Hi, so I’m new here and apparently I seem to be a mystery. 4 weeks ago I had central chest pain radiating into my back and tingling/numbness to my left arm. I had an ecg done which was normal and given omeprazole whilst waiting for the doctor, as they thought it may have been indigestion as I had just eaten. When the dr examined me he said only for the fact that I had left arm pain would he be running some blood tests.
I’m 36, non smoker and very active, with weight lifting and boxing 4-6 times a week. I’ve competed in white collar boxing shows and undertook several mud obstacle races. I have no risk factors and no family history.
First troponion level came back at 68, three hour came back a 436. Further ecgs were normal. I was treated as a NSTEMI until further diagnosis proved otherwise. I had a CTPA to rule out a clot on my lung as I had recently been on a long flight,and on the pill, and my d-dimer had come back marginally raised at 0.6. I had a bedside ultrasound of my heart (echo) which didn’t show anything untoward.
CTPA was clear, and I went on to have an angiogram, all again which was clear. I had a further echo before I was discharged and told I possibly had a small PFO (hole in the heart). But I would need a further echo with contrast and an MRI scan.
I was sent home with a sick note for 4 weeks stating MI, and put on clopidogrel, aspirin and Atorvastatin.
I’m generally pretty well person, however I have had recurrent chest infections and over the last two years been diagnosed with exercise induced asthma, I however only use my inhalers when I run ( which I try not to because of a dodgy knee) and if I get a bad chest infection.
My last chest infection being at the beginning of the year.
A mix up with appointments meant that I seen the cardiologist a week after I was discharged, he is still no further ahead with what’s caused any of this and he’s a few possibilities
Pericarditis
Myocarditis
Spasm
Hole in the heart
NSTEMI
He states the further echo and MRi should give him a clearer diagnosis.
Since this has all happened I’ve onviously been a little shocked, no work, no gym, no flying nothing until he can decide what’s going on. Other than being ridiculously tired I’ve been ok other than being a little emotional at times!
Although it’s a little late in the day, I have my appointment today for the echo and MRI results. I have no idea what to expect and part of me thinks it will all be clear, so where do I go from here? I’m a mystery that’s confused. How did I even get here I have no idea.
Well hopefully I have some news for later!!
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Sarahc36
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Hello, it’s always a shock to get this sort of diagnosis and it’s difficult to get your head around it too. It takes time...for tests, for results, for medication to take effect, etc etc etc. Hopefully your appointment today sheds some light on your condition and the way forward. Everyone on here is really helpful so don’t hesitate to come back with an update. If you need to discuss your case with someone who is medically qualified or just want some 1-1 support then the BHF nurse helpline is wonderful...and quicker than a GP appointment.
Yeah it’s definitely a mind field out there and I’ve done nothing but trawl the internet looking at all the possible scenarios, and possibilities and non of them still seem to add for me.
My saving grace I suppose is that I was in the right place at the right time, I’m a A&E nurse and this all happened whilst on shift, I know I’ve been given the right care and treatment but also part of me thinks are they just being over cautious as I’m one their own as such!!
When I say I have shocked the cardiologist and his team and my own consultants and team it’s not an understatement I am apparently the fittest and healthiest member in the department! I can’t even put it down to doing a strenuous session at the gym or boxing as I’d pulled a back muscle the week before all of this had happened so had done no exercise all week prior to this.
Well my appointment is later this afternoon so I will report back once I know more. I have a great support around medically with questions.
Hope all goes well with your mri etc and that you get some answers soon. I have heart failure (diagnosed age 31, 7 years ago) and mri showed a massive scar on my heart but nobody, myself included, has any idea when or how it happened. My condition was picked up at an antenatal appointment, completely by fluke and I had zero concerns about my heart health until that point. The mystery of it is very frustrating but I know we are not alone in being far from the stereotypical heart patient. There are lots of us on this forum who are young and apparently healthy...other than our wonky hearts! So there will be lots of us who can empathise with your shock and confusion. Let us all know how you get on today. Lots of love xx
Well results just in I have takotsubo cardiomyopathy, Been put on low dose ramipril and bisoprolol for 2 months and a repeat mri as LV function isn’t quite perfect but it should help.
There’s still chance it could have been a spasm but no signs of pericarditis, myocarditis or NSTEMI.
I acknowledge you must be feeling totally bewildered. The emotional impact of coming to terms with what has happened can take sometime.
The ' fallout ' can be considerable.
Do tell to your GP or Cardiac rehab nurses if you feel you need further support. Some hospitals have a Cardiac Psychologist to help.
Cardiology is not an exact science and it can be actually quite difficult to diagnose a heart attack.
Most are due to permanent blockages another group about 10% are Myocardial infarction non obstructive coronary arteries MINOCA
Usual causes:
Vasospastic angina with Microvascular and coronary artery spasms.
Spontaneous coronary artery dissection
Takostubo cardiomyopathy/ syndrome.
Takostubo cardiomyopathy and Vasospastic angina are thought to be related as it is suggested that Microvascular dysfunction is the underlying cause of both conditions.
Another common theme is that all these unusual causes of a MINOCA are more common in younger fit women.
It is good news that you have a diagnosis and the Cardiologists had the sense to treat you appropriately and did not dismiss your symptoms because you were younger woman with no risk factors. It is really important to establish a good relationship with your Cardiology team.
Hopefully you will with time and medication improve. I live with vasospastic angina and also have no risk factors and puzzled quite a few Cardiologists over 6 years ago when I was admitted with a suspected heart attack.
There is growing research and understanding of Takostubo cardiomyopathy and I am sure someone else with the lived experience of the condition will chip in with their advice too.
Thank you, and yeah you are right we are the worst type of patients 🙈.
It’s definitely hard to get my head round, and somewhat more now as I feel like I’ve dealt with a lot of shall we say stress type issues in my life and never had an issue...
Just finding it hard to understand why now and not before as such. I guess though it’s part of the process looking for answers and reasons, some which I guess I will never really have!
They seem to think my recurrent chest infections may have something to do with it, but I still feel like they are ruling out the major problems and just concluding with this as they don’t have much else to go on! However I’m hoping the medication and repeat mri in 2 months will clear some of this up.
I’ve looked at what Dr Dawson does and will probabaly drop her an email and see if I can help at all with her studies.
Hello again. I’m not sure about being happy or not but I think a diagnosis can give you a bit of peace of mind that you’re not a mystery and there’s a tried and tested way forward.
A useful link in addition to those above is Cardiomyopathy UK
Thanks... you’ve all been fantastic, why I didn’t get on this 4 weeks ago i’ll Never know but glad I have now!
Thanks for the links also! My bedtime reading is getting busier by the minute.
I’m hoping it will help eventually, I do feel somewhat a bit of a fraud though as it went round work, family and friends albeit not by me that I’d had a heart attack and now feel silly for saying well actually it’s not!
Something I guess i’ll Have to come to terms with! The funny thing I suppose in all of this that it’s a stress event.... and all of this is making me stress! But I just have to take one day at a time and roll with it!
Now onto looking at how these tablets might effect me and if I should jump on a flight somewhere for some peace and quiet.
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