Pregnant and not sure if this is any type of cardiac issues, advice please...

[LosingMyMindInGA]

Sorry if this is long but I need to give some background info..I don't know if this is all related or not but I'm putting it all out there just in case.

OK so for years, as far back as I can remember, occasionally I get this achy feeling or pain in my chest around the heart area. By occasionally I mean may be once every several months.  Even more rare I get this really sharp stabbing pain in the same area that makes me stop in my tracks and I can't even bend over til it's gone...but it only lasts a few seconds.  Docs have blown it off or told me it was indigestion or heatrburn.  

During my last pregnancy I developed a varicose vein in my right leg at the end of my 2nd trimester.  It started in the front where my leg joins my hip and runs inward towards my crotch, around the inside of my leg and onto my rigth outter labia.  Other than being very unsightly and mildly tender it didn't cause any problems and went away immediately after birth.

Now with this pregnancy it showed up around 13 weeks, same place.  This time though it gets really tender and the whole right side of my pubic mound gets swollen, my leg tends to feel heavy and/or achy.  I noticed several weeks ago I had a "dent" along one of the surface veins on my shin on the same leg.  I showed my obgyn and he said it was a collapsed surface vein and the same one in my left leg is doing the same thing.  He attributed it to whatever pressure is causing the vericose vein.  

Now, wednesday night I didn't sleep well, kept waking up and EVERYTHING ached, every muscle, every joint.  When I got up thursday morning I hurt so bad all over, I was having BH contx before I even got out of bed.  I threw up pretty hard just one time that mornign but I was running a fever between 99 and 100.4 the whole day.  I had also been feeling like I had to do #2 but never could do anything.  At 130 I went to my ob.  My BP was fine and my HR was normal (72 If I remember correctly).  My cervix was closed, they monitored the contx and babys HR and baby was fine, in the 160's like normal, contx were mild so determined them as just BH even though they were moderately painful.  He gave me an an antibiotic and told me to get some milk of magnesia and take it becuase it would help relax my uterus.

Around 5 I was feeling a bit better, contractions had almost all but gone..just one or two every now and then.  I went ahead and took 2 tbsps of the Milk of Magnesia to a) help my uterus but mostly b) to see if it would help me go #2.  Around 6:30 - 6:45 I started having these waves or intense pain in my upper back between my shoulder blades unlike anything I had ever felt.  They would start of mild and build in intensity until it was around a 7 or 8 on the pain scale, it would stay that way for 30-45 seconds then fade out.  A few minutes later another wave would come along.  Sometimes I would feel the pain up into my neck and into my left shoulder and sometimes it would cause a pain/ache i my heart area along with a knot-feeling in my breastbone.  I also had mild shortness of breath during them.  Well my mom said it sounded like it could be the signs of heart trouble.  DH and I opted to go have it checked out.

Since I'm 22 weeks they sent me to L & D who pretty well blew off everything I said.  They checked my temp which at first was 98.8 but I had just drank some room temp water.  They hooked me up to the contraction, heartrate monitor for the baby and did my heartrate and BP.  When I first got there I was still getting a few waves of the pains.  The first time they did my bp/hr my bp was elevated a little, not out of normal range, but higher than normal for me, my HR was 133 and babys hr was running high 170s to low 180's.  The nurse waited a few minutes and took my temp again it was 99.1.  She attributed the high heart rates to the temp.  They monitored me for awhile then called my doc who said give me tylenol and send me home.  

I got to thinking about this last night and I realized that my Temp was HIGHER when i went to my ob earlier that day and mine and babys heartrate and my bp were normal.  But when i went to L & D and was having those pains, it was all higher, however, as the pains started going away while I was there, the heartrates and my bp went down and back to normal.  That seems a little strange to me.  

My question is...does this sound normal? Should I bring this up to my ob at my appt on the 19th?  Maybe ask to have some tests done like an EKG or something to make sure there ISN'T a problem with my heart? I'm fine right now, but that really freaked me out.

