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back pain with Atrial fibrillation
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back pain with Atrial fibrillation

I am a 34 year old male, I have been diagnosed with Atrial fibrillation about two and a half years ago, (I don't smoke, or drink, and I avoid all caffeine). I have had all the tests, thyroid, echocardiogram, blood work, x-rays, everything came back normal. (All the tests have been done multiple times) I am in Atrial Fib/flutter most of the time, I am currently on 150mg of Metoprolol twice a day and a 81mg aspirin. I have been experiencing chest pain (a dull ache) 80% of the time, My chest tightens up, I also get a sever pain in my back below my shoulder blade on the left side, This causes difficulty breathing especially when bending over, and is very painful when taking a deep breath. I have been to emergency when this happens. The pain does come and go with the A-Fib, The pain is worse when I lye on my back or stomach. Pulse was just over 150 and was in Atrial fib, it changed to Atrial flutter with oxygen, and slowed to 90. They don't know what is causing the back pain, and don't seem to be concerned.  I also have very sore legs, feels like I just ran a marathon, all the time. My chest is sore to the touch most of the time. I don't like to complain, but should I be concerned.  I don't feel well about 50% of the time, but you wouldn't know it to see me, I hide it well. I do all right at work but I am completely exhausted when I get home. I am also concerned what long term side effects the medications have over the next 50 or 60 years?
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74076_tn?1189759432
Hi Darcy,

These are tough cases.  You have AF and lots of symptoms that sound unrelated to AF.  It is impossible to tell what is causing the symptoms -- I don't think it is all related to the AF though.

It is reasonable to try something like flecainide or propafenone to try to maintain sinus rhythm.  If this doesn't work, dofetilide or sotalol may help.  If these agents dont' work and your symptoms are debilitating, you could consider an atrial fibrillation ablation (PVI) at an experience center.  ASK THE DOCTOR HOW MANY THEY HAVE DONE!  It takes a lot of ablation to really feel comfortable doing them.

Before having an ablation,  you will have to understand the back pain symptoms may not get better, they may not even be related.  Keep this in mind and make sure you are willing to take this chance before proceeding.  

I am not sure what to tell you about the back pain if it is not related to the atrial fibrillation.  It is unlikely related to AF.

Both aspirin and metropolol should be safe over 50-60 years.  They have been around for a long time.
I hope this helps.  good luck and thanks for posting.
20 Comments
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Avatar_n_tn
I second that recommendation.  Get a second or even third opinion.  I wouldn't put up with your symptoms at your age under any circumstances.
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Avatar_n_tn
I would be curious to know what is in the future for people with atrial fib. I had echo today and the person administering the the test said arrhythmia is pretty common in the population and about 30 percent of the genral population will develop a fib in their life time. I saw Barry Manilow talk about a procedure on t v briefly that he said cured his.  He never said what the procedure was.  He said he was going to the e r almost weekly to get converted, and that the procedure cured him. Does anyone know what the proceudre was?
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Avatar_n_tn
I know that AFIB is exhausting.  I had AFIB from time to time and then received an ablation.  Thanfully it worked.

I have a few questions:

How long have you been in AFIB?
Have you ever tried to be converted?
Has your cardiologist suggested going to a heart center?

I have a friend who was in AFIB for years.  He had a valve replacement, and during that they did a maze surgical procedure to take care of the AFIB.  It worked.

I think it is wise to look for ways to get back into rythmn.  But I am also aware that some will never be in rythmn.

Trust you will find some relief; especially with the symptoms.
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88793_tn?1290230777
Hi darcyb, I was diagnosed with A-Fib in Feb 05.  At the beginning, I've pain in BOTH side of the palm (below the little finger).  I couldn't sleep due to that pain.  Now, I've a very stiff upper back chest.  As you said "a dull pain" as well.  These few days, I've a very noisy chest.  It looks like blowing bubbles.  Do you have that sensation too?  

I'm not a Dr but I can tell from my experience. "long term side effects the medications have over the next 50 or 60 years?" Some few months some few years (wasn't need 50 or 60 years that long, I persume.) Keep an eye on your blood work figures, you'll find your answer.

To bama jane,  "I would be curious to know what is in the future for people with atrial fib."  I suppose it gets "Fib" till the heart shut down or "Fib" to die.  I've read some website said that it cann't get cure.  The best is kept in Sinus Rhythm.  Another website said A-Fib could be related to H. Pylori.  Here are the link, hopes it can help someone.

http://www.refluxissues.com/ms/news/526323/main.html
http://www.mydna.com/health/digestive/resources/news/200506/news_20050616_bug.html

