Chest Pain!?!?

[ecarter202]

So coming up on almost a year now, was the first time in my life where I thought I may die. At 20 years old, this is should be more likely from driving your car too fast, or getting alcohol poisoning. Instead, it was from an experience when I was flying downhill on my mountain bike.

After riding about 7 miles, and gaining a good 1.5 - 2k ft in climbing, we started back downhill, so we could come back up. I was pushing it, trying to keep up with an avid, competitive cyclist and an ex-professional downhiller. All of a sudden, my chest gets hit with, what it felt like, a bolt of lightning + maybe some needles; a very sharp, piercing pain. We stop, and I am trying my best to stay calm to lower my heart rate. After about 10 minutes of waiting for it to go away, and it not doing so, I decide to go back to the car and drive over to the nearest emergency room. I get there, and they keep me for 7 hours.

What they found was really not that much. Enzyme levels were high (as expected from working out), but apparently they weren't in a "safe level". Also, I was slightly dehydrated, only have had drank maybe 30 - 40 oz of liquid on the ride up to that point. Those 2 things were all they found.

I consulted 2 cardiologists, had a PET scan, cardiac MRI, CT scan, of course, a few ECG's, a stress test, and the only thing they told me was: take ibuprofen. I was instructed to take 800mg/day for 2 weeks, and after the ibuprofen diet was over, got back on that bike.

Unfortunately to me, the chest pain stuck. However, this time it was only pressure, and never actually painful. I bought a Garmin 500 to monitor my heart rate, and kept it under 170 (some rides even 160 to be safe). So far, haven't had any actual pain. I didn't ride from about October to now, and after riding yesterday for 19 miles, 1k ft gain, avg bpm of 139, and getting more chest "pain", I am getting very, very scared and upset that biking may not be a competitive part of my life.



I write this only to maybe find someone who can advise me. Maybe someone who, hopefully not, has experience something similar and knew how to treat it. And also to warn someone out there who is pushing it too hard, to go at your own pace, working smart = working hard on the bike.



Thanks!!

 

[alienator]

So coming up on almost a year now, was the first time in my life where I thought I may die. At 20 years old, this is should be more likely from driving your car too fast, or getting alcohol poisoning. Instead, it was from an experience when I was flying downhill on my mountain bike. After riding about 7 miles, and gaining a good 1.5 - 2k ft in climbing, we started back downhill, so we could come back up. I was pushing it, trying to keep up with an avid, competitive cyclist and an ex-professional downhiller. All of a sudden, my chest gets hit with, what it felt like, a bolt of lightning + maybe some needles; a very sharp, piercing pain. We stop, and I am trying my best to stay calm to lower my heart rate. After about 10 minutes of waiting for it to go away, and it not doing so, I decide to go back to the car and drive over to the nearest emergency room. I get there, and they keep me for 7 hours. What they found was really not that much. Enzyme levels were high (as expected from working out), but apparently they weren't in a "safe level". Also, I was slightly dehydrated, only have had drank maybe 30 - 40 oz of liquid on the ride up to that point. Those 2 things were all they found. I consulted 2 cardiologists, had a PET scan, cardiac MRI, CT scan, of course, a few ECG's, a stress test, and the only thing they told me was: take ibuprofen. I was instructed to take 800mg/day for 2 weeks, and after the ibuprofen diet was over, got back on that bike. Unfortunately to me, the chest pain stuck. However, this time it was only pressure, and never actually painful. I bought a Garmin 500 to monitor my heart rate, and kept it under 170 (some rides even 160 to be safe). So far, haven't had any actual pain. I didn't ride from about October to now, and after riding yesterday for 19 miles, 1k ft gain, avg bpm of 139, and getting more chest "pain", I am getting very, very scared and upset that biking may not be a competitive part of my life. I write this only to maybe find someone who can advise me. Maybe someone who, hopefully not, has experience something similar and knew how to treat it. And also to warn someone out there who is pushing it too hard, to go at your own pace, working smart = working hard on the bike. Thanks!!

