Chest Pain

[middy]

I have had chest pain & sob for 4 years upon exertion.  I'm 70, female and normal weight.  Had ALL testing including 2 heart caths - one to exclude pulmonary hypertension. ECHO had PA 50 & rt. heart cath was normal.  Stress test  - "very poor functional capacity, continually dropping BP which prompted a tilt table "positive" for vaso vagel syncope.  Heart cath showed Diastolic dysfunction and relaxation of left ventricle.
I suffer upper back pain, hypothyroid, migraines.  I take 30mg of Inderal, thyroid,  previcid, .3 premarin.  I'm extremely fatigued, can't sleep, RLSand everlasting chest pain.  The drs don't know what is causing my pain but suspect costochondritis and fibromyalgia.  My life is spent lying on the couch.  
Could you please help, I don't like being an invalid.

Florence

[Advocate]

I had suffered fro several years with SOB and pain on inspiration and expriation. Told I had "anxiety" finally found that I had repeated pulmonary emboli with markes atelectasis in three lobes; excellent treatment (120 miles away) at MCV, found a benign retroperitoneal mass that was causing the clots to form due to pressure on the vena cava; bld pressure was consistently 150/75, PFTa, lung CT, VQ all said I was WELL on May 8 ... but then I got sick, REALLY sick... SOB, fatigue, bld presssure was HORRIBLE 160/130, 150/110 consistenly high diastolic, chest pain ... different from PE pain, negative troponin, pulse ox was about 91 just walking; VQ was suspicious... pulomonary angiogram showed moderate pulmonary hypertension but the lungs were clear..no clots; ECG ok. Everyone was stumped THEN I got a letter from Rite Aid that I had received the counterfeit Lipitor. I stopped the fake stuff ... stopped all lipitor and four days later pulse ox was 99 and I felt MUCH better however my bld pressure has remained unimproved even though we added catapress patch. Still suffer fatigue ... My getup and go got up and WENT!Could it be that fake lipitor, docs can't find out what was in it yet? Any ideas, echo next week checking for CHF which is highly suspected.

[CCF-M.D.-KE]

Dear Middy,

Sorry to hear about your episodes of chronic pain and SOB.
Without examining you it is difficult to make specific commments, however I can make some general suggestions.
You do not have blockages in the heart arteries according to your heart catheterization. However, you do apparently have diastolic dysfunction on your echocardiogram. Diastolic dysfunction can be a cause for shortness of breath. Beta blockers are the standard treatment for diastolic dysfunction which you are already taking. I would also encourage some type of exercise.

It does not sound as if your chest pain is coming from your heart, thus other causes should be explored. The pain could be from the chest muscles or bones or even the gastrointestinal (GI) tract could be the cause. Hope you feel better.


Thanks for your question,


CCF-MD-KE

[Ianna]

Hi ZW,
-
It makes perfect sense to me...
-
Thanks - *Ianna*

[ZW]

I'm sorry too that that many women are put on HRT to protect against heart disease, or combat cognitive difficulties arising from heart surgery and heart disease. The second study I cited explains why that's a crock.

Many people, both men and women, take statins to lower cholesterol in the mistaken belief they prevent heart disease. They do not. In fact statins cause heart disease, and muscle aches and pains as well as a multitude of other symptoms. ZW

-----------------------------------------------

From Red Flags Weekly
Article by Dr. Peter H. Langsjoen MD.

"In my practice of 17 years in Tyler, Texas, I
have seen a frightening increase in heart failure
secondary to statin usage, "statin
cardiomyopathy". Over the past five years,
statins have become more potent, are being
prescribed in higher doses, and are being used
with reckless abandon in the elderly and in
patients with "normal" cholesterol levels. We are
in the midst of a CHF epidemic in the US with a
dramatic increase over the past decade. Are we
causing this epidemic through our zealous use of
statins? In large part I think the answer is yes.
We are now in a position to witness the unfolding
of the greatest medical tragedy of all time -
never before in history has the medical
establishment knowingly (Merck & Co., Inc. has
two 1990 patents combining CoQ10 with statins to
prevent CoQ10 depletion and attendant side
effects) created a life threatening nutrient
deficiency in millions of otherwise healthy
people, only to then sit back with arrogance and
horrific irresponsibility and watch to see what
happens - as I see two to three new statin
cardiomyopathies per week in my practice, I
cannot help but view my once great profession
with a mixture of sorrow and contempt.

