Chest pain after TX.

  I have experienced on again off again chest pain since finishing tx 1 year ago. My pulminary Dr kept attributing it to a strain from working out which I thought was ridiculous. I know the difference between a strain and a throbbing pain in my chest that moves around. Anyway this time I convinced him to do a Cat Scan and low and behold I am not crazy. They found a Plueral effusion (buildup of fluid on the lung) and a Pericardial effusion (buildup of fluid arouind the Heart). This is what was causing the pain. Now I have to find out what can be done about it.

   I am sorry to say that these Dr's have no idea what side effects the Interferon and Ribaviron can cause. Looking back I now remember something on the medications insert saying something about the medication causing Heart problems in some people. I hope this is not the case with me. I wiil bring the films to the Dr tommorrow and see what he says about it. I read the radioligists report and I am hoping that it can be treated and fixed. I start thinking about it and start worrying that it could be heart damage or something else just as serious.
    
   I guess I should be grateful that I am SVR and I am but I still want everything. I will keep you posted

Bobby

[nygirl7]

Jesus Bobby I am so sorry to hear this but so glad they finally FOUND the problem and didn't keep assuming it was in your head!

I do remember having to take the EEG before treatment but honestly I have no idea what it was for.  Fluid buildup around the heart - I don't know anything about but I have to admit I would be concerned too. I don't remember ANYBODY ever having this problem before.

I will keep you in my thoughts and prayers.  PLEASE keep us informed.  This kind of thing IS something that we should know about just in case it is related to treatment.

My personal opinion - they should call a real hep specialist and find out for SURE if it's related or not.  I would insist!

[Bobby1952]

I am trying to ask Dr Dieterich but his forum doesn't seem to be working right. I will ask Med Help what is going on.

[jdwithhcv]

Wow, Bobby, sorry to hear that.  Sounds pretty scary and dangerous.  Let us know what happens.  I'll be thinking about you, and worrying until I hear.

jd

[smaug48]

Bobby, sorry to hear that.  Many, many moons ago (way before I knew about Hep C)  I had pericarditis that became quite severe because first I ignored the symptoms and second I was misdiagnosed like you initially were.

What happened to me was, or at least what the doctor thinks, is that I got a virus that inflamed my pericardium, and the friction between the pericardium and the heart caused pericardial efflusion.

Because of the efflusion, the heart doesn't beat as well, which leads to a downhill of fluid building up in the body because the heart can't pump it out (I had fluid in my lungs and my stomach became distended from so much fluid build up).

Believe it or not, I was basically treated with Bufferin to reduce the inflammation.  Once the inflammation went down, the fluid started getting pumped out.

My heart doctor said that sometimes the pericardium becomes stiff afterward - if this happens, the pericardium has to be taken out.  Scary, yes.

But that didn't happen to me - my heart has been fine ever since.  Seems like you caught your condition earlier than I caught mine, so hopefully that means you can be fixed quickly with no complications.

I recommend seeing the best cardiologist that you can find.

smaug

[Bobby1952]

   Thankyou for your input. My Pulminary Dr thinks it could be a Virus also. The only thing he doesn't understand yet is why it keeps coming back. He wants to rule a few things out first like TB (he gave me a PPD) and is taking a echocardiogram to correlate with the Cat Scan. After these results he will probably refer me to a cardiologist. So its going to be a while longer. I took Levaquin (strong antibiotic) each time and it cleared up within a week. After the first time it took 8 months to come back then it came back 4 months after that.  The first time this happened was right after tx and I was in the hospital. They did a whole lot of blood tests looking for bacteria and couldn't find anything. There is a name for these type of blood tests but I can't remember it now. Very strange. I hope they get to the bottom of this.

[smaug48]

For what it's worth, I think I got the pericarditis because at the time I was burning the candle at both ends and also tried to go vegetarian without doing any research first - I just took away the meat without any thoughtful replacement.

