Feelings like may be going to have heart attack in chest

[ayoung]

I have had these feelings quite often since I have been diagnosed with PMR. Also after one year of taking prednisone, starting at 25, presently at 2, am starting to have all symptoms over again. My body pain was 0 until I got down to 2mg.

[SheffieldJane]

I had the symptoms you describe before I was diagnosed. I was taken to the local hospital from my GPs surgery where I was put on a heart monitor for 24 hours. Nothing irregular was found. When I complained weeks later of palpitations and jaw pain accompanied by a doomy feeling, I was put on a heart monitor to walk round with again 24 hours and nothing untoward. It's important that thorough checks are done for you. However, my guess is that it is related to your body/ Adrenal system straining away to manage without The steroid boost. There may be a case for returning to your last " pain free" dose of Prednisolone . To be safe you need to be checked out though and anxiety is a major side effect of Prednisolone. Best wishes a young.

[Roltuba in reply to SheffieldJane]

Thanks ayoung for sharing this one and for all the fascinating replies. I have the same symptoms from time to time - otherwise I'm a fit but frustrated 68 year old male (despite the PMR) with no strength in his arms and shoulders, but down to 7.5mg from 15 and holding! When I saw my GP about this pain several months ago (which only occurs when I'm at rest) he sent me off to the rapid response heart unit at Worcs RH, (and told a fib that it came after strenuous exercise), when I passed all the tests (treadmill at max included) with flying colours. Now I've been told to not make a fuss. He knows very little about PMR so I'll share this story with my Rheumatologist when I next see her in October. Thanks fellow forum members for providing, for our medics, so much helpful information (deep irony intended).

[PMRpro Ambassador]

Then you have probably got to the dose you need to manage the symptoms we call PMR - the underlying autoimmune disorder that is the cause of PMR is still active. All the pred does is manage the symptoms to give us a decent quality of life until that burns out - it is not a cure and is required until remission happens. That means you are not reducing relentlessly to zero - you are reducing to find the lowest dose that manages the symptoms. You have probably found it.

You have been VERY lucky to have been able to reduce to well below 5mg without any problems in a year. But now you probably need to go back to 3mg, wait a while and then try again. It doesn't mean you won't get lower - just not yet. And it may take another year or two for that to happen but without trying another reduction every so often you won't know. Did you have raised ESR/CRP when the PMR was diagnosed? Have you had them monitored over the last year? If symptoms are starting to reappear then that is a sign that the inflammation isn't being managed fully and is starting to build up again - and the ESR/CRP may reflect that. Not necessarily already though - they take a while, often lagging behind a bit. But if the trend is they are creeping up, you need a slightly higher dose.

As for the heart symptoms - I developed paroxysmal atrial fibrillation (that means it comes and goes) almost certainly as a result of the autoimmune part of PMR which has damaged the electrical cells that govern heart beat. I had seen the GP repeatedly about the "palpitations" but he could find nothing - my pulse was regular whenever he saw me and he put it down to age. My BP was also always fine when checked, I was complimented on it! Until I was admitted to hospital and the treatment I was given triggered a massive a/f episode. Once that was sorted out I realised that the episodes I had had for the last several years were gone - they had been short episodes of a/f. Unless they are monitoring you at the time it won't be seen on the ECG trace - and mine were very intermittent. My GP had suggested that when it happened I call 999 - which I thought was rather OTT. It isn't though: paramedics carry an ECG machine and are there in a few minutes, often quickly enough to get a trace with the evidence even if it only lasts a short time - it never happens at the surgery when you have an appointment! But it does need investigating and not just with a one-off or even 24-hour ECG - unless it happens while it is being done.

[Greensleeves in reply to PMRpro]

How strange, I've been to the GP this morning again as I started having pain between my ribs a month ago . I presumed it was gastric and doubled my omeprazole. Nothing eased it . Last Saturday I was up all night with chest pains. Like being crushed in a vice . It was horrendous and I'm not a baby when it comes to my pain threshold.

I've hardly eaten as I thought hiatus hernia or gall stones.

