Palpitation and Chest pain?

Posted by siddlebittle @siddlebittle, Jan 14 9:01am

Hello. Am Female aged 38 and otherwise good health. Experiencing some weird symptoms on and off for the past three years. Started first when I was a few weeks pregnant with my last born (2021 - mid COVID era) and started getting breathless and then suddenly one night woke up with palpitations and dull pain on left side shoulder and chest. Wasn’t a full on tightness but very hot and cold sweats. Went to emergency and they did all heart checks. EKG, echo, ultrasound. All tests were seemingly fine except blood test showed slightly elevated Troponin levels. Doctors didn’t seem concerned but palpitations and dull pain continued for a few weeks especially at night and when lying down. Then symptoms disappeared for two years. Then appeared again last year (2023). Same time of year (Feb - winter). Same palpitations, dull pain and breathlessness and again goes away after a few weeks, usually when weather gets warmer. Same again in later 2023/2024 but after a very bad flu/ virus. Palpitations strong at night, dull pain that comes and goes around chest and shoulder and arm. Sometimes feels like heartburn. Not constant. Worse at night. But feel more breathless and sometimes light headed. Pain around shoulder blade and back of neck. Chest xray clear. Some relief with Ibubrofen and hot and cold therapy. Chiropractor says left side very tight. Doctors don’t seem overly concerned and no clear diagnosis. But tightness can be very scary. Have bad posture and bit of tech neck. Any one experienced the same? Advice?

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Increased troponin levels indicate injury to the cardiac muscle. Yours could be caused simply by stress. The dull pain in the shoulder and neck are a sign of myocardial infarction in women. It could really be just tech neck and caring for children.

Find a good cardiologist. The tests are the easiest, safest way to get a "clear diagnosis." Cardiac stress, CT Angiogram, NMR lipo profile.
https://www.nytimes.com/2022/05/09/well/live/heart-disease-symptoms-women.html#:~:text=Most%20studies%20suggest%20that%20a,any%20chest%20pain%20at%20all.
Praying you just need vacation time.

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@gently

Increased troponin levels indicate injury to the cardiac muscle. Yours could be caused simply by stress. The dull pain in the shoulder and neck are a sign of myocardial infarction in women. It could really be just tech neck and caring for children.

Find a good cardiologist. The tests are the easiest, safest way to get a "clear diagnosis." Cardiac stress, CT Angiogram, NMR lipo profile.
https://www.nytimes.com/2022/05/09/well/live/heart-disease-symptoms-women.html#:~:text=Most%20studies%20suggest%20that%20a,any%20chest%20pain%20at%20all.
Praying you just need vacation time.

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Could it be related to the spine or pericarditis since symptoms only appear in winter and after a flu / virus?

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What were your Troponin levels? Above the normal range? Usually the ER tests twice. Did yours change in that time?

I would buy a Kardia mobile, a small credit card device that gives you an EKG at home. You put two fingers on either side of it and wait 30 seconds. You could also wear a monitor but since the episodes are infrequent that might not give answers. Some people use an Apple watch. A Kardia can also be reassuring in some instances.

Since pregancy was a trigger, you could look into a hiatal hernia, which can cause palpitations. https://www.mayoclinic.org/diseases-conditions/hiatal-hernia/symptoms-causes/syc-20373379

If your Troponin increased significantly past normal range that is a different story. Mine was lightly above normal on second test after an episode of afib. I was told that did not indicate damage. Perhaps your palpitations also raised the Troponin without damage. A cardiologist could tell you.

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@siddlebittle

Could it be related to the spine or pericarditis since symptoms only appear in winter and after a flu / virus?

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Yes.
There are so many preferrable causes for your symptoms than MI. But if you are passing clots, simple remedies could alleviate the hazard, and the symptoms.
More heart attacks happen in winter cold. I have similar symptoms in the neck and upper shoulder around the blade from the spine. Thank goodness for chiropractics.
It could be wise to rule out cardiac issues.

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@siddlebittle Hello. I would like to welcome you to Connect. Of course consulting a cardiologist is important when you have chest pain or palpitations. It can be possible to have these symptoms from other issues that are not heart related. Having a tight left side may indicate a problem like thoracic outlet syndrome and that may cause arm pain and shoulder blade pain symptoms and breathing issues. If you also have a cervical spine issues, you may also have neck muscle spasms that can tighten up the area between the neck and shoulder.

I do have TOS and cervical spine issues and had a C5/C6 fusion. TOS may affect breathing and tightness can physically restrict the expansion of the chest. I have done myofascial release to treat this and get my rib cage moving properly or closer to normal again. I have had chest pain caused by muscle spasms and stretching with fascial release has relieved it right away. Patients should not diagnose themselves. If heart issues have been ruled out, a physical therapist who does MFR therapy may be able to ease some of the tightness and pain.

