A friend (female, age 59, otherwise fit and well) has developed paroxysmal AF (atrial fibrillation) over the last year. At first the episodes were rare (one every two or three months) but have become more frequent. Episodes have always self terminated in under 24 hours.
Now the odd thing is nearly every episode has been preceded by right shoulder/upper chest pain in the previous 24 to 48 hours. The pain usually has settled before the AF starts. The pain is aggravated by movement and yawning. It sometimes radiates up into the neck and head. It is not relieved by antacids. The pain can be quite severe and wakes her from sleep. Sitting up relieves the pain.
ECG, bloods, echo & upper GI endoscopy are all normal. She is normotensive and on no medication (although about to start flecanide). She's an irregular jogger but can manage up to 8 miles at a time. There is no family history of heart disease.
Her cardiologist is stumped by this pain followed by resolution followed by AF pattern.
Any suggestions? Really struggling to find any reports of anything similar on the web.
You might want to post this in the experts forum to get more professional advice though there is a charge. This is the patient forum so we can give advice only based on personal experience. I guess what I wonder is what her heart is doing on the days she is experiencing the chest pain. Has she had a monitor to get a recording of what is going on? Has she gone to the ER while having the pain? I would highly recommend she visit the ER if she hasn't while she is having the symptoms. But have her also check her pulse to see if it is beating fast or if it is irregular. Tell her to note what she did the day prior to the pain and even what she ate. It could be something as simple as what she is eating or over strain from exercise or something like ectopic beats that is causing the pain so I would say try to see if she can find a pattern that might lead to the cause. I know if it only happens a few times a year it might be hard to pinpoint but it seems there is some sort of process going on that she may be able to narrow down with time. That is the unfortunately thing with heart rhythm issues, it can sometimes be like finding a needle in a haystack taking years to figure out. Best of luck figuring it out and maybe someone will pop on with a similar issue. Keep us posted on how she is.
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