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Respiratory Disorders (Expert Forum)
What further tests are warranted for atypical chest pain, SOB, lightheadedness
Answered by
MN
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What further tests are warranted for atypical chest pain, SOB, lightheadedness
by waffles69, Jun 13, 2008 04:01PM
Hi- I am a 30 year old male, I am obese but not ridiculously obese...I'm about 70-80 pounds over ideal weight. My chest always feels funny like something is pulling at it from the inside, and I get extremely lightheaded and weak...as well as from walking up a single flight of stairs I will be left breathless, and often with near syncope...just from a flight of stairs. I also awaken frequently from my sleep short on breath, and sometimes with sinus tachycardia of 160 as evidenced by my event monitor.
I went as far as a stress test that showed mild anterior hypokinesis and LAD ischemia, but then had a cardiac CTA which was squeaky clean with calcium score 0. Chest xray normal, BNP normal, Thyroid Liver and CBC/CMP normal, SED rate 0. Mild mitral and pulmonic regurgitation on Echo.
I cannot stress enough how horrible I feel with the pulling at the inside of my chest, weakness and lightheadedness. Other things that started when this did was that my pulse began resting in the low 40's at night, and I also started having hard palpitations at times which also give me near syncope. I even exercise 30 minutes a day and I don't feel any better except for a short time.
Sometimes I wonder --- Since all these tests I've had were normal, could perhaps there be a subtle imbalance of a certain chemical or mineral in my body, something not detected by the usual CBC and CMP.
I remember a story on TV about someone with that disease which causes excess copper to build up in the body (I know that's not what I have), but I wonder about a similar situation which is subtle and undetected -
Do you have any thoughts for me?
I went as far as a stress test that showed mild anterior hypokinesis and LAD ischemia, but then had a cardiac CTA which was squeaky clean with calcium score 0. Chest xray normal, BNP normal, Thyroid Liver and CBC/CMP normal, SED rate 0. Mild mitral and pulmonic regurgitation on Echo.
I cannot stress enough how horrible I feel with the pulling at the inside of my chest, weakness and lightheadedness. Other things that started when this did was that my pulse began resting in the low 40's at night, and I also started having hard palpitations at times which also give me near syncope. I even exercise 30 minutes a day and I don't feel any better except for a short time.
Sometimes I wonder --- Since all these tests I've had were normal, could perhaps there be a subtle imbalance of a certain chemical or mineral in my body, something not detected by the usual CBC and CMP.
I remember a story on TV about someone with that disease which causes excess copper to build up in the body (I know that's not what I have), but I wonder about a similar situation which is subtle and undetected -
Do you have any thoughts for me?
Doctor's Answer
by National Jewish Health, Jun 16, 2008 05:57PM
, Jun 16, 2008 05:57PM
Being 70 to 80 lbs over ideal weight would be sufficient to account for your shortness of breath, especially if associated with poor physical fitness, but the mitral and pulmonic regurgitation might be more of a factor than the report of "mild" would suggest.
With a pulse of 40 at night, your symptoms might also be due to abnormal cardiac rhythms. You didn't mention cardiac monitoring and you should have that done. You should also be checked for obstructive sleep apnea.
You might also want to have your adrenal glands checked.
Finally you could have a circulatory problem with impaired venous return or a problem with reduced tone of arterial blood vessels, either of these leading to hypotension, commonly called low blood pressure. You should also have your blood pressure checked with postural change and with exercise. Should you be having recurrent hypotension you might, during these attacks, be having a reduction in coronary artery blood flow, to account for your chest pain.
Good luck.
With a pulse of 40 at night, your symptoms might also be due to abnormal cardiac rhythms. You didn't mention cardiac monitoring and you should have that done. You should also be checked for obstructive sleep apnea.
You might also want to have your adrenal glands checked.
Finally you could have a circulatory problem with impaired venous return or a problem with reduced tone of arterial blood vessels, either of these leading to hypotension, commonly called low blood pressure. You should also have your blood pressure checked with postural change and with exercise. Should you be having recurrent hypotension you might, during these attacks, be having a reduction in coronary artery blood flow, to account for your chest pain.
Good luck.