Was the stress test a stress test with echo? I can understand your anxiety. I've had a similar issue: a pressure pain in chest and shoulder accompanied sometimes with shortness of breath. It's been going on since about 2000-2002-ish. After going through the standard cardiac testing, I saw an orthopedist who discovered a massive arthritic area in my rib cage, both at the sternum and in the shoulder joint. It was bad enough that the doctor wanted to remove my 1st and 2nd ribs on one side, along with the distal end of the collarbone on that side. I haven't had that procedure done yet. I go through periods where that pain comes back for days or weeks, and then it goes away for weeks or months. It certainly causes anxiety since it mimics some classic cardiac symptoms, and as an ex-paramedic, I'm prone to over-thinking things. Every test I've had has come back with nary a sign of cardiac issue. I even had a bilateral cardiac catheterization done as a part of the required workup for a different surgery (not cardiac related), and the cardiologist said my coronary arteries were perfectly clean. Still, I get the anxiety, so I understand your feelings on that point. Have you seen an orthopedist for this issue? It could be worth your while since what you're feeling can also be musculoskeletal pain. Have you seen an internist? What you're experiencing can be symptomatic of GERD (gastroesophageal reflux disease). There are ways to relieve your worry. Taking anti-inflammatory meds and meds like acetaminophen (Tylenol) can reduce the pain if the pain is musculoskeletal. Make sure to take the meds according to the directions. Don't take extra (Tylenol is the most common drug upon which to overdose, and a Tylenol OD can cause liver damage or a very painful, slowish death). If you feel ibuprofen doesn't work, you might try something like naproxen (Aleve) or even aspirin instead. With the exception of Tylenol, the meds mentioned are NSAIDS and can potentially cause ulcers if taken too long or in too large doses. It's best to take those with food. Again, it's best to consult with a doc before starting new meds, even over the counter meds. As to the worry, one important test you can do is a simple one: if you can reproduce the pain or make it worse by pushing where it hurts, it's not cardiac pain. The other thing to do is to try not to worry too much. I know it's easy to say but hard to do. However, mental state has been confirmed to affect pain levels and the efficacy of pain medications. In other words, if your mental state sucks, medications for pain might not work so well. If your worried, you can actually increase the pain you feel. Let us know what happens. Good luck.

 

[ecarter202]

I appreciate the information. I would have went into more detail on the original post, but felt I was rambling on already. I do have a bad case of gerd, and have since I was born. I have to take medication for it for the rest of my life, on a daily basis. Also, I have dextrocardia; my heart is on the right side and flipped horizontally. The only thing that would pull me away from believing the pain is due to these issues, or conditions, is that I have never had any previous problems for 19 years, always being extremely active. Before the season really starts back up ill go get scoped for esophagus issues again. I'll keep this updated with new results. Thanks again, and sorry to hear about your problem as well. Sounds like a serious procedure, and hope all goes well with whatever you decide.

 

[alienator]

I appreciate the information. I would have went into more detail on the original post, but felt I was rambling on already. I do have a bad case of gerd, and have since I was born. I have to take medication for it for the rest of my life, on a daily basis. Also, I have dextrocardia; my heart is on the right side and flipped horizontally. The only thing that would pull me away from believing the pain is due to these issues, or conditions, is that I have never had any previous problems for 19 years, always being extremely active. Before the season really starts back up ill go get scoped for esophagus issues again. I'll keep this updated with new results. Thanks again, and sorry to hear about your problem as well. Sounds like a serious procedure, and hope all goes well with whatever you decide.

So I assume your lungs are also reversed? Are the rest of your organs reversed?

 

[ecarter202]

Originally Posted by alienator .


So I assume your lungs are also reversed? Are the rest of your organs reversed?

No, just my heart. However, I do have 6 lobes on my lungs instead of the usual 5; this can cause congestion and pressure against the heart when the lungs fully expand.

 

[Nitefeatherz]

I was having issues with chest pain and fluttery feelings in my chest; the doctors diagnosed me with asthma and prescribed inhalers which made everything worse. It turned out to really be mitral valve prolapse with Intermittent Positional Tachycardia...

is it possible that this is a cardiac issue that is only intermittent- and happens occasionally- and just doesn't show itself when you are sitting with the doctor???

My cardiologist missed my tachycardia for years- they only caught it accidentally during a stress test. (The stress test shouldn't have caught it either- but when I moved to do the ECG the arrhythmia finally kicked in while the cardiologist was looking.)

When they finally asked me if I had certain symptoms going on- it was stuff I'd been dealing with for YEARS and had always figured was normal...since it had ALWAYS been the case and wasn't causing any pain. I just learned to deal with it.

Certain arrhythmias can get worse if you are dehydrated- my tachycardia will get much worse if I don't drink enough water...especially when riding. I've also got to watch my electrolytes- if it is too hot or I am sweating too much that causes problems as well if I'm not careful.

If you have 6 lung lobes instead of 5, and the GERD- you may be having symptoms that are being misappropriated by what is already diagnosed.

I would be careful to drink a lot of water and if it happens again take note of EVERYTHING that is happening- what you were doing, eating, drinking, medicating with, etc...