatar universal
My Dr. thought it could be Lyme but that blood test came back negative.
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Avatar universal
The chest pain is sometimes on the left side, sometimes under the left and right breast and sometimes in the center but it's sharp/burning.
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97628 tn?1204462033
Have you seen a Rheumatologist?
Do you work out?
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Avatar universal
I don't work out. I
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Avatar universal
I've never been depressed or had anxiety attacks or anything. That's what's been so odd about being sick for almost 2 months. It came up out of nowhere on Thanksgiving Day and it's just gotten worse.


I'm not sure if I mentioned dizziness in my OP, but lately I've had that as well, along with extreme tighness in the jaw.
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Avatar universal
Also have pain under the arm which I've been told by friends could be related to my breast implants. Not sure though.
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Avatar universal
do you have the old (or brand new) silicone implants? If you do, specifically ask your doctor to check for silicone poisoning just to be safe... During anxiety attacks, its not uncommon to not feel anxious. Ive had panics attacks wihle getting pedicures and feeling completely relaxed.. Ide also look for a muscular or neurological disorder.. If your blood work and ekg's are fine while you're symptomatic, there is a great (GREAT) probability it is not your heart... Ekgs are also not very good for indicating structural abnormalities, so the biatrial enlargment seen on the ekg could very well be a falso positive. I would get an echo just to be safe, and then pursue something else..

Also, when you are dizzy, do you get tunnel vision, or does the room spin?
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Avatar universal
ROBIN:
I would say get a complete workup; cardiac, gi, all necessary blood work and then consider anxiety/panic as a possible cause.  I am wishing I would have done that sooner.  I have been so concentrated on my heart.  I have ALOT of the same symptoms as yours.  Left ONLY sided chest pain, arm pain, jaw pain, armpit pain and back left scapula pain.  I denied anxiety for so long that I think I made my symptoms worse.  I too had a panic attack OUT OF THE BLUE,  seriously NO REASON.  My first ever.  Never had anxiety, never had any history of panic disorders or even stress for that matter.  It's all gone downhill from there.  Because I convinced myself it was heart, I have seen 3 cardiologists and had numerous tests.  All normal.  I honestly did TOO much reading on the internet and in turn self diagnosed myself with a lot of different heart ailments that couldn't possibly be happening.  I have ALMOST come to believe that it is not my heart but when the pain starts, panic follows so fast I can't stop it.  

Get all your normal workups done to be safe but don't exclude anxiety as a cause because you don't feel stressed or anxiety ridden.  Neither did I -- well, until this all happened and now I have worked myself into a bad place.

COLLEGEGIRL143

I was just wondering why you asked the difference in dizziness, whether it was room spinning or tunnel vision.  The reason I am asking is because of dizziness I have been having the past few weeks.  It is the room spinning, feeling like I'll black out kind.  Haven't yet--lol
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Avatar universal
I have the saline implants, which were put it in 2002. I haven't had any problems with them that I know of.

The kind of dizziness I get is just like a fuzzy feeling, like I can't focus.

I had a Stress Echo done which came back normal. I had a follow up with my cardiologist yesterday and he did another EKG (has to be my 5th), and it was Borderline normal, whatever that is.

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Avatar universal
borderline normal, i have no idea what this would mean because there are 100000 things that can come up on an ekg and make it abnormal.

The fuzzy, cant focus thing, is very textbook of anxiety.. Its usually referred to as being disociative.

Justlooking, I ask that question because the tunnel vision is usually presyncope, and the room spinning, is 9 times out of ten associated with the inner ear. its also reffered to as vertigo. Its the same feeling you get if you spin around in circles to much, or get too drunk lol.. It doesnt mean you are going to pass out, but alot of people get scared of the feeling and assume thats what is.  Look up labrynthitis if you'de like to read more about symptoms concerning the room spinning.
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Avatar universal
thanks.  i see my primary tomorrow and will mention it to him.  i have a history of pretty chronic ear infection, normally middle ear though.  thanks for the explanation.
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61536 tn?1340698163
Dizziness is common and usually not extremely serious.  I have a small bone in my inner ear broken (nasty car wreck, gotta love those drunks) and I've had balance and dizziness issues ever since.  I've just come to accept that, but sometimes it does take me off guard.

As for the other stuff, I really have to agree with others that it sounds like anxiety.  When my anxiety started (that I could pinpoint with symptoms) it seemed totally out of the blue too, with no prior history, and my symptoms were nearly identical to yours.

With the bilateral atrial enlargement and borderline EKG, I would be asking a few questions though.  It's your right to know.  If nothing else, maybe it will put your mind at ease.  Knowing, good or bad, is always better than what your mind does to you just wondering.
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97628 tn?1204462033
Heart attack, when you have normal tests and are so young, is pretty far down the list of possibilities. You may want to have a thorough check-up with your GP and, if all remains normal, research anxiety and depression, which can cause aches and pains and a feeling of something stuck in the throat.
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Avatar universal
I wanted to add that I've had tons of bloodwork done and the only thing that has come up is that I'm slightly B-12 deficient.
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