Not heart disease but, what is occurring ???

[jakelepeg]

Back in April, my wife and I were holidaying in Thailand when she suddenly felt unwell, she felt nauseous, had pain in her left arm and across her chest and her blood pressure rose to 180/95 (normally it’s low at around 110/70).

We immediately went to A&E at the local hospital where she underwent various tests (bloods, ECG etc.) but the doctor could find no problem. He did however prescribe her Amlodipine 5mg and advised her to rest in bed for the remainder of the holiday and to stay out of the sun.

We returned to our house in SW France and my children had made an appointment with a local renowned Cardiologist for the following day. After more tests, ECG etc. he also found nothing of concern.

Two weeks later, my wife suffered the same symptoms as encountered in Thailand and our GP sent her straight to hospital where she spent the next week in the Cardiac ward. Despite intensive tests which also included an Angiogram, nothing could be diagnosed and they then sent her to a Gastro-intestinal specialist where she had an endoscopy which again proved negative.

So, over the last few months she has suffered no relapses but, two weeks ago felt nauseous, very tired and had a pain down her left arm. After visiting the GP, he put her on Amlo again as her BP was raised a little.

Two days ago, she felt nauseous, tired, and pain in her left arm and a heaviness across her chest.

The symptoms presented would in most other cases be diagnosed as a heart problem but, this has been ruled out completely.

Does anyone have any suggestions as to what the problem might be?

[ed34]

If the symptoms were present during testing and nitro spray makes no difference, then I very much doubt if it's heart related. Even MVD should give something on tests when lots of discomfort is present, even vasospasm. I would perhaps discuss the issue with a good osteopath, in case a muscle is trapping a nerve or something.

[jakelepeg]

Thanks for your time, I will certainly do some research in the areas you suggest. You sound like you have certainly been through the mill, I trust you are now on course for a full recovery and a long, quiet and peaceful life. Greetings from SW France.

[ChatterAlly]

I suffer with vasospasms (prinzmetal angina or unstale angina). I have several stents in my heart and another major artery to my leg.  I have had 2 heart attacks, also.  The past couple of years I spent many nights in the ER and CCU, only to be told they weren't sure why I had the chest pains.  The pain was so much like the pain I had with my heart attacks. This past April though, because I got the attention of the nurses in CCU, they were able to pick up on the spasms by looking closer at the data from the monitors.  Evidently, these spasms can be hard to detect.  It takes diligence and some knowledge. Every time I had a spasm the monitor would go crazy and start beeping.  I told the nurse I had the pain then, but she said the monitor was acting that way because I had moved.  I knew I hadn't.  After this happened 3 times, I was able to convince her.  The amlodipine is great for the spasms, and the nitro works every time for me.  I take the nitrostat under my tongue. There is a lot of reading on the internet if you know what to look for.  You could try researching "small vessel disease, vasopspams, unstable angina or microvessel disease or even Cardiac Syndrome X.  The chest pain with these spasms are never brought on by exertion.  I do have some angina when I walk across a room.  But the thing that bothers me the most is when these wake me from a dead sleep.  That can happen as much as 5 times during the night.  Before being put on the Amlodipine I could have as many as 12 to 15 spasms in a day. It was awful for me.  The hard part was the not knowing what it was.
I hope you can find an answer for her. The pain I have is a burning ache that radiates across my chest.  In the really bad episodes it can radiate up my jaw and into my upper arms. Both of them.  Take care and keep us posted. Ally

[jakelepeg]

The symptoms can last 2 days or so and were fully apparent whilst hospitalised. Now that you mention a spray, my wife has just remembered she presented with the same symptoms back in the UK some 10 ago or so (so whatever is happening has been dormant over all those years) She saw a cardiologist back then who did all the normal tests which showed up normal and he did give her a spray to use under the tongue when she suffered pain. However, she did try this a couple of times but the pain persisted. The pain in her arm normally starts at the shoulder and is really uncomforable rather than painful. The pain in her chest starts  at the breast bone and radiates across the chest. Thanks for your input, much appreciated.

[ed34]

From the sound of it, the symptoms come on at random, not specifically with any kind of exertion to work the heart harder. Perhaps one simple test they could do is to offer your Wife a Nitro spray. When squirted under the tongue, this opens the arteries and allows more blood flow. If it is heart related, then this is more than likely going to give relief. If it does, then perhaps the cardiologist or doctor could consider vasospasm. This is where one of your Wife's coronary arteries goes into a fast spasm, constricting blood flow. These can happen completely at random and without any warning but are difficult to diagnose. There are medications which can help prevent them.
One problem with vasospasm is they are generally short in duration, too short to get to a hospital/doctor and have an ecg or echo before the symptoms pass away. I assume the symptoms had passed when your Wife had her tests?  How long do the symptoms last? a matter of minutes?
Anyway, just a consideration to think over.