Langsjoen article to FDA
http//:www.fda.gov/ohrms/dockets/dailys/02/May02/052902/02p-0244-cp00001-02-Exhibit_A-vol1.pdf


"The peer-reviewed scientific evidence supports
the following findings:
1. Statins block the endogenous biosynthesis of
both cholesterol and CoQlo by inhibiting the
enzyme HMG CoA reductase, thus decreasing
mevalonate, the precursor of both cholesterol and
CoQio.
2. CoQlo is essential for mitochondrial ATP
production and is a potent lipid soluble
antioxidant
present in cell membranes and carried in the
blood by LDL. CoQl 0 is biosynthesized in the
body and available fiom dietary sources.
3. Statin-induced decreases in CoQlo are more
than just hypothetical drug-nutrient
interactions.
Good evidence exists of significant CoQlo
depletion in humans and animals during statin
therapy.
4. Scientific evidence confirms the existence of
detrimental cardiac consequences from statin-
induced CoQlO deficiencies in man and animals."

Merck patent on Coenzyme Q10 dated 1989:
Patent # 4,933,165

http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&Sect2=HITOFF&d=PALL&p=1&u=/netahtml/srchnum.htm&r=1&f=G&l=50&s1=4933165.WKU.&OS=PN/4933165&RS=PN/4933165

Lovastatin induced heart problems:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2247468&dopt=Abstract
OR:
Proc Natl Acad Sci U S A. 1990 Nov;87(22):8931-4.
PMID: 2247468 [PubMed - indexed for MEDLINE]

"The five hospitalized patients taking lovastatin
evidenced an increase in cardiac disease from
lovastatin, which was life-threatening for
patients having class IV cardiomyopathy before
lovastatin or after taking lovastatin. Oral
administration of CoQ10 increased blood levels of
CoQ10 and was generally accompanied by an
improvement in cardiac function.

[arthur]

I'm sorry...I thought this was a forum to exchange personal
opinions and experiences...it's not a platform, it's a forum.

[ZW]

I'm sorry too ....... my personal experience involves being put on statins to protect against heart disease and being disabled by side effects. My symptoms are similar to those in the post I answered. I wanted to share that experience and my opinion is just that, so I included medical citations to allow anyone reading my post who may be having a similar experience some knowledge about adverse effects of drugs they may be taking.

If you post here just to be discordant and facetious you are not helping anyone.

ZW

[Momto3]

Not to worry...The doctors on this Forum are great about answering questions.  Hang in there....I'm not sure why all the statin stuff ended up under your question....Hmmmm!  Have a great day!

[middy]

I was hoping a doctor would give me some answers about my inquiry.  I do not take STATINS and never had.
Florence

[ZW]

Are either of you taking, or have taken, statins? The symptoms you describe, including "fibromyalgia", (which only means muscle aches) can be caused by statins. ZW

Please click on and read these documents:
Statins
http://www.dispace.com/message_boards/drugs/Lipitor/_disc70/00000e0e.htm

Premarin
For more information about the study, go to http://jama.ama-assn.org/cgi/content/full/289/20/2651

More news came out today from the Women's Health Initiative study of menopause hormone therapy.  In a substudy published in the Journal of the American Medical Association, researchers concluded that women taking a combined menopause hormone therapy were more likely to develop dementia than women taking the placebo.  Below, please find the National Women's Health Network's statement about these new results.