Wish I could give you more details on what medicines I took, but it happened 18 years ago.  I can say that after I was first diagnosed, I entered the hospital (I was in Tokyo at the time) and they drained my pericardium with a long needle (now there's a pleasant thought!).  I started to get better after three weeks, but then it came back, so I went back to the US where I finally got rid of it for good.

You might want to consider taking it easy on the workouts until you get rid of this thing - your heart is probably getting stressed enough with the efflusion..

Let us know what happens.

smaug

[abbas__new]

Dear friend,

The mechanism of this injury appears to involve the brain's special immune cell called the microglia. Normally, these cells remain dormant in the brain. That is, they are sleeping. Microglia cells can be activated by numerous factors, including mercury, aluminum, iron, overvaccination, and brain trauma, strokes, infections (viruses, bacteria, rickettsia) and cytokines such as interferons.
Once activated, microglia can move about the brain secreting very toxic compounds, which include two excitotoxins (glutamate and quinolinic acid). These excitotoxins dramatically increase free radical generation in the brain as well as oxidation of lipids (called lipid peroxidation). These radicals damage synaptic connections, interfere with neurotransmitters and can even kill neurons. In addition, these activated microglia generate other toxic compounds such as prostaglandins (PGE2), which increase brain inflammation.
If the microglia activation is short lived, the damage to the brain is minimal and recovery takes place. Yet, should the activation continue, which would occur with high-dose and long-term use of interferons, the damage could be substantial and irreversible.

[GSDgirl]

geeze Bohby I hope they get to the bottom of your problem and get you back to feeling better.

Denise

[copyman]

Hey Bobby, that is some scary stuff. I hope it turns out ok for you and had nothing to do with TX. Hope you are feeling better soon and keep us posted.

[Bobby1952]

   I don't quite understand the connection you are explaining. How does this inflamation (inflammation) in the brain affect the Lining of the heart. If you could explain it in laymens terms I would appreciate it.

[alijee]

very sorry to hear. Please inform us about your day to day condition and what does the doc say.

[Bobby1952]

   There is no doubt in mine it is related to tx. Whether it was the Interferon or Riba. Or maybe Indirectly because of all the infections I had while on tx. I had a stress  test about a year before tx and  was A ok.

[Rockerforlife]

I dont have any chest pain or anything,but i just got back from a dental school and thet refused to clean my teeth..because my blood pressure was too high...it was 145/90....its usually always 120/80 on average....they even took 3 readings and waited inbetween the tests...and wouldnt you know it....when i get home...i go 3 different drug store blood pressure machines and i was 120/80...BTW...they used 2 different machines on me at the dental office....does the TX drugs cause radom spoikes in blood pressure....

i just cant win...LOL

[GSDgirl]

My BP did the same thing, from perfect even low to 145 / 90.  I am still on a beta blocker

Denise

[lalapple]

maybe get your heart checked out.  Interferon and Ribavirin causes all sorts of weird things in me, my thyroid has issues how and it makes my heart pound pretty fast, so when i stand up for too long, i feel chest pain.

[Rockerforlife]

my pulse is 75...that normal...it does seem to me my blood pressure is spiking at random...im going to test everyday to keep track..ill take your advice and check out my heart..im surprised the study dont recommend a heart test for everyone on TX every few weeks

[GSDgirl]

pulse and heart rate the same?  I forget. My heart rate is 90 usually and that is high

Denise

[Rockerforlife]

pulse and heart rate the same? ....

yes,at least this is my thinking.,,,90 beats a minute is high

[DoubleDose]

For whatever its worth, I never had anything remotely close to high BP before my two tx'es.  It became borderline after tx #1, and after tx #2was certified high BP.  I have been on BP meds for five years now, since ending last tx, and SVR.  I still get many chest pains, but mine is more costochondritis.  It is painful inflammation between ribs, and at the connections of ribs to spinal column.  When my stress levels are high, I feel like my ribcage is being crushed, and like a spear is poking through my mid to upper back.

