Cardiac Syndrome X

[johnevansab]

Age 35,
Congenital Heart Defect - VSD with patched valve and a couple of holes.
I have been having chest pains on and off (mostly off) for the past year - year 1/2.
The respiratory results came back with a borderline asthma.  I had slight weezing while I breathed.
I have swelling of the feet  2-3 time a week which are VERY HOT and sometimes painful.


I was placed on a puffer (I don't remember the name but it was the "newer" kind which was supposed to have less side effects).  I was on it for 8 days and I had increased breathing problems and went cynotic a couple of times.  My wife who is a graduate nurse told me to stop - which I did.  I went back to the internist after a month and a half.  He prescribed me Qvar.  

After a week I felt a little better.  My swollen feet hadn't appeared for two weeks!  I went on holidays and was amazed at my health.  I was able to walk and hike for miles without being winded.  I thought this is the best thing ever.  Within 2 days of being back from holidays but I still had 7 days of holidays I started to have chest pains.  I thought I was having a heart attack they were so bad and went to the emergency room.  A number of times.  I saw my family doctor who told me to see the internist and the internist did lots of test:
Stress Test - normal
Pulmonary effusion - normal
xray - pulmonary blockage???
Troponin levels 0.1
Creatin levels - normal
Co2 levels - within range but on the higher side

He thought I might have hypertension.  He sent me to a hyptension specialist.  The specialist did almost the same tests... to the conclusion that my heart is okay and my lungs are good.  He stated the likelihood that I have hypertension is close to nill.

I now have started to have mucus production and my lungs are super sensitive to the cold.  They had not been before sensitive to cold or humidity before.

I gave up on myself and said that I was finished.  I stopped taking Qvar and within 4 days started feeling a little better!  That dumbfounded me.  My heart stopped doing on and off irregular beats.  The pain points subsided.  The pressure in my chest felt a little better.

I went back to the family doctor and saw an alternate doctor at the medical clinic and she gave me some antibiotics to clear a possible infection in my lungs (even though they sound clear).

My mucus production is down but my lungs are still sensitive to the cold and I still have some chest tightness.  My feet are starting to feel a little hot again but not painful.  I have minor pain in the heart area, and I am still tired (Most days).

Cardiac Syndrome X?
Car Accident in February?
Could QVAR execerbate Cardiac Symdrome X?

Any thoughts?

[grendslori]

Can you explain what the x-ray report means when you say a pulmonary blockage? When is your cath scheduled for?

[johnevansab]

I wish I could post my stress test results here then you could look at it.

[johnevansab]

The Hypertension Specialist Doctor wasn't being funny.  He said that I should not use Nitro.  He alluded it could be damaging.  He even went so far as to say it does not save anyone if they did have a heart attack - that it only alleviated the pain symptoms.  He said it could all be in my head.

I told my doctors I am okay with it being in my head - just fix it.  Just not with pain management practices - no covering up pain.

I saw a new doctor a few days ago.  She has taken eastern medicine as well (chinese medicine).  She recommends that I come see her at her private practice and have some accupuncture.  She said at minamum it would alleviate some of the pain.  She did an "Alternative" medicine module as an internist and she said the doctor which she followed showed her a complete different side to medicine.  I'm all in for anything which is going to make the pain go away permanently without pills.

[grendslori]

The causes of chest pain would show up on the stress test and would have been easily seen in the S-T portion of the EKG, so I would have to ask what kind of doctor was Dr A? A cardiologist? Internists are not cardiologists, so I would question his reading. Nitro works by opening up the arteries so they are more than a pain killer for the heart (I take it the doctor was being funny) The fact that you got some relief, tends to make one think that there is some kind of problems; doctors always use the response to drugs as a way of finding a diagnosis.

[johnevansab]

I should have put this as well.  I had two stress tests.  

Test One:
Doctor A read the report and said it was normal.

Test Two:
Internist A read the report and said it was abnormal.  
Hypertension Specialist A read the same report and said it was normal - stated maybe I was not fit enough.

I am 5'7", 142lbs and slim.  I lead a sedetary lifestyle (computer programmer) but I do take time out for walks and bike rides.  I did before this all started.

I have not had an angiogram yet.  That will be done in the new year... hopefully sooner rather than later.

My cholesterol is currently normal - 8 years ago it was a little high and was brought under control within 2 months by changing my eating habits.  No more fast food for me.

If I take a nitro pill the pains subside for 15 minutes, but it doesn't work right away.  The hypertension specialist told me not to take nitro pills because they mask any problem.  He said they basically are a pain killer for your heart.

[johnevansab]

The Internist initially thought I had asthma.  I saw an asthma specialist and had some tests done.  The results were that I had borderline asthma.  That is when the internist prescribed the puffers.

The pains did not subside.  The internist sent me to a hypertension specialist where I saw the asthma clinic again for tests.  The asthma specialist said that a 2 percent deviation from being on puffers versus not on puffers could be explained by a patient trying harder for the last test.  The asthma specialist said she would not recommend any asthma medication.

One I stopped the puffers - my pains subsided by half - back to where it was before taking the puffers.  However now the pain is much more constant rather than on and off.

I should state I have never smoked, and don't do drugs (including alcohol).

[Trackermom]

Have you looked into asthma?

[grendslori]

Forget the idea of Cardiac X Syndrome; with that there is an abnormal stress test and a normal angiogram; your stress test was normal. Could the drugs cause the problems? The fact that you improved after stopping the drugs would tend to make anyone think so. See your doctor and sort this mess out.