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Thread: Chest Pain

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    Default Chest Pain

    I am a newbie here, so hello all!

    Monday morning (at about 2:30am) I woke up with horrible chest pain right in the middle of my chest. It felt almost like a muscle spasm and the pain actually woke me up. This has happened before and I went to the emergency room thinking I was having a heart attack. (It is THAT painful) The ER doctor ran an EKG and told me I was too young to have a heart attack (36). What a crock. Anyway...I didn't go to the ER this time because I also had a migraine and didn't want to sit there just to be dismissed again. ( I have an appointment with my Rheumy on Friday)

    My question is... Have any of you experienced this and, if so, what did you rhuemy do about it? I read that it can be anything from GERD to heart problems. I'm a little scared. I think I will push Dr to recommend a cardiologist just to make sure and to put my mind at ease.

    Any info you could share would be great!

    Cyndee

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    Saysusie is offline Super Moderator Super ModeratorEmperor of the Universe
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    Hi Tumbleweed:
    Yes, what you are experiencing is not uncommon and many people with Lupus suffer from chest pains for serveral reason. Both my daughter and I had chest pains. Hers was due to pericarditis. Here is a brief explanation of pericarditis:
    Pericarditis is an inflammation of the sac around the heart, it is the most common heart involvement in people with lupus. This condition occurs when antigen-antibody complexes-also known as immune complexes-are made during active lupus and cause inflammation within the pericardium.
    Symptoms are sharp chest pain that can change with changes in the body's position and frequently may be relieved by leaning forward slightly; this chest pain may feel like a heart attack! Occasionally, shortness of breath can occur.
    Pericarditis can occur in conditions other than lupus, therefore the cause must be determined before treatment begins. To help diagnose pericarditis, the following tests may be ordered:
    blood tests
    chest x-rays
    electrocardiogram (EKG)
    echocardiogram (ultrasound of the heart) can tell if there is fluid around the heart.

    My chest pains were from Pleuritis; below is a brief explanation of Pleuritis (inflammation of the lungs):
    Pleuritis (pleurisy) is the most common pulmonary (lung) manifestation in Lupus. The pleura is a membrane that covers the outside of the lung and the inside of the chest cavity. It produces a small amount of fluid to lubricate the space between the lung and the chest wall. As lupus activity generates immune complexes, they initiate an inflammatory response at this membrane, a condition called pleuritis.
    Symptoms of pleuritis are severe, often sharp, stabbing pain that may be pinpointed to a specific area or areas of the chest. Sometimes the pain is made worse by taking a deep breath, coughing, sneezing, or laughing.

    Nearly all lupus patients have chest complaints at one time or another. Most of the complaints are not related to the heart, even though they may be present in the area around it. For instance, the costochondral margins (where the breast bone, or sternum, attaches to the ribs) may become irritated and produce chest pains. Many patients think they are having heart problems, but it can be easily differentiated from a cardiac problem because the area is tender on being touched. Also, the esophagus is directly behind the heart and pressure sensations under the breast bone can result from esophageal spasm. Occasionally, patients with shortness of breath or asthma believe their pain is cardiac.
    Patients with systemic lupus erythematosus frequently have inflamed heart tissue, and as a result have a rapid pulse. This racing of the heart or tachycardia, is common in the disorder and is managed with anti-inflammatory therapies. Tachycardia may have others causes also, such as an infection. Chest pains from the heart are generally a consequence of the two conditions I mentioned above; pericarditis or myocarditis.
    Palpitations, or irregular heart beats, may result from mitral valve prolapse, Libman-Sacks endocarditis, or artherosclerotic disease.
    Lupus patients are more susceptible than others to hardening of the arteries in the heart area because of their increased prevalence of high blood pressure and elevated cholesterol levels due to steroid therapy.
    Lupus can affect the heart in a variety of ways, ranging from infection to inflammation, and these can produce numerous symptoms and signs. There are inexpensive and noninvasive procedures, such as an EKG or 2-D echo, that can be used to identified and appropriately manage any heart manifestation as a result of lupus.
    I hope that this has been helpful!
    Peace and Blessings
    Saysusie

