Are chest pains normal during dialysis?

[pdbetterhalf]

My husband started hemodialysis in April of this year after being on PD for a little over a year. Within weeks, he started being hospitalized for dizziness and large drops in blood pressure. Recently (over the last 6 weeks), he has been sent to the ER from dialysis 3 times because he's having chest pains from his chest around to his back and radiating up to his jaw. His left arm (with the fistula) and hand have also gone numb. He is always tired. None of the testing shows a heart problem. His nephrologist says it is acid reflux, but his gastroenterologigst disagrees. The nephrologist refuses to consider that the problem has something to do with this. Has anyone else experienced chest pains?

Thanks!

[cs65 NKF Ambassador]

I did experience chest pain during dialysis and my blood work suggested a heart attack, so they sent me to the cardiac unit at a major hospital. An echocardiogram found I had Takutsubo cardiomyopathy, where the left side of the heart balloons out and does not beat normally. I also began to develop low blood pressure from the meds they gave me at the hospital. It took about 3 days before they could do a cardiac catheterization because I couldn't swallow. That ended up showing one 70% blockage in a coronary artery as well as smaller blockages, so they began treating me with a statin and a daily low dose aspirin for those. My local cardiologist prescribed carvedilol for the cardiomyopathy, which I was able to take for a while, plus I went to cardiac rehab. I did completely recover, but I had to stop taking the carvedilol because I started having low blood pressures during dialysis. Eventually they put me on midodrine to raise my blood pressure during dialysis on as as needed basis. I would keep exploring cardiac causes for your husband's chest pain.

[pdbetterhalf in reply to cs65]

Thanks so much! That is very helpful information. He was admitted to the hospital 2 days ago with the same symptoms, and the doctor's have decided to do a cardiac catheterization tomorrow. Does having the cardiomyopathy affect you ability/eligibility for a transplant?

Thanks again!

[cs65 NKF Ambassador in reply to pdbetterhalf]

I was already on the transplant list, so they just put me on inactive for the 6 months to recover, then put me on active again. What that that means is they couldn't call me for surgery during that 6 month period. I've been on the transplant list for 3 years now. My cardiologist had to approve me for surgery again. The hardest part of the cardiac catheterization is having to lie straight on your back for many hours afterward. There shouldn't be much pain - they put the needle in the groin area (femoral artery) in my case. It all depends on what they find in your coronary arteries - major blockages may have to have stents. Good luck to both of you!

[pdbetterhalf in reply to cs65]

They found a minor artery in the back wall of the heart was 80-90% blocked and inserted two balloons. They said that dialysis made this artery too still to install a stent. He has to start cardiac rehab in a couple of weeks, and he is inactive on the transplant list now until he is cleared by the cardiologist. Thanks so much for responding to me. You gave me information which made it easier for me to explain what was going on to my husband which made him more hopeful as well.

[cs65 NKF Ambassador in reply to pdbetterhalf]

Oh, good! I'm glad that helped! I've been thinking about you two and hoping that things were going well. Take care and I hope he has a speedy recovery!