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Prior pericarditis w/effusion 1 1/2 yr ago, with isues
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Prior pericarditis w/effusion 1 1/2 yr ago, with isues

Hello,

Personal data: 25yr old male, 74 inches height, 178lbs
Diagnosed, and treated for pericarditis, w/effusion
Diagnosed with , and currently being treated for Asthma, and sleep apnea.

Family cardiac history: Fathers side- grandfather first heart attack left ventricle spasms at age 88
Mothers side - grandfather suffered major sudden heart attack at age 31 which damaged and scarred heart and artery, survived due to cardiac nurse wife "grandmother" being immediatley present, later died age 59 as result of related heart failure. Docs unable to perform required surgery due to intensive scarring.

I am currently serving in the armed forces. Summer of 2009 in the mid east I was diagnosed with pericarditis w/ effusion, confirmed via echo. At the time my symptoms were difficulty with taking deep breaths, extremely sharp pains of the heart, and general weakness. They did many 12 lead ekg's before diagnosis which really told the doctor nothing. Treatment consisted of ridiculous amounts of IBUPROFEN which helped but did not solve the issue. Fall of 2009 I returned stateside, and was finally referred to cardiology where I was put on a gout medicine "which i found odd" called colchicine which made the pain stop within a week to two weeks for the most part. The cardiologist never did anything more then an EKG which came back normal *suprise*, and had another echo performed which concluded there was no longer effusion. I continued the colchicine for about a month longer.

During the time I was taking the colchicine the sharp stabbing pain subsided to just an occasional quick bout at its worst bi-weekly. Ironically a deep but slight dull ache, and heavy feeling around the heart began in the same stretch of time that the sharp stabbing pains subsided. I was told this was likely just lingering pains from the bout of pericarditis. Well, its now 2011, and since the pericarditis bout that dull ache has continued, and become more annoying though i would still consider it non excruciating. I had a recent bout wherein I felt a rapid buildup of pressure, like all of a sudden there was a brick in my chest, which lasted roughly 15 minutes, and *immediately* subsided with one extremely painful heartbeat. I did not go seek medical attention for that as I figured since the pain was gone, and my EKG's always come out normal that it would get me nowhere. In retrospect I probably should have just gone to the ER anyway.

Since that time the dull ache has progressively become more annoying though my blood pressure, and pulse has dropped from the 150's/90's, and 100bpm resting that i saw during the pericarditis bout down to 138/88 (done this morning), with a resting BPM of 50. Prior to the pericarditis I was throwing 120/60, and 42bpm consistantly. I was running 2miles in 13 minutes. After the illness my times were more in the 17-18 minute range. Since then I have finally dropped that time down into the 15's again.

Recently diagnosed with asthma, and sleep apnea I had a sleep study done wherein I was monitored by a 2lead EKG which presented random fits of PVC's, and PAC's. I am now on a 5 day blood pressure check as last week during a pre deployment checkup I threw a 138/90's blood pressure with a 73 resting BPM. Today, on day two of this BP check i did just slightly better on the BP, and heart rate was 50bpm they did another 12 lead ekg with concerns to the dull ache I had been describing which returned sinus bradycardia, and early polarization. Upon physically listening he did make it a point to inform me that he was hearing PVC's, though no friction rub was heard this time. He has put in a consult for another echo to be performed to try to observe whether there is sign of effusion again.

My question is: If the echo comes back negative on effusion which I have the feeling it will as I'm not feeling sharp stabbing pains ect... associated with pericarditis.... Could there be damage to my heart which would not necessarily throw an otherwise normal EKG besides the sinus bradycardia, and early polarization? If so, what steps should I take to ensure I get a proper diagnosis, and if needed treatment rather then the army's run of the mill "heres ibuprofen, drink water" response to everything?

Secondly, could PVC'S, PAC'S, and early polarization be related to the prior bout of pericardial effusion? If so, what steps should I be taking?


Apologies for the long read, thanks for bearing with me,
Ken

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Avatar_m_tn
correction : any time i said early polarization i meant early repolarization.

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