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Anyone up for a differential? May be heart-related?
I didn't know where else to post this. I'm wondering if anyone else has had similar symptoms AND found a cause? I don't know what the cause is yet, but doctors are currently thinking "heart". I've done a 24hr Holter monitor (awaiting the analysis), and am currently wearing a loop monitor for the next two weeks.
A month ago, I was perfectly normal. For all intents and purposes, I was in perfect health. I do have MVP, but was told (about 8 years ago, when it was discovered during a test for HCM, after my sister was diagnosed with the condition), it was nothing to worry about. (I was told I do not have HCM.) I also have occasional atrial flutter.
Other than the MVP, I was pretty healthy. I am female, nearly 50-years-old, and have never had a serious health problem. I eat a disturbingly-healthy diet, exercise every day, have never tried any illegal drugs, don't drink alcohol, and take no medications. I was sailing along without a care in the world.
One day, I woke up and did some exercise, had a nice breakfast with my husband, and chilled on the couch afterwards, playing a game of solitaire on my iPad. Out of the blue, I suddenly:
- felt like I was losing consciousness,
- my eyesight went blurry, I had difficulty focusing,
- my heart started pounding,
- I felt like I wasn't getting enough oxygen,
- my muscles started trembling,
- I went cold, then had whole body shivering, with
- nausea and
- diarrhea.
My body was screaming at me that I'm about to die. Obviously, I didn't die, and I have never actually lost consciousness.
Subsequent episodes have lasted 1-5 minutes. I have had more than one episode in a day. Individual symptoms can come and go all day. However, I have had a few days, in the past two weeks, where I've felt nearly perfectly normal.
While I still have transient, individual symptoms, my last acute episode was two weeks ago. As luck would have it, the day before, the day of, and even the day after, my 24hr Holter monitor, were days where I felt completely normal (for the first time since the episodes began). Alas, I do still have individual symptoms, and managed to catch some of the heart pounding, heaviness, and general discomfort, on my loop monitor, last night.
More info:
- vitals are all in normal ranges after episodes (and even during, if I have the presence of mind to check)
(BP typically under 100/under 70 with a high of maybe 130/100, HR 60-100bpm, temp. 35.9-37.4C)
- CBC mostly in normal ranges, a couple of slightly high or slightly low readings, but of little concern
- blood cultures negative
- ECG normal ("very good")
- no positional relevance (acute episodes occurred while sitting upright or lying on either side) (I rarely even have individual symptoms while standing.)
- not activity related (strenuous exercise does not elicit an acute episode or individual symptoms)
- and due to eyesight blurriness, had my eyes checked, and found no evidence of any disease whatsoever (and even with the continuing blurriness/difficulty focusng, my eyesight still tests 20/20)
- my scalp is often tingly/somewhat numb, especially across occiput
- I don't automatically associate transient pains with this problem, but do have occasional head pains, heart pains, and cold or hot sensations around my heart. These last mere seconds, and are not recurrent in the same spot (with the exception of the hot/cold heart sensations).
I don't think I've missed any major symptoms, so if it's not there, it's probably not part of my problem.
There are sooooooooo many conditions which fit a few of these symptoms, but not all, or really even most of them. I mean, I've never had limb numbness or paralysis. My heart rate has not gone above 120bpm (I've never seen a reading above 100). I don't have recurrent headaches. Neither my HR nor BP have been especially low, either. My temperature is always normal. I've never fainted.
I have an echocardiogram scheduled when I return the loop monitor. But, I fear, if all that turns up nothing specific, I'll be left to just live like this. So far, I've been the one pushing for tests. All the doctors I've seen seem either apathetic to my plight, or even as though they think I'm fabricating it all (given that my vitals are always fine when they check them). It's irksome, to say the least, given how disruptive this problem has been to me. I have a renewed appreciation for those who live with chronic health problems. I took my excellent health way too much for granted.
I just started driving again, recently, with two episode-free weeks behind me. But I still have the heart pounding that can even wake me in the middle of the night, the feeling I'm not getting enough oxygen, the blurry vision/difficulty focusing, random odd pains, just generally feeling "not right", with the worry a full-blown episode could occur at any time, since I don't know what's behind them, at all.
If anyone happens to have had a similar problem, and knows of a resolution (or treatment/prevention), I would dearly love to know about it. I'm kind of left to diagnose my own problem, since doctors can't easily figure out what it is; my test have come back negative so far; and maybe because I seem perfectly healthy to them when I see them, when I'm not having symptoms, they don't take it seriously. If the heart monitor results come back inconclusive, I'm not sure where I'll turn next. Both a doctor friend of mine (who lives far away) and the optometrist I saw strongly recommended I fight for an MRI or CT scan, due to the scalp tingling, transient head pains, and blurry vision/difficulty focusing. So, I'll try to do that, if this appears not to be heart related.