--
National Women's Health Network
Tuesday, May 27, 2003

HORMONE THERAPY DOUBLES RISK OF DEMENTIA
NETWORK CALLS FOR CURBS ON DRUG COMPANY INFLUENCE OVER PRESCRIBING

Ten months ago, we learned that combined menopause hormone therapy increased the risk for breast cancer, heart attack, blood clots and stroke (JAMA.  2002; 288: 321-333).

Two months ago, we learned that combined menopause hormone therapy offered no benefit for mood, sexual function or vitality (N Engl J Med2003; 348).

Today, we have learned that combined menopause hormone therapy doubles
the risk of developing dementia (JAMA. 2003; 289: 2651-2662).

These study results pose two questions for us.  The first is what will women do?  And the second is why didn't we have this information earlier, before tens of thousands of women had been harmed by using unproven drugs?

Now that we have the information, women will weigh it in light of their individual health needs and histories and will make the best decisions they can for themselves.  Knowing the risks, some women may still choose to take hormone therapy for temporary relief from hot flashes or to prevent bone fractures, but no woman of any age should use this drug regimen for any other reason.  Women must demand that any doctor recommending menopausal hormone therapy support that recommendation with strong, scientific evidence from a randomized control trial proving that the drugs are effective for the reason they're being prescribed.

Women can, and will, take on this responsibility.  But they shouldn't have to.  In this country, our medical and drug regulatory systems are supposed to guarantee us high quality care and assurances that the drugs prescribed to us are safe and effective.  But these systems have failed women because political pressure has prevented effective regulation of the pharmaceutical industry.

Combined hormone therapy has been promoted for almost twenty years for long-term use by healthy women.  During this time millions of women have used it and each year tens of thousands of women have suffered serious harm, including breast cancer, blood clots, heart attack, and even dementia, as we have just learned.

The die-hard defenders of hormone therapy will claim that the study results don't apply to all women or all hormones.  But there's no evidence for those claims.  And after decades of selling unproven drugs to women, it's long past the time when women can accept such claims based on faith.  We must demand evidence to support the drugs being prescribed to us.

"We have to ensure that our regulatory agencies have the resources they need to protect us and we have to demand that doctors prescribe based on evidence, not on drug company marketing," says Cynthia Pearson, executive director of the National Women's Health Network.  "Health care providers and drug regulators have been unable to rein in drug company marketing and women have suffered."

The Food and Drug Administration has made science-based decisions about hormone therapy, but the agency does not have the authority or the resources to stop the drug companies when they stretch the truth, distorting the facts and misleading health care providers and women.  Doctors have let women down by not practicing evidence-based medicine. If doctors are going to deserve the place of trust they command, they
must accept the charge of seeking independent evidence for claims made by drug companies.

Health care providers often lack the time and motivation to seek out independent sources of information about new drug developments and instead have come to rely heavily on marketing materials, sometimes disguised as educational resources.  Drug companies have used every marketing tool imaginable to persuade health care providers and women that hormone therapy drugs offer important, desirable and yet unproven benefits.  Drug sales representatives make weekly visits to doctors' offices bearing free drug samples, office supplies emblazoned with brand-name logos and expensive gifts.  Drug ads fill medical journals, saturate medical conference materials, and are embedded in medical education lectures, paid for by drug company sponsors.  Drug companies influence the vast majority of information that health care providers receive.

This marketing investment has paid off in billions of dollars of profit at the cost of harming tens of thousands of women.  This has to change. It's time to curb drug company influence.  The Network calls for the elimination of drug company money from medical education; granting FDA the authority to pre-approve drug ads; and preventing people with significant financial ties to industry from participating in the
development of professional practice guidelines.
                                ###

For science-based information about hormone therapy and alternative menopause options, get The Truth About Hormone Replacement Therapy (Prima Publishing, 2002) a book by the National Women's Health Network.

National Women's Health Network
514 Tenth Street, N.W., Suite 400
Washington, DC 20004
Tel: [phone]
Fax: [phone]
http://www.womenshealthnetwork.org

[arthur]

I'm sorry...I was looking for the HEART Forum...