Raynauds, Norvasc and Chest Pain

My daughter is 16 years old and has secondary Raynauds(secondary to JRA). She is an athlete (intense training 4 hours a day) and her bp runs 90s/50s  and her heart rate runs 50s to low 60s. She is 5'2" and 102lbs.

Prior to being diagnosed with Raynauds she was experiencing tight chest pain and shortness of breath especially with a raynauds attack and with exercise.

Six months ago she had an echo which was normal and a PFT which was low function. Her attacks were so severe with constantly blue feet and somtimes attacks all the way to her hips that her rhuematologist put her on 2.5mg Norvasc and 375mg Naproxen twice a day. The attacks continued so she increased to 5mg Norvasc. My daughters bp actually increased a little with the increase in medication; however she was still experiencing the tightness in her chest so the rhuematologist wanted to cut back down.

I am concerned because she still experiences chest pain and shortness of breath but we have found that her symptoms actually increased when she tried to cut back on the Norvasc and if she is late on a dose she has a very difficult time the minute she exerts any energy. The tightness is bad enough that she feels like she can't stand up straight and she is very short of breath.

Could  the increase in chest pain and the shortness of breath possibly be due to the decrease in medication or  even the Raynauds ...or could there be a heart issue that has yet to be detected? With my daughter's athletic lifestyle I am not sure if it is time to revisit her cardiologist.

[Douglas Bogart, MD]

I would suggest that your daughter go back  to the cardiologist.  She may need a change in the calcium channel blocker (Norvasc)  or further testing like an exercise echocardiogram.