Thanks, in advance, for your help. :)
A month ago, I was perfectly normal. For all intents and purposes, I was in perfect health. I do have MVP, but was told (about 8 years ago, when it was discovered during a test for HCM, after my sister was diagnosed with the condition), it was nothing to worry about. (I was told I do not have HCM.) I also have occasional atrial flutter.
Other than the MVP, I was pretty healthy. I am female, nearly 50-years-old, and have never had a serious health problem. I eat a disturbingly-healthy diet, exercise every day, have never tried any illegal drugs, don't drink alcohol, and take no medications. I was sailing along without a care in the world.
One day, I woke up and did some exercise, had a nice breakfast with my husband, and chilled on the couch afterwards, playing a game of solitaire on my iPad. Out of the blue, I suddenly:
- felt like I was losing consciousness,
- my eyesight went blurry, I had difficulty focusing,
- my heart started pounding,
- I felt like I wasn't getting enough oxygen,
- my muscles started trembling,
- I went cold, then had whole body shivering, with
- nausea and
- diarrhea.
My body was screaming at me that I'm about to die. Obviously, I didn't die, and I have never actually lost consciousness.
Subsequent episodes have lasted 1-5 minutes. I have had more than one episode in a day. Individual symptoms can come and go all day. However, I have had a few days, in the past two weeks, where I've felt nearly perfectly normal.
While I still have transient, individual symptoms, my last acute episode was two weeks ago. As luck would have it, the day before, the day of, and even the day after, my 24hr Holter monitor, were days where I felt completely normal (for the first time since the episodes began). Alas, I do still have individual symptoms, and managed to catch some of the heart pounding, heaviness, and general discomfort, on my loop monitor, last night.
More info:
- vitals are all in normal ranges after episodes (and even during, if I have the presence of mind to check)
(BP typically under 100/under 70 with a high of maybe 130/100, HR 60-100bpm, temp. 35.9-37.4C)
- CBC mostly in normal ranges, a couple of slightly high or slightly low readings, but of little concern
- blood cultures negative
- ECG normal ("very good")
- no positional relevance (acute episodes occurred while sitting upright or lying on either side) (I rarely even have individual symptoms while standing.)
- not activity related (strenuous exercise does not elicit an acute episode or individual symptoms)
- and due to eyesight blurriness, had my eyes checked, and found no evidence of any disease whatsoever (and even with the continuing blurriness/difficulty focusng, my eyesight still tests 20/20)
- my scalp is often tingly/somewhat numb, especially across occiput
- I don't automatically associate transient pains with this problem, but do have occasional head pains, heart pains, and cold or hot sensations around my heart. These last mere seconds, and are not recurrent in the same spot (with the exception of the hot/cold heart sensations).
I don't think I've missed any major symptoms, so if it's not there, it's probably not part of my problem.
There are sooooooooo many conditions which fit a few of these symptoms, but not all, or really even most of them. I mean, I've never had limb numbness or paralysis. My heart rate has not gone above 120bpm (I've never seen a reading above 100). I don't have recurrent headaches. Neither my HR nor BP have been especially low, either. My temperature is always normal. I've never fainted.
I have an echocardiogram scheduled when I return the loop monitor. But, I fear, if all that turns up nothing specific, I'll be left to just live like this. So far, I've been the one pushing for tests. All the doctors I've seen seem either apathetic to my plight, or even as though they think I'm fabricating it all (given that my vitals are always fine when they check them). It's irksome, to say the least, given how disruptive this problem has been to me. I have a renewed appreciation for those who live with chronic health problems. I took my excellent health way too much for granted.
I just started driving again, recently, with two episode-free weeks behind me. But I still have the heart pounding that can even wake me in the middle of the night, the feeling I'm not getting enough oxygen, the blurry vision/difficulty focusing, random odd pains, just generally feeling "not right", with the worry a full-blown episode could occur at any time, since I don't know what's behind them, at all.
If anyone happens to have had a similar problem, and knows of a resolution (or treatment/prevention), I would dearly love to know about it. I'm kind of left to diagnose my own problem, since doctors can't easily figure out what it is; my test have come back negative so far; and maybe because I seem perfectly healthy to them when I see them, when I'm not having symptoms, they don't take it seriously. If the heart monitor results come back inconclusive, I'm not sure where I'll turn next. Both a doctor friend of mine (who lives far away) and the optometrist I saw strongly recommended I fight for an MRI or CT scan, due to the scalp tingling, transient head pains, and blurry vision/difficulty focusing. So, I'll try to do that, if this appears not to be heart related.
Thanks, in advance, for your help. :)
I've been fortunate like you to have the availability of vascular, cardiac and digestive tests, and always the tests have either ruled in or out problems. I think I read that you have MVP, and so just everyone who reads this thread. Everyone has a degree of MVP. Probably everyone has goofy heartbeats.
Given your tests, I'd rest easy and listen to ChesterCookie.