Pika.
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Avatar_m_tn
When I was originally diagnosed with Atrial fibrillation the medication worked well, but every couple of months it comes back and they have to increase the medication. I feel absolutely horrible for about a month every time they increase my medication.
I have only seen a cardiologist once, and I got absolutely nothing out of that visit. I have been treated by my family doctor, and I have never been referred to see another cardiologist.
I  am in and out of  Atrial fib constantly, some times for 10 minutes, sometimes for days, Sometimes I go a month or two with no problems at all, only to have it come back worse than ever. They have never been worried about converting it back to normal rhythm, they are only concerned about slowing my heart down.
The last time I went to the emergency they only gave me oxygen and when it slowed to 90 they released me, I was in and out in about two or three hours.
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Avatar_n_tn
My own situation is this for anyone who is interested.  My first experience with afib was about 35 years or so ago.  I am now 62 years old.  It lasted about four minutes and it finally converted through coughing.  Every so often in subsequent years it would do this and I could get it back on track through coughing.  However in 1994 I woke up in the middle of the night and it was out of rhythm.  This time my coughing technique didn't work.  To top it off I was on vacation in Colorado and wound up in the emergency room.  I was 50 at the time.  After 12 hours on intravenous procanimide it converted to normal sinus rhythm.  After another day or so I was released with meds that I took until 2000.  Then I started to have frequent PVCS and PACS.  I was outfitted with an event (holter?) monitor and some 5,000 PVCS were recording during this period. At that point my cardiologist wanted to put me on Sotalol.  Reading up on this led to me GOING into afib, that lasted some 53 hours continuously. At this point I didn't care anymore, submitted to the sotalol and have been on it for over five years and my life is otherwise normal.  I exercise daily (hard)and am in normal sinus rhythm.  Would I put up with afib?  No way.  My bed would literally "rock and roll" from all of the gyrations of my heart.  It was a thoroughly miserable condition.  Unless someone has actually experienced this themself, they cannot possibly understand how debilitating this condition is.  

Can something be done about this?  Absolutely, if one gets to the right cardiologist who knows what to do and what meds, if any, to prescribe.  

Sorry this took so long but I thought it might be of interest to know of one person's experience who's been through the drill.

For what it is worth, my own theory that a lot of afib is because of high blood pressure that has enlarged the heart, but that is my own views and am in no way qualified to establish this as fact, but if anyone has high blood pressure, I would do everything possible to get this under control and to get a regular daily exercise program and lose weight.  And don't even think about smoking.  And finally, reduce mental stress.

I also take meds for high blood pressure but my weight is also a contributory factor.
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Avatar_n_tn
To my knowledge I was in A-fib one time or at least this attack made me stand up and take notice. I awoke with these one morning.

HR at ER was 186. I was lethargic and too weak to stand.  I was sweating and very short of breath. They immediatley converted me back to NSR with IV drug that worked in 8 minutes time. They took heart enzymes and they were normal in ER room. They kept me there and repeated heart enzymes in 4 hours and they were elevated. This means that this A-fib attack was doing some damage to the heart muscle. Scary.
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88793_tn?1290230777
I wander they took heart enzymes after the ablation?  Does this procedure cause damage to the heart muscle too?  Does anyone know or have answer or want to have a guest?
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Avatar_n_tn
Pika, with me I did not have an ablation. I was brought back to normal sinus rythm via an IV drug called Ibulilide (sp) With heart enzymes, they may not be elevated right away if some damage has occurred.  That is why hospitals order this again 4 hours later before sending a person home to make sure they are OK.  I was not OK and they admitted me and gave me IV heparin for 48 hours even with a now normal sinus rhtym of 84 BPM.  The very second I returned to normal sinus I was no longer short of breath and I felt great but apparently this episode that they call a "heart event" caused the Troponin to spill over and that heart enzyme is the gold classic, I was told, to determine that something has or is happeneing to my heart muscle.  They also did a thyroid TSH test and this was normal as they thought I was in a Thyroid storm.   I do have thyroid problems and am on a high dose of thyroid meds so who knows what happened  I could not tolerate the Sotolol or the Norpace and am on a beta blocker and an ace inhibitor and Plavix. They are ordering a Cardiac MRI next week to see if there was any muscle damage due to that A-fib attack.
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Avatar_n_tn
Yes, the ablation does cause a small amount of heart damage, as they are using a laser to "burn" the area of the heart that the arrhythmia is coming from.  When I had my last ablation, they took the normal series of 3 enzymes, and they are just checking to make sure they are trending downward (getting lower).

My experience (as I have had 3 ablations now) is that the heart is rather "angry" for a period of time post-ablation.  My resting heart rate was up, and my heart experienced various types of arrhythmias during the healing process.  This is all normal.