Here is a link to our Myofascial release discussion. There is a provider search at http://mfrtherapists.com/

Neuropathy - Myofascial Release Therapy (MFR) for treating compression and pain
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Bad posture causes symptoms with TOS by having forward slouching posture that further compresses an area that is already compressed. Compression points are between the scalene muscles on the side of the neck and under the pec minor muscle going into the arm pit. Turning the head can cut off circulation to the arm. My hands used to turn blue and purple and get cold to the touch. Some patients can pass out from turning their heads. Many doctors miss this diagnosis. Typically TOS symptoms are increased at night because of either compressing the shoulder if a side sleeper or neck posture positions or sleeping with an elevated arm raised around should height. A forward head and neck position exacerbates symptoms. Doctor who do diagnose TOS are often thoracic surgeons and Mayo is a good place for this evaluation. When I was evaluated, they had tiny blood pressure cuffs on my fingers and by raising my arm and turning my head they demonstrated a big drop of blood pressure. When they listened to my pulse in my neck, and I turned my head, that pulse stopped. Here are a few links.

https://mskneurology.com/how-truly-treat-thoracic-outlet-syndrome/
https://my.clevelandclinic.org/health/diseases/17553-thoracic-outlet-syndrome-tos
https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988

Have you heard of thoracic outlet syndrome before?

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@windyshores

What were your Troponin levels? Above the normal range? Usually the ER tests twice. Did yours change in that time?

I would buy a Kardia mobile, a small credit card device that gives you an EKG at home. You put two fingers on either side of it and wait 30 seconds. You could also wear a monitor but since the episodes are infrequent that might not give answers. Some people use an Apple watch. A Kardia can also be reassuring in some instances.

Since pregancy was a trigger, you could look into a hiatal hernia, which can cause palpitations. https://www.mayoclinic.org/diseases-conditions/hiatal-hernia/symptoms-causes/syc-20373379

If your Troponin increased significantly past normal range that is a different story. Mine was lightly above normal on second test after an episode of afib. I was told that did not indicate damage. Perhaps your palpitations also raised the Troponin without damage. A cardiologist could tell you.

Jump to this post

I'm not familiar wth Troponin and I'm not a medical person. I agree that a visit with a cardiologist is a good idea. The kardia mobile device is also an excellent suggestion. I had palpitations off and on for a long time. I told my dr. and she sent me for a variety of tests: ekg, echo cardiogram, stress echo, etc. I was even given a halter monitor to wear. All came back normal. Problem was I wouldn't have symptoms while I was being tested. I got a kardia mobile and used it when I did have symptoms. The result said atrial fibrillation or afib. I was not convinced yet every time I had symptoms I got the afib result. I saved the results and printed out several. My primary care Dr. referred me to a cardiologist who looked at the print outs and evaluated my symptoms. She diagnosed me with afib and I was referred to an electrophysiologist who prescribed medication. It's now under control. Obviously, this is no substitute for seeing a medical professional. I wish you well.

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@daphne17

I'm not familiar wth Troponin and I'm not a medical person. I agree that a visit with a cardiologist is a good idea. The kardia mobile device is also an excellent suggestion. I had palpitations off and on for a long time. I told my dr. and she sent me for a variety of tests: ekg, echo cardiogram, stress echo, etc. I was even given a halter monitor to wear. All came back normal. Problem was I wouldn't have symptoms while I was being tested. I got a kardia mobile and used it when I did have symptoms. The result said atrial fibrillation or afib. I was not convinced yet every time I had symptoms I got the afib result. I saved the results and printed out several. My primary care Dr. referred me to a cardiologist who looked at the print outs and evaluated my symptoms. She diagnosed me with afib and I was referred to an electrophysiologist who prescribed medication. It's now under control. Obviously, this is no substitute for seeing a medical professional. I wish you well.

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@daphne17 Troponin is an enzyme that is released from heart muscle when it is damaged. In the emergency room, they test for troponin in the blood to determine damage to diagnose a heart attack. If you go there complaining of chest pain, they test you for this.

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@jenniferhunter

@daphne17 Troponin is an enzyme that is released from heart muscle when it is damaged. In the emergency room, they test for troponin in the blood to determine damage to diagnose a heart attack. If you go there complaining of chest pain, they test you for this.

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With all the testing I've had, I never knew that. Thank you.

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@jenniferhunter

@siddlebittle Hello. I would like to welcome you to Connect. Of course consulting a cardiologist is important when you have chest pain or palpitations. It can be possible to have these symptoms from other issues that are not heart related. Having a tight left side may indicate a problem like thoracic outlet syndrome and that may cause arm pain and shoulder blade pain symptoms and breathing issues. If you also have a cervical spine issues, you may also have neck muscle spasms that can tighten up the area between the neck and shoulder.

I do have TOS and cervical spine issues and had a C5/C6 fusion. TOS may affect breathing and tightness can physically restrict the expansion of the chest. I have done myofascial release to treat this and get my rib cage moving properly or closer to normal again. I have had chest pain caused by muscle spasms and stretching with fascial release has relieved it right away. Patients should not diagnose themselves. If heart issues have been ruled out, a physical therapist who does MFR therapy may be able to ease some of the tightness and pain.

