defining pain..

[nicobella]

HI. I am a 32 yr old female. Pretty good shape. Low weight due to a thyroid problem that I had (which is now under conrtol). I have been off meds for a while now as well. I have been having some chest pains/discomfort that come and go. Sometimes I get it is my left arm...mostly in the tricep area. I also feel heat fluttering or skipped beats from time to time. I have has a few EKG's done, wore a holter monitor for 24 hours and had a chest x-ray. ALL NORMAL. However i did not have any symptoms at the time of the tests. My question is this....is there any way for me to tell if the pain is an actual heart problem or if it could just be from gas or indigestion?? My doctor says not to worry, that I have a healthy heart...and so on. I asked for an ECHO just to ease my mind but they told me it was not necessary. My blood pressure is always normal....anywhere from 90/60 to 110/75. Normal resting heartrate...around 60bpm. I just worry becasue I had bulimia for many years (about 10) and fear that I might have caused heart damage. However the doctor's say that would have shown up on the chest x-ray and other tests. Should I get a second opinion... or see a Cardiologist??
thanks
melissa

[CCF-M.D.-MJM]

Hi nicobella,

I am glad to hear  you are on the mend from previous health problems.  I want to assure that the heart problems that most people have with anorexia/bulemia is at the time when the are having problems with their condition.  Most of the heart problems are actually metabolic (electrolyte) problems that secondarily affect the heart.  The pains that you describe above do not sound cardiac.

If you think a second opinion will help you believe that you are ok, you should ask for it.  I do not think there is anything wrong based on what you wrote above.  You need to believe this so you can move on.  If a second opinion will do this, you should have one.

1.  is there any way for me to tell if the pain is an actual heart problem or if it could just be from gas or indigestion??

Heart related chest pain is usually related to exertion and may have shortness of breath, swelling in your leg.  You are very young for these sorts of symptoms.  Again, if a second opinion will help you, you should have it.

I hope this helps.  Thanks for posting.

[nicobella]

I forgot to mention that I have also been having vertigo on and off for the past few months as well. Actually since lsat April or may. It gets worse for a few weeks then sort of clears up a little (never actually goes away 100%). I have seen an ENT and they found no hearing loss or anything. They did see that i had sinus infections that come and go as well. Could the vertigo be heart related as well?

[cristabelle]

Hi, I'm not an MD, however, it's good that all your tests have come back good.  I would see a cardio if it were me. My sister Kathy is a NP in Charlotte and she says they see quite a few patients who have any history of eating disorders/nutritional counsel.
best of luck,
cristabelle

[nicobella]

when you say that your Aunt who is an NP see's a lot of patients with eating disorders and so on....what do you mean by that. that she see's them with? Heart problems or just in general??
thanks for the reply
melissa

[cristabelle]

Nicobella,
I'm sorry I wasn't real clear.  My sister sees them come through the cardiology office.  I didn't mean they all have heart problems.  She never discusses specific cases with me, however, she said most of the patients with eating disorders do NOT have heart complications more prominent than the general population, (palps, high BP etc.).

Sorry for the confusion, just wanted to encourage you.  Looking forward to the DR. response.
cristabelle

[Karonnie]

Hi Nicobella

I understand how frightening pains which may or may not be associated with the heart and your palpitations may be.

I personally would suggest finding yourself a good cardiologist that you can sit down and ask your questions to, hopefully he/she will be able to request further tests or explain why no further tests are required. It annoys me a bit that whilst you seem to have these flutters a valvular problem is totally ruled out prior to confirmation, you could have a bicuspid valve or something. I note also that you did previously have a thyroid problem. I am also wondering if this "evening" out of the problem - were you getting heart symptoms with the hyper / hypo state? Maybe the body is still adjusting.  The heart gets itself into a pattern of rythm - why arrthymias remain around after all symptoms of infections etc are long gone and why docs don't like you staying on beta blockers too long etc. I am wondering if your heart is still learning to readjust itself or maybe the addition of kelp to your diet will clear up any last minute thyroid imbalances which may actually be causing this during certain times of the day (even stress ect can have a bearing on the production but not show up in your bloods) and or certain with / without certain dietry intake. Also note down the day and time of the month etc you get them - can you see any pattern? Is it maybe when you're ovulating and just before and after your period if you're not on a contraceptive pill or could it be just after your period has started if you are on one? Sometimes estrogen increases or progestron to estrogen imbalances  can give you heart symptoms, if you previously had eating disorders these hormones where not being normally produced and synthesised so may have not been a problem before.

I hope you find peace of mind and / or relief soon.

Karen