Myocarditis - Heart Rhythm question

[mjd8366]

Dear Doctors,
28 year old male with no H.D. history, no family history (besides high chol.), good bp and good cholesterol, I don't smoke, good health, not obese

27 Dec 11 - wake up with severe nauseua and vomitting... severe dehydration and go to E.R. Kept overnight to monitor High WBC (which dropped) and hydration level (after 5 IV bags). Released next day

A day or two later I developed chest pains in various places around the left and left-center chest cavity.

A few nights later the chest pains still continuing on left chest. After a couple of nights where I felt like I had shortness of breath, I returned to E.R. EKG normal, b-dimer test came back neg.

Chest pains (same varied "left side") continue over days and i see Primary care. He does physical, says vitals and heart sounds normal, suggests not to worry about "atypical" chest pains based on history.

That night I developed a weird "strained" sensation in left chest that seemed to radiate to left shoulder. Ignored it based on previous medical advice. Previous chest pains have faded at this point.

The next night, I had similar sensations and returned to E.R.. EKG normal, a series of 5 tubes of blood were taken for tests, and chest x-rays were taken. All normal

3 days later I visited my Primary again with "unusual feeling" in left chest. On examination, he identifies a missed 10th heart beat..is unconcerned. For peace of mind, he orders 24 hour Holter and stress Echo.

I just completed a stress Echo/EKG and the cardiologists said "everything looks good". Still waiting on holter results. "Weird sensations" in left chest still come and go. Having trouble sleeping and waking up in middle of night frequently. I have been having problems with infrequent episodes of fatigue and lightheadedness as well.


1. Does this sound like myocarditis/pericarditis related arrythmia?

2. Is this arrythmia likely dangerous? How high are my chances of sudden cardiac death(real worry)?

[Koregol Prabhakar, MD]

Dear mjd8366,

Thanks for posting your query.  I appreciate the effort that you have made at providing a detailed history.

Presently, your history is suggestive of a problem in the pleura. Given your history, examination, electrocardiogram and stress electrocardiogram findings, the likelihood of heart disease is extremely low.

1. Your symptoms are not suggestive of any arrhythmia. They are more suggestive of high levels of stress that you have developed.
2. Since your symptoms are not suggestive of an arrhythmia, the chances of sudden cardiac death and further complications does not arise.

At this stage, all that you need is some counselling and few medications to relieve your stress. I would suggest that you consult your primary care physician for the same.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Prabhakar C Koregol

[CrohnieToo]

Until the doctor responds (I'm just a patient).

Altho older I had all the "normal" test results too. UNTIL we ran a 30 day event monitor. We can even have "events" we aren't aware of.

Two episodes of atrial fibrillation plus some PCVs and PACs during that 30 days.

A Holter monitor won't "catch" the problem unless the problem occurs whilst you are wearing the monitor, therein lies the value of the 30 day event monitor.