I hope this helps.

steph
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Avatar_n_tn
What with the leg and back pain, you might consider seeing a rheumatologist, or at least consider having your internist run some basic blood work to check for chronic inflammatory diseases.
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Avatar_m_tn
I did some research on my own and I found that Metoprolol has a list of "Rare side effects", that include, Back or joint pain, Chest pains, shortness of breath, or decreased ability to walk. which describes exactly what I am feeling. I am going to print the page and show my doctor next week when I go in to see him. it might be as simple as trying a different medication.
The back pain that I am feeling is exactly like having chest pain, but it is more painful in the back than the front, but it does go all the way through my chest and back, and it is only there when I am in A-Fib and my heart rate is over 150. it is not actual back pain.
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Avatar_n_tn
I'm new at all this. This is my story I recently went into the doctor for constant back spasms, my brother is a Chiropractor and I have had back problems for a long time.But recently the past two months my right side of my neck and shoulder area, around my shoulder blade pain with numbness into my fingers, my brother suggested I go see my MD and see about getting an MRI to see about nerve damage. When I went in they checked my pulse and the nurse said I had an irregular pulse, they did an EKG and said it was abnormal and scheduled a stress test next week. My wife is studying to be a RN (nurse) and listened to my heart with a stethescope and said that she could hear a pause in my heart beat it went, lub,dub,lub,SKIP,dub and so on every 3-4 beats a skip. I have been looking online at all kinds of information about Atrial Fibrilation and the symptoms and I do have alot of them. Shortness of breath, Sleep apnea ( I am on a C-Pap machine now), low energy, sometimes dizzy, decreased memory,low sex drive, and fatigue. I am very scared and do not understand why my doctor would wait a week to get me in when my heart is skipping beats, should I be concerned and what are the chances of me dying? I am 37 years old, I do not smoke or drink, I am somewhat overweight but by no means obese, I take a 81mg asprin daily along with vit E and daily vitamins, and after all my reading I am not drinking any caffeine. After my stress test should I request to see a cardiologist to get a second opinion? I have my blood drawn each year LDL/HDL levels every year that has always been great, low blood pressure 110/80. I do not know who responds to this but would love to hear from a Doctor or cardiologist
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Avatar_m_tn
I am not an expert, but I don't think you have anything to worry about. two and a half years ago when I found out that I had A-Fib I worried myself sick about it, and in my case stress only makes it worse. You need to be checked for all the possible causes. But at your age my guess is that everything is fine. For me the A-Fib causes an extremely fast heart beat, around 200 beats/min. In my case the A-Fib is caused by extra electrical impulses going to the two upper Atria chambers.
In my heart, from what I understand everything is normal,  it gets its normal electrical impulses for it to beat, and these impulses are in perfect time, and then it gets extra impulses to the atrial chambers, which causes them to beat faster and miss beats.
This condition is not life threatening, especially in people our ages. Doctors are very smart people and if they thought that there was a serious problem you would be in the hospital. A irregular heart beat can be a very anoining problem, but not usually life threatening.
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Avatar_n_tn
My problems have a history of being several-fold.  I am currently 34 years old and was diagnosed with fibromyalgia at about age 24.  I've been through chiropractors and massage therapists with little relief.  After many years, I finally had another back x-ray and found out I have a spinal disorder ein which several of my thoracic discs are degenerated and there is some compression of a few of the vertebrae.  Needless to say, I have chest pain nearly all the time.  However, I do get periodic arrhythmias, and it seems to be related to anxiety and pain.  I do chew tobacco, but have no history of heart disease in the family.  My mother does get arrhythmias now and then.  I guess my question is that based on my history of pain and whatnot, could these be a result of little more than anxiety, or something more?  Should I be worried?  

For me the arrhythmias do not appear to be as dramatic as those of many others I have read, but my blood pressure does seem to respond to different body positions.  Perhaps this part may be in relation to pain?  If you have any answers it would be much appreciated.
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Avatar_m_tn
I would suggest you quit chewing tobacco, nicotine and caffeine speed up the heart and help cause some arrhythmias. Anxiety is another cause, Definitely ask your doctor, only he or she can determine if there is a more serious problem. Arrhythmias are very common.
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Avatar_m_tn
Just an up-date, My doctor changed my medication to 300mg of Diltiazem. All of my leg muscle pain is gone, I can walk again without pain! And the chest pain that goes all the way through to my back is also gone!
Metoprolol took all of my energy, and ambition, which I really didn't realize until I stopped taking it.
I found it very difficult to get out of bed while taking Metoprolol.
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Avatar_n_tn
please bare with me as i am new to this site and have never written an online comment before. around 5 yrs ago ( i was 34 yrs old at the time ) i was taken to the er by ambulance from work because of a rapid heart beat and shortness of breath. long story short, all tests were negative and i soon felt better (other than the embarassment). 5 months ago i was taken to the er by ambulance from home because of back/chest pain and an irregular heart beat. i was told by the paramedics that i was in afib and they gave me an iv and took me to the hospital. i was in afib for 20 hours and had numerous tests done (ekg,echo,xray,blood work etc...). they sent me home and my cardiologist put me on flecainide (2x aday 25mg ea.). i still get symptoms such as the dizziness and shortness of breath but i think the meds have helped with the rapid heart beat. this "disease" may not be life threatening as i have been told but it truly sucks. its very embarassing when people are around and it sure feels "doomsdayish" to me when it happens. the worst part is not knowing what is causing this. i too may have nerve or disc damage in my neck that is causing this and will be getting more tests for that. chest scans came back normal.
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Avatar_m_tn
A related discussion, Heart Arrhythmia/AFib with back pain was started.
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