Given your tests, I'd rest easy and listen to ChesterCookie.
oh, and just to back up my differential, when you experience anxiety or panic attacks you tend to hyperventilate. It can cause every single symptom you've listed. When you overbreathe the concentration of carbon dioxide decreases in your blood leading to these symptoms. Google this and/or hyperventilation syndrome and see if it makes sense to you and your situation. Good luck!
I'm going to go out on a limb here and say that every single symptom you've listed is consistent with ANXIETY and it sounds like you've had an anxiety attack (let's presume all your other results have been normal).
While you may not have felt anxious before your first attack, that doesn't preclude you from having an anxiety attack. And now you've had one, you will likely (and rightly so) fear another one leading to these continued symptoms.
My other thought was how much had you eaten that day? Was it sufficient? A lot of your symptoms also could have been from hypoglycemia. And then the rest after that, pure anxiety and panic.
Just some food for thought. Given normal vitals (when you remember to check), this would be the most logical differential diagnosis. Think horses when you hear hoofbeats, not zebras.
Shock sounds HIGHLY unlikely. There was no blood loss, cardiovascular collapse, infection, etc. Again, I strongly believe this is anxiety. I have seen shock (I am an ICU nurse) and you just don't bounce back from it like that.
While you may not have felt anxious before your first attack, that doesn't preclude you from having an anxiety attack. And now you've had one, you will likely (and rightly so) fear another one leading to these continued symptoms.
My other thought was how much had you eaten that day? Was it sufficient? A lot of your symptoms also could have been from hypoglycemia. And then the rest after that, pure anxiety and panic.
Just some food for thought. Given normal vitals (when you remember to check), this would be the most logical differential diagnosis. Think horses when you hear hoofbeats, not zebras.
Shock sounds HIGHLY unlikely. There was no blood loss, cardiovascular collapse, infection, etc. Again, I strongly believe this is anxiety. I have seen shock (I am an ICU nurse) and you just don't bounce back from it like that.
The symptoms you describe in your first post seem to match perfectly the symptoms of shock. This is usually caused by a sudden drop in blood pressure and lack of oxygen to organs. I remember having an accident once, where a very heavy object fell onto my hand and trapped me. I suddenly felt all the symptoms you described and it was very scary. Luckily, when the object was removed, I recovered, but it took about 20 minutes.
:-)
ed34, I'm not in England, but I get your meaning about the NHS. Ours is an annoying system, too, at times. And I specifically scheduled the cardiologist appointment to immediately follow the echo., so I can get the results right away. (This is actually their normal procedure.) I did have an echo. a few years ago, at the request of my sister's cardiologist, after SHE was diagnosed with HCM. Just as you said, that tech. was quiet as a church mouse. Only my GP was allowed to give me the results. My doctor's office called to arrange an appointment, to give me the results. "Can't you just tell me over the phone?" "No." So, a week later or so, I haul myself all the way downtown, park, and wait to be seen, so he can tell me I don't have HCM. :( In his defense, he did have to tell me about my MVP, which was discovered in that echo. So...
skydnsr, thanks! :-) I am looking forward to my echo. and cardiology consult. Alas, just an hour or so ago, the cardiologist's office called to tell me there will be no technician available on the day of my appointment, and will have to re-schedule. :-( On the plus side, I will have my loop monitor that much longer, and hopefully snag more data. I mean...I don't want a more serious episode to occur, but if it's going to, it'd be great if I'm still wearing my monitor. I haven't had any really bad incidents while wearing it so far; just mild ones.
ed34, I'm not in England, but I get your meaning about the NHS. Ours is an annoying system, too, at times. And I specifically scheduled the cardiologist appointment to immediately follow the echo., so I can get the results right away. (This is actually their normal procedure.) I did have an echo. a few years ago, at the request of my sister's cardiologist, after SHE was diagnosed with HCM. Just as you said, that tech. was quiet as a church mouse. Only my GP was allowed to give me the results. My doctor's office called to arrange an appointment, to give me the results. "Can't you just tell me over the phone?" "No." So, a week later or so, I haul myself all the way downtown, park, and wait to be seen, so he can tell me I don't have HCM. :( In his defense, he did have to tell me about my MVP, which was discovered in that echo. So...
skydnsr, thanks! :-) I am looking forward to my echo. and cardiology consult. Alas, just an hour or so ago, the cardiologist's office called to tell me there will be no technician available on the day of my appointment, and will have to re-schedule. :-( On the plus side, I will have my loop monitor that much longer, and hopefully snag more data. I mean...I don't want a more serious episode to occur, but if it's going to, it'd be great if I'm still wearing my monitor. I haven't had any really bad incidents while wearing it so far; just mild ones.
For the type of symptoms you have, there has to be something significantly physically wrong somewhere. I'm sorry the doctors aren't taking you more seriously. I think that if you just keep working through the possibilities, the answer is going to have to become apparent. I'm sorry it's not an easy answer. You will have to be persistent; I don't see any alternative to that. Fortunately, your echo is scheduled for next week, so if it is a valve issue, that test should pick it up, I would think. Good luck.
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