Also, the beginning of 2009 I was told I had slightly elevated cholesterol but a few months later another doctor look at the same results and said it was fine.  

Any advice or experiences would be greatly appreciated, again sorry this was so long.

[LosingMyMindInGA]

Thank you for the input.  

[grendslori]

While you are pregnant, they probably won't want to do any testing. After your baby is born you can ask to have an EKG, a 24 hour Holter and a stress test along with an Echocardiogram. I'm not saying they will be willing to do these tests. You didn't say anything about your parents or siblings, if there was any heart disease there anywhere. CAD and blocked arteries generally take about 20 years to develop. The type of pain you are writing about is not consistent with heart disease so i don't think a doctor will do the testing based on those symptoms. take care

[LosingMyMindInGA]

There is a lot of history of heart related conditions in my family. Great Gdma died of pulmonary embolism at age 47, Great GPa died of heart attack at 77 (he had coronory artery disease), my grandmother and grandfather both died of heart failure with complications from COPD, and my uncle had congestive heart failure and died from a massive heart attack.  My grandmother and great grandmother both had several children with no issues.  But later one died in her 40's the other in her 50's.  So apparently pregnancy is not always an onset for problems.

I'm not saying you are wrong, I just don't want to end up like them, I don't to find out too late that it was somethign that needed looking into.  I guess the whole point of my post was wanting to know what types of tests I should ask my doctor to have done to give me peace of mind that nothing is wrong.  I would rather know beyond a shadow of a doubt that I was just being paranoid, for lack of a better word, than for something to happen later.

[grendslori]

I feel a bit compelled to write on your post, not only as someone who has worked in the cardiology field, but also someone who has her own heart issues as well as having a young daughter who has been through chest pain and a heart transplant. I have a few things to add. If you had a problem with true heart related chest pain, you would have never been able to have gone through so many pregnancies; the OBs wouldn't have wanted to risk your health. During my second pregnancy I developed a gallop murmur (a sign of heart failure), neither of my pregnancies were easy and I was put on complete bed rest. Heart related chest pain is caused by a lack of bloodflow to the heart muscle which means you have to have clogged arteries (Coronary Artery Disease) or some form of Cardiomyopathy (heart muscle which is diseased). Sometimes, a congenital form of heart disease can result in chest pain, but even as common as that is in babies, chest pain is still VERY rare in those children. Congenital heart disease and the Cardiomyopathies would be noticed by a doctor listening to your heart due to the types of distinct murmurs that they cause. Coronary Artery Disease (CAD) would be affecting your life on a daily basis, even before you became pregnant and after you became pregnant would definitely have worsened; you wouldn't have missed that one, and neither would your doctor. Your BP, HR and temp are all normal; a temperature isn't considered being a true temperature until it reaches 100.5+ so even that was normal. Your baby's HR is also normal, which, had you been running a temp, the baby would have been affected by that. The type of pain and the duration also do not point to heart related chest pain. You are more than likely doing just fine.

[LosingMyMindInGA]

Thank you for your response however I don't appreciate you assuming that I'm some paranoid anxiety ridden pregnant woman who freaks out over every teeny twinge.  I am not one to run to the doctor for every little thing.  If anything I probably don't go as often as I should.  I have had back problems of various degrees from pulled muscles to massive bruising to ribs out of place to ripped ligaments....this was not a muscular or ligament type pain.  As my post stated I have had some aching and pains prior to my pregnancies but nothing like this. Unfortunately in this small town I live in we all might as well provide our own health care becuaes if we don't research and insist on testing, etc, nothing would ever get done.  

I have been pregnant enough times to know about the excess blood volume and other things you mentioned.  Unfortunately it IS hard to describe something over a computer and as I stated in my previous reply I'm not asking anyone to diagnose me, I'm simply asking if anyone else has experienced anything like this and if so what it may have been.  