Here is a link to our Myofascial release discussion. There is a provider search at http://mfrtherapists.com/

Neuropathy - Myofascial Release Therapy (MFR) for treating compression and pain
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Bad posture causes symptoms with TOS by having forward slouching posture that further compresses an area that is already compressed. Compression points are between the scalene muscles on the side of the neck and under the pec minor muscle going into the arm pit. Turning the head can cut off circulation to the arm. My hands used to turn blue and purple and get cold to the touch. Some patients can pass out from turning their heads. Many doctors miss this diagnosis. Typically TOS symptoms are increased at night because of either compressing the shoulder if a side sleeper or neck posture positions or sleeping with an elevated arm raised around should height. A forward head and neck position exacerbates symptoms. Doctor who do diagnose TOS are often thoracic surgeons and Mayo is a good place for this evaluation. When I was evaluated, they had tiny blood pressure cuffs on my fingers and by raising my arm and turning my head they demonstrated a big drop of blood pressure. When they listened to my pulse in my neck, and I turned my head, that pulse stopped. Here are a few links.

https://mskneurology.com/how-truly-treat-thoracic-outlet-syndrome/
https://my.clevelandclinic.org/health/diseases/17553-thoracic-outlet-syndrome-tos
https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988

Have you heard of thoracic outlet syndrome before?

Jump to this post

I too have had chest pain caused by muscle spasms and stretching along w/ left arm/ pain and when I turn my Neck I feel as if I could Pass out. @jenniferhunter
As I've been reading more of your progression on your diagnosis Jennifer, I honestly feel I need to address the TOS To Mayo when I go, even though my family Practitioner say, my T Spine is in good standing, but Cervical Radiculopathy/Spinal Stenosis is to the extreme. Back In January 2023 I was working again ended up in ER W/ what totally felt as a Heart Attack, my manager had to drive me, and after all heart testing everything was Good and they even recommended Stress Test, Echo. EKG And so on. Later to discover it was From my C-Spine and my Ribs are always out of Place and Chiropractic discovered my pelvis is always shifted @ 40 degree and has to be realigned, which then can and does cause pressure in ribs/ lungs, and my breathing, hence, feeling like a Heart Attack.. All this being stated will be Addressed @ Mayo. I am so Thankful for all on here that share their Trial and Tribulations, and continue to respond respectfully.

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@wil24

I too have had chest pain caused by muscle spasms and stretching along w/ left arm/ pain and when I turn my Neck I feel as if I could Pass out. @jenniferhunter
As I've been reading more of your progression on your diagnosis Jennifer, I honestly feel I need to address the TOS To Mayo when I go, even though my family Practitioner say, my T Spine is in good standing, but Cervical Radiculopathy/Spinal Stenosis is to the extreme. Back In January 2023 I was working again ended up in ER W/ what totally felt as a Heart Attack, my manager had to drive me, and after all heart testing everything was Good and they even recommended Stress Test, Echo. EKG And so on. Later to discover it was From my C-Spine and my Ribs are always out of Place and Chiropractic discovered my pelvis is always shifted @ 40 degree and has to be realigned, which then can and does cause pressure in ribs/ lungs, and my breathing, hence, feeling like a Heart Attack.. All this being stated will be Addressed @ Mayo. I am so Thankful for all on here that share their Trial and Tribulations, and continue to respond respectfully.

Jump to this post

@wil24 Susan, Yes, asking about TOS while you are at Mayo is a good idea. They will refer you for an evaluation to a vascular lab. I think the doctor I saw there was Dr Shepherd. It was in the Gonda building and so was my neurosurgeon, so it was easy to get there.

I am similar to you in that my pelvis goes out of alignment with one side being pulled forward due to tightness on one side of the body from my neck to my pelvis. It is tight through the rib cage and restricts expansion. This is what my physical therapist works on with stretching and Myofascial Release to loosen everything and get it back where it belongs.

TOS is not a spine problem, but it occurs next to the spine where nerves leave to spine and travel between scalene muscles and then between the collar bone and rib cage. My TOS was aggravated by the cervical spine surgery causing inflammation in the same area, and I had to bear with it for awhile in healing before I could go back to PT. My surgeon did let the PT address breathing issues about 2 months after surgery with instructions not to touch my neck. It did cause pain as scar tissue was tightening up after surgery. I finally put my hands on my chest near the collar bone and pulled down to alleviate the pain by stretching it, all without touching or moving my neck. I was in a neck brace and no spine hardware waiting for the fusion process to start. There is surgery for TOS in some circumstances, but it usually isn’t recommended because scar tissue from the surgery can make it worse. With cervical spine surgery, you may have increased tightness anyway in close proximity to the thoracic outlet (brachial plexus) area. That would be something to ask about. It sounds like the spine issue is the bigger problem and that is how it was for me which they determined during the evaluation.

FYI another reason for palpitations or Afib could be high levels of thyroid hormones and anxiety to a degree. They will probably check the thyroid in your work up.

If you have questions about this, please ask.

Jennifer

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