  I also have developed painful shoulder joints, pains in various tendons, especially calves, thighs, forearms and hands.  I workout regularly and watch my diet, all of which makes little difference in my symptoms.  I get red, burning cheekbones when I work too much, have too much stress, or a little too much sun...very Lupus-like, and when I get that symptom, it comes with fatigue, brain fog, and balance abnormalities.  Just a few of my post-tx fun experiences.  In spite of it all, I manage to live a full and pretty demanding, exciting life, and run a high profile consulting business...so I am not whining....just stating facts.   I am happy that at least the HCV has gone bye-byes.  

Best wishes to all of you.  Check out the costochondritis as one potential culprit when experiencing recurrent rib and chest pains that the doctor says is NOT heart or lung related.  One way of checking is that for me, moving my spine or ribs in certain ways, or exaggerating the twisting of my trunk, will trigger painful rib symptoms.  Its mechanical for me, and probably related to autoimmune type forces inflaming the connective tissues...just as happens in Lupus.

DoubleDose

[jmjm530]

Sorry Bobby. Hopefully you will be seeing a cardiologist soon. I only glanced at this summary from Mayo but definitely sounds like something to be on top of right away.
http://www.mayoclinic.com/health/pericardial-effusion/DS01124

[Bobby1952]

  I say my Liver Dr yesterday for my 1 year post tx visit. He was pretty straight forward saying there is no way to really know if the Interferon caused this. But he agreed it is a possibility because of the Throat problems I had for a long time while on tx.
  
   Monday I get the Echocardiagram and then it takes about a week for it to come back. Then I see the Pulminary Dr again and I have a Appointment next week with the Cardioligist. My Liver Dr says that if the Echo shows any fluid they may have to stick a needle in a drain it. This doesn't bother me because I just want them to fix it. Will keep you posted.

[Bobby1952]

   Does anyone know what the heck this guy " abbas__new" is talking about in this post. I have no idea what he is saying.

[jdwithhcv]

I'm not sure but it very likely is intended to support his theory that NOBODY should treat with interferon.  That has been a continuing theme in most of his contributions.

Hope you feel better soon.  I am glad to see your doctors are taking action.  I will be on the lookout for your results.  Good luck.

jd

[meakea]

Are you particularly nervous about being at the dental office?  If so (and a lot of people are), that could account for your higher BP at the dental office.

I am rather embarrassed to admit that I have acquired a phobia about going to the doctor's office.  Each and every time I go to a doctor, my heart starts pounding and my heart rate increases the minute I reach the parking lot.  Every time my BP at the doctor is 145/90 or thereabouts.  At home, my BP is always on the lower side (100/68 in the evenings and around 115/75 in the mornings).  Because of my doctor anxiety, I am sure to take my BP readings at home regularly so that when I go to the doctor I can tell them that the higher readings in their office are not normal for me.  I've been this way for years and I remember exactly the day it happened that I got this doctor phobia.  I was sitting at my GYN doc's office waiting to hear the results of a cervical biopsy (scared I can cancer).  The nurse took my BP and it was high for me at that time (130/85) and she made a HUGE deal about that to me and started talking about strokes, etc.  She actually scared the **** out of me about my BP on top of the fact that I was already scared that I might have cervical cancer.

From that point on, my BP kept getting higher and higher each time they took it until it was common for me to have 160/90 at their office.  I was convinced I had high BP and I couldn't quit thinking about it.  Finally, I purchased a home machine and found that when I didn't feel that horrible anxiety that I felt at the doc's office, my BP was totally fine.  

Long story but I guess I was just venting my experience with a lousy nurse that has caused me discomfort every time I go to the doctor.  You'd think I'd be able to rationalize this and stop being this way but, no matter what I do to calm myself down, it doesn't work.  Sad.

[meakea]

I wish you the best with this.  Please let us know how this all turns out.