In reply to your statement "if your heart had a problem your doctor would definately know about it" - I sincerely beg to differ, there is no way for him to know abuot it without having testing done I don't know what doctors your wife went to but the obs I've always used don't routinely check the mothers heart health unless there is cuase for it.

Just becuase your wife was anxiety ridden and a bundle of nerves through out her pregnancy does not mean every pregnant woman is the same way.   I may be a little paranoid abuot this but frankly when it comes to something as serious as potential cardiac or vascular problems I dont' think one can be too cautious.

[ed34]

You have reminded me of the three pregnancies my wife went through. Wow they were times I have tried to forget, apart from the births that is. My wife was continually asking me if she should go to the hospital, due to all kinds of things. My full time job was convincing her that everything was fine and she was bound to feel some odd things going on. Sometimes her back would give stabbing pains, but this is so common during pregnancy. I think if it wasn't for the fact she was pregnant, she would have been on a bucket of vallium every day to calm her nerves, anxiety isn't a strong enough word. The way to look at it is this....
Your heart was working fine before you was pregnant, and if it had any problems they would definitely come to bare when you are carrying a child. Your heart is now pumping more blood around the body, so you can supply your child. It's working harder so the child can be oxygenated, fed and have all waste products removed. Your kidneys are working harder to remove the extra volume of waste, in fact your whole body has adapted in a fantastic way. With all these changes, you are bound to feel different. If your heart had a problem the doctor would certainly know about it, and your baby is not in stress because its heart too is good. Anxiety causes all kinds of problems, even pains and I know it isn't easy to control but you mustn't let it take over. Of course its a mothers instinct to worry about the child inside when they feel something odd, but I really don't think there's anything wrong with your heart.
I used to say to my wife "we want the baby to come out saying theres my mum, not thank god im out of there".

[LosingMyMindInGA]

No I didn't get any results from the laxative, but I hadn't eaten anything all day thursday becuase I felt like crud.  Plus when I threw up thursday morning, I could see everything I had eaten since wednesday at lunch had come back, it looked like nothing had digested.  I haven't had the pain since other than a few very mild intermittent aches in the left side of my chest.  I know you guys here can only guess, but I figure it doesn't hurt to see what others experiences or suggestions are.  As for the temp being the cause of the high heartrates I honestly don't think my temp was high enough at the time to cause that.  As I said my temp was higher earlier that day when i went to my ob and both heartrates and bp were fine.  Temp was lower when I went to L & D but I had the pains and everything was higher.  I don't know, maybe I'm just being overly paranoid.  


This is my 8th pregnancy (2 resulting in 1st trimester miscarriage) and I've never experienced anything like that before, during pregnancy or otherwise so I guess it just freaked me out.  The fact that I like in a small town in the middle of nowhere doesn't help. Docs around here are famous for not taking a patient seriously or ignoring symptoms.  I guess I really just wanted to know if it sounds like something I should push the issue on and demand testing or if I should jsut let it go.  Becuase Its gonna be a big deal if I have to put my foot down with the docs.

[twopack]

I have no idea what your collective symptoms mean.  Only a doctor can tell you that even though I do understand you wouldn't be hanging around here if your doctors had done a better job at listening to you.  Two thoughts come to mind.

First, pain and/or anxiety will cause your BP and pulse to rise.  You are right that they also rise with fever.  Maybe your temp wasn't elevated enough?

Intestional gas can cause what is called referred pain in areas outside the abdomen.  It's not uncommon to feel it up between your shoulder blades and even into the shoulders.  Part of the colon lies close to the diaphram.  If the colon is distended from constipation or gas it could push on the diaphram and cause referred pain to the shoulder.  (People complain of this ALL the time after laproscopic surgery when the belly has been distended with CO2 by the surgeon.)

Of course, pregnancy pushes everything even further up into your abdomen and toward the diaphram.  You said you were constipated and took a laxative.  Did you get results?  Did the pain stop after that?

If the pain continues you certainly should try to get another doctor's attention and find out what's going on for sure.  We can only guess here.