Heart related?

[MariaBanelli]

I am currently being investigated by a Cardiologist and am waiting for a CAT scan. A few days ago we went camping but because I am so tired, we just did some light walking. After two days every muscle in my limbs are in agony and so is the back of my legs and arms. I am too weak to even pick up my little dog and hold him. I am 55 normally very fit. I rock climb, cycle at least 20 miles a day and swim four times a weak normally. Could these new symptoms be related to my heart? I don't smoke, seldom drink and I am around 120lbs and 5ft 5'

[MariaBanelli]

Thanks Achillea, I will keep this post updated.

[achillea]

Yes, doctors are rushed these days.  Our economies have made deliberate, thoughtful medical practice difficult for everyone, and--be it well noted--that includes doctors who went into the business with high idealism.  Without sounding too much like a sexist pig, I would dare to observe that women of a certain age who without dramatic, even cartoonish symptoms, are likely to be brushed off.   Even by female doctors!

Fortunately (or unfortunately), your symptoms had real drama.  I do hope this fact leads to good treatment and a nice outcome.

[MariaBanelli]

Thanks Achillea,

You are absolutely right in what you say. Sometimes though, getting a doctor to listen to you isn't that easy. At one point I had to insist a doctor paid attention to what I was saying instead of rushing through his 2 minute slot with me in an impatient fashion. Whilst I appreciate that doctors are rushed off their feet, if they don't know all the facts and all the symptoms, why would they go down all the avenues?

I really hope it is a neurological illness and not pulmonary fibrosis.

[achillea]

Sometimes, what looks like heart trouble is not that. You were obviously  worried about your family's significant cardiac history, but doctors are supposed to look at all possibilities, and the combination of symptoms and a detailed personal history always give excellent clues.

Overall, what you recounted here strongly suggested neurological troubles, especially your symmetrical, generalized muscle pain and increasing limb weakness (and even to some extent your breathing difficulties).  These symptoms are suggestive of neurological diseases like Guillain-Barre and MS, but they can also be caused by exposure to toxins.  Your all-important history of living on boats and having long term contact with toxic and lung-obstructive substances pointed your doctors in the direction they are now taking with you.

I hope you get more answers and effective treatment soon.

[MariaBanelli]

First off, thanks everyone for taking the time to write. I didn't reply as I ended up in hospital and have just come home today.

I called 111 with my symptoms and they immediately sent an ambulance. I have spent the past four days going through tests as an inpatient.

ECG was clear
FVC was greatly reduced whilst laying flat.
Infection was ruled out.
MRI showed up patchy ground glass in R mid zone of lungs.
This means I am now being investigated for Pulmonary fibrosis :(

They have taken lots and lots of blood and will be checking for things like copper levels. Unfortunately we spent years living on a boat yard where fibreglass and copper paint.

I'm also now under a Neurologist who is going to be doing some nerve tests on me, hopefully next week.

I'm under a Repository specialist who wants to be with me when I go in for my CT angio and I'm under a Cardiologist.

Its like a secret covent in that place. I ended up with a note book and pen and every time I had a test, including blood pressure, I wrote things down and asked for the doctors or nurses name. I just said, 'sorry, I'm a bit dappy so just want to make sure I understand exactly what's going on. They seemed to become a lot more informative with me after that.

Still got my CT to go but that has to be at Papworth.

[achillea]

Maria, would it be possible to put the way your symptoms appeared in a chronological order?  For example, could you describe your first symptom of feeling unwell, and when it occurred?

Was it the chest tightness and tingling, or was it the muscle pain and weakness?  

Did your muscular pains start in the legs and sort of move upward?

Do you have pain in the muscles of your shoulders and chest, as well as in your legs?

Is the weakness in your arms the most recent symptom?

Did you first notice the breathlessness when walking, or did you first notice inability to breathe when lying flat in bed?

I mention this only because an orderly history can help sort things out.

[skydnsr]

I'll throw one more hat in the ring.  I'm thinking it might be aortic stenosis.  The echo will tell the tale on that one.  Maria, I would take it easy; no strenuous exercise -- no walking up flights of stairs, nothing that even makes you short of breath -- until you get some answers.  If it should happen to be aortic stenosis, it can be corrected by surgery.  We will be thinking about you.  

[achillea]

"I asked if the ECG was okay and she said it was fine but wasn't going to put me on the walking machine."

There are non-cardiac contraindications for a treadmill test.  One is high blood pressure.  The nature and location of your muscle pains might also be factors.

[ed34]

Sorry to hear about your Father. I too have had 3 attacks and got to hospital quickly as thankfully I had lots of symptoms. Strange that all my ECGs looked normal too. I too am intrigued as to what triggered them to refuse you using the treadmill and yet they let you go home. It seems to be acceptable to walk up hills etc at home but not in the test? how odd. Papworth has a pretty good reputation.