GP is taking it very seriously so I had an ECG and blood tests at the surgery. ECG was ok but I know these aren't foolproof.

Going back on Wednesday for blood results and then echo followed by Endoscopy if that's clear .

54 years old , PMR 4 years now and on maintenance dose of 5mg pred as life is so stressful being a carer . This illness thrives on stress as your know .

I never had the raised blood markers and rheumatologist said quite common in younger people with PMR .

Hope you get some answers .

[PMRpro Ambassador in reply to Greensleeves]

You too! Not a nice experience - and one that would have had me dialling 999! I'm assuming it is a bit better now?

Yes - I keep harping on about young patients often being "atypical" and I'm sure that is why so many in their 40s are simply missed or told it's fibromyalgia/depression/"your age" whatever. All not as in-your-face rude as telling the patient it is all in their head - which a lot of them think. I told the GP I did realise that was what he was thinking - I think he had the grace to blush...

[Greensleeves in reply to PMRpro]

Yes it's improved but I am living on the edge as the pain came from nowhere and I don't want to experience it ever again. I've been told off for not ringing 999 but I stupidly sat it out hoping it would pass and all would be well .

Strange how some of us can behave so irrationally due to fear .

I've been given strict instructions to ring the emergency services immediately if it does.

Well done for telling your GP you realised what he was thinking. I hope he's learned from you .

[PMRpro Ambassador in reply to Greensleeves]

I should jolly well think so! My MIL used to say she always waited 3 days to see if a pain went away - I pointed out if it was a heart attack she would probably be dead!

Apart from any other consideration - there is a window for doing the fancy new techniques for dealing with clots and they aren't that long. And ambulance crews prefer not to have to dash in at high speed with the poor paramedic in the back being slung around all over the place as they try to keep you alive long enough to try the fancy stuff! My daughter is one...

[Greensleeves in reply to PMRpro]

Good lord it's pretty scary stuff .

Hopefully the blood tests will shed some light and this GP is very thorough.

He will leave no stone unturned. Let's hope it's not gall stones then !

I did wonder about embolism's . The workings of the mind eh .

Your daughter is a saint .

[PMRpro Ambassador in reply to Greensleeves]

I have 2 pretty scary daughters! The other one was all over the papers last week for holding on to someone who'd fallen in the Thames and saving her life. Can't let them out alone!

[Greensleeves in reply to PMRpro]

How wonderful, you've done a good job , both brave and giving something back to society ! You must be so proud. It's the parenting . x

[PMRpro Ambassador in reply to Greensleeves]

I'd like to think so. At one point their cousin who markets alcohol was earning more on her own than they earned together. Her brother is on silly money as a PR person. There's something wrong somewhere!

[Greensleeves in reply to PMRpro]

I agree , the money is so unfair when you make comparisons to say a City broker and the good they bring into the world .

[pmrdec112014 in reply to PMRpro]

I saw that article!!! Its a smalk world!!

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My first visit to ER ekg normal but the doctor heard the pause. I was skipping a beat about 2-4 times a minute. Wore a monitor for 24 hrs and was given another pill to slow my heart rate down.

Once I got down to 20 mgs it all seems fine now still on the new med. I truly believe it is all prednisone induced.

I had such a feeling of doom I had given my son all my info on banks insurance etc...

[Shastring]

Hi Ayoung,

Thats what scares me, Im 64 and diagnosed with pmr five months ago, possible gca and under care of both rheumy & neuro opthomologist.

Started on 25 mil and totally pain free for two months, started slow taper by 2.5 mil 6 weeks ago and about 95% pain free and now they want to go down another 2.5 and Im afraid that as I taper more pain will return but I guess we have to get to the most tolerable at the lowest dose. Im going to visit my kids for a week and told the Dr I will not taper until I get back to Florida where I live and he said ok. He even told me that should I get worse to up the dose to where I was but Im not comfortable doing this on any regular basis and just waiting til I get home.

It sure feels like a roller coaster of a journey!

Good luck,

Sharon