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    The one time I had such severe chest pain that I was literally doubled over, it was (of course) during off hours when my rheumy's office was closed. My husband took me to the ER, but there was such a long wait, and I was moaning with each breath I took (it felt better to lean forward and exhale), so we left there and he took me to one of those Urgent Care clinics. They did an EKG and other tests, and luckily, the doctor was a woman who was familiar with Lupus. She asked some other questions and determined that I had pericarditis. She gave me an Rx for an anti-flammatory (I hadn't been taking one at the time), and within two hours the pain had all but subsided.

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    Default Re: Chest Pain

    Quote Originally Posted by TumbleweedPDX
    I am a newbie here, so hello all!

    Monday morning (at about 2:30am) I woke up with horrible chest pain right in the middle of my chest. It felt almost like a muscle spasm and the pain actually woke me up.
    Had you anything warm to drink? A lupus flare I had last year I experienced heart attack-like pain in the center of my chest and it turned out to be esophageal spasms. I noticed I would get them when I drank coffee or tea. Some people get them after drinking something cold.

    Mine just went away without treatment but some people have to take medicine for it if it is chronic.

    Ariel

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    Cyndee!

    How are you now? Did you get rid of your chest pain?
    I am a norwegian girl living in Oslo, 28 years old.

    I got SLE and Sjøgrens Syndrom when I was 19.
    I suddenly woke up in the middle of the night with terrible pains in my chest, I got really afraid. Before that I had not noticed any other symphtoms. I got my diagnose, but mye problem is that I did not get rid of the pains. They are not as bad as back then, but it hurts when I breathe in (sorry for my English, I have spent many years in Berlin, so I "lost" my English among german words....)

    So, I am very curios to find people with the same problem.
    I take medicines, but they don\t work aigainst the pain... the doctor does not know what to do, there is no inflammation at the moment (the doctor cannot find anything on the pictures) - but I have problems with sports and activity because of this and walking up stairs for example.
    Maybe you have got some good tips?

    Back then (1997) I had a pericarditis and pleuritis, which Saysusie describes.

    OsloCalling

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    OsloCalling, I can only offer some hope of relief from scare. I have the same symptoms as you are having and have had them for 20 years or more. I have found nothing to help the situation but nothing ever got any worse or caused any serious problem. I do not recommend that you try this but I got so disgusted one time that I just kept going when my breath shortened and it did not cause me any other problem but did not let up either. I get the throat closing symptom when I drink something cold only if I am thirsty and not just when I drink a cold drink.

    Melart

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    Hi! Thanks for your report and support!

    What ist the "throat closing symptom" - never heard of that...

    a doctor told me newly, that my symptoms are normal, she called it "shrimping longues". and she ment I have to live with it, but fysiotherapie (?) may help. I get worse, when I push myself, so for me it is importan not to be "overactive"...

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    Sorry: shrinking lungs

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    hi..I had pericarditis twice at the start of my symotoms. I sitll have strange and various types of chest pains. I have no idea how I would ever know if I was actually having a heart attack someday!! Also, I have neuropathy. Until recently it had only been in my limbs..causing severe cramping. Now at times I get bad cramps in odd places...a few times it has been close to the middle of my chest.

    This whole dx is so frustrating :roll:
    Christine
    current Dx UCTD, (likely SLE)
    meds, Topomax (neuropathy), Planquinil, synthroid, Athsma meds, current 7mg of steroid, Muscle relaxor for pm foot cramps (prn), Lexapro.

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    That's weird that the ER would have you wait while you were having severe chest pain. I would think that would be a reason to be one of the first seen by the doctor. That's odd??? Does anyone mnow why chest pains are not a priority in the ER? Maybe I don't know the whole story?

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