[MariaBanelli]

One thing I didn't mention was. When I had the ECG it was done by a nurse and it was meant to be a rest and exercise test. I was all wired up and told to relax and that I would be then put on a walking machine. When the nurse came back in she told me she wanted to have a word with someone and came back in saying we are going to do some further tests (echo C) and refer me to Papworth. I asked if the ECG was okay and she said it was fine but wasn't going to put me on the walking machine. I wish I had asked why not. I wish I had asked more questions but I guess I will have to wait for all the test results before I get any answers.

Thanks ed34. I'm sorry you had to wait and suffer like you did.

My dad had 3 silent heart attacks before the biggie that killed him. He had 2 ECG when he suspected he had a heart problem and both showed up normal.

[ed34]

What threw me was the pains in your legs and now it strongly sounds like the heart or pulmonary system or maybe a combination of both because one can greatly affect the other. We all know that an ECG doesn't always pick up on heart problems and this includes some heart attacks, particularly to the left rear. If I was in your shoes, next time you get any form of chest discomfort, shortness of breath or jaw ache, I would get to A&E. They will see you within minutes and run tests. I waited for various tests and by the time they realised what the problem was, I had a heart attack but luckily survived. Don't worry about getting to A&E, just call an ambulance. There are signs all over hospitals saying "feel chest pain, call 999". The first thing the hospital will do are repeat ECG's and a troponin blood test.

[MariaBanelli]

I will and thank you.

[achillea]

In this post, you have listed the relevant symptoms that led to the investigation of your heart, namely chest constriction, breathlessness, and tingling in the arms and jaw.  Those can be red flags for heart/circulatory troubles.

However, the patterns of your tingling, numbness, and muscle pain, plus the fact that the EKG was OK, point away from the heart, I believe, but your echocardiogram will give more specific information about that.

If your heart turns out to be all right, then your lung function should be investigated to find out why you are having problems with breathing.

The unusual patterns of numbness and pain you describe suggest that you will also be seeing a neurologist as part of your workup.

You have certainly presented a complicated medical situation here!  Please do keep us posted about your progress.

[MariaBanelli]

Thanks for all the replies.

I am not on Statins, though my cholesterol is on the high side.

The reason I am being investigated is, a few weeks ago I woke up in the night feeling as though my chest was being constricted. I had tingling down both arms and up into my right jaw. The constricting only lasted a few minutes. The following day the tingling down my right arm continued and the left side of my face felt numb. The sort of numbness you get after a dental block.

I know I should of seen a doctor straight away but we were away on holiday in a foreign country and I decided to wait till we got home.

The doctor gave listened to my heart and said I had a heart murmur. The ECG turned out fine but my blood pressure is high and so to be sure I have been referred for an echo cardiogram and a cat scan.

I am a very fit and active person but over the past month I have noticed an increased weakness in my arms. I normally march on when I walk the dog but I'm walking at a slow pace because I am breathless. Keep in mind I was diagnosed with asthma about 10 years ago but I haven't had any episodes of asthma for 5 or 6 years. I'm waking up at night breathless which means I'm having to prop myself up with pillows. I am using an inhaler and that helps.

I haven't had any repository illnesses lately. I believed I was in peak health. This does feel like flu though, I mean its really knocked me for six.

My dad died of a heart attack at 53 (he was a heavy smoker) and my nan died of congestive heart disease in her mid 70s.

The Cardiologist said I should call my doctor if I get any more symptoms in between the tests but I don't know if this is a symptom or just something else.

[achillea]

Your pain does not sound at all heart related to me.  The pain distribution is wrong.

Every time I've taken a statin, I have developed muscle pain, but mine has tended to be localized to specific areas, and is not a whole body situation.  Statins are not the only cause of rhabdomyolysis, of course, but you don't mention any experiences that are likely causes of this condition.

What you describe sounds like some kind of more spectacular general inflammatory condition, particularly considering that you are normally quite athletic.

If I were a doctor, I'd ask if you recently had a respiratory or intestinal illness (re their connection to Guillain-Barré syndrome).   I'd want quite a bit of blood work, too, including your Sed Rate, which checks levels of inflammation.  I'd probably refer you to a rheumatologist for more extensive evaluation.

[ed34]

Well tiredness can be associated with fatigue and according to a trial in California University, statins seem to affect energy levels of Women. In a trial 40% of the women noted fatigue. Of course statins may not be in use with the poster.

[Occupant]

It is this "I am so tired" thing that gets me. When I had severe Rhabdomyolysis from the Statin drugs that was never an issue. There is something else at work here.

[ed34]

That is strange. How was your breathing when you had the discomfort, did you find yourself short of breath? I assume they did an ECG and it was normal? For ischemia to affect the legs and arms, would mean either multiple blockages or a serious blockage in the main aortic arch. I think this is unlikely. The first thing which comes to mind with what you describe are statins, and I'm wondering if you are taking these?