Cardiac or Gallbladder?

I am a 48 yo female who has had PVC since my 20's..no big deal, I live with them. In the past year, however, I have had an intermittent "spasm like" pain that runs right under my breast line/where lower bra sits. The sensation is over in less than a snap of your fingers and virtually simultaneously "zings" from my left/heart area to the right side of my chest, under my right breast.  I have had an EKG, stress test, nuclear imaging, echocardiogram of abdominal area, (kidneys, liver, gallbladder) and a HIDA scan. The only thing they have found is my gallbladder is got a non-existent ejection rate..but I have absolutely NO symptoms associated with gallbladder problems. Of course, a surgeon wants to take out the gallbladder, but until I know that it will solve the weird chest pains, I am hesitant. The "spasm" like pain can go for months or weeks without presenting, then it can do it several times a day...no lingering pain, no prob. breathing, exercising does not bring it on, I can be sitting, or standing, or laying down..nothing really makes a difference. It just shows up.  

If anyone has any clue to what this might be, I'd be eager to learn...I can learn to ignore it like I do the PVC's but geez, one day, I might ignore everything just a little too long and drop dead!!  My father died of a Heart Attack at 49, but he was a smoker too, I am not, don't drink, exercise 3x's per week, but need to lose about 30lbs.  Hard to exercise when you think you might drop of the "big one!"

[itdood]

Perhaps you can try an event monitor to see if these spasms are heart related.  When you feel them you press a button to record when it occurs.  that might give you more info to help with your decision.  Your cardiologist can set this up.  Cardionet, whom I prefer, will ship the thing out to you.  it's all done via mail and 30 minute training phone call.

[ptadvoc8]

If everything checks out with your event monitor and your heart, you might want to consider talking with your doc about trying a drug called Ursodiol before having your gallbladder taken out. A "non-existent" ejection rate is believed to possibly signify a non or only partially functioning gallbladder and of course they tend to want to take them out in this country -- especially now that they do it with laproscopic, minimally invasive surgery.

On rare occasions even without gallbladder symptoms, I have read of patients who developed pancreatitis believed to be due to gallbladder malfunction. They may tell you that since the gallbladder is non-functioning, you don't need it and why take the risk of having problems from it? However, removing the gallbladder, while often absolutely necessary and frequently very curative, does carry it's own risks in surgery and long-term lifestyle side effects, which I am sure you have read about.

Ursodiol is basically a bile salt (similar to what your gallbladder would put out on it's own) and although it is an uncommon drug, it is used in for a few common conditions involving the liver, gallbladder and as a gall stone preventative in some weight loss methods. While it is most commonly used for dissolution of certain types of gall stones, it has been anecdotally shown to reduce "biliary" pain in many patients with gall stones, non-functioning gall bladders and some liver ailments. However, you want to be careful with this med because while very similar to normal bile salts and used every day by patients for years and years on end, it can rarely affect the liver in some patients, so you need to be monitored when you start taking it. One draw back is that is may take several months before you know if it will be effective or not.

I have no idea whether Ursodiol would help your symptoms in your case, or if your pain is even related to heart or gallbladder -- or something totally different. So it is only a suggestion of something to consider discussing with your doc if indeed your gallbladder is not functioning, you are still having pain, the heart stuff looks good and they can't figure out what else it might be. Good luck and best wishes!