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Heart Palpitations Forum >> Symptoms and other concerns >> General Questions
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Message started by rebem86 on Mar 1^st, 2013, 6:31am

Title: General Questions
Post by rebem86 on Mar 1^st, 2013, 6:31am

Good Morning!

So I have been now seeing my therapist for about 2 months and I am feeling better than I have been in awhile, however, yesterday was a rough day. I had to move a bunch of computers at work for about an hour which was very strenuous. I constantly thought about my pulse and how I was feeling as this is the first serious workout I've done in months. I have only been doing walking as its all I have been comfortable doing.

However, the chest pain came back and lasted all day. It felt pretty muscular and topical to me as I was lifting 40 pound boxes up and down for about an hour. However, it was on the same left side which makes my self preservation bell go off. I worked up a good sweat, however after the pain set in I started getting back into my old nervous habits.

The thing that scared me the most is later that night right when I fell asleep I woke back up with a feeling that I could not breathe. My breathing still feels off even this morning, but I attribute that to being nervous about bloodwork I had done this morning with 12 hours of fasting. But I know that I can't have a breathing issue because I have undergone a PFT and a methacholine challenge test which both came back normal. My blood oxygen level has always been 99%. So it can't be true shortness of breath, but it sure does scare me.

My chest and back pain has been gone since they discovered I had eosinophilic esophagitis and placed me on the liquid budesonide. However, yesterdays workout that caused me pain has kind of made me take a few steps back and I am coming here for some reassurance. I was feeling so good the past two weeks that I talked with my Dr. about cutting my Xanax prescription in half (I take 0.5mg twice a day).

Also I saw a different cardiologist within the practice I normally go to to ask if I could come off the Toprol XL as I thought we found the reason for my chest pain. However, the Dr. reviewed my Holter Monitor and thought that it could be something I try but not until after I finished my prescription for budesonide as steroids could have a tachycardia effect.

So RLR what I am asking for is some direction and guidance that you have provided to me and countless members of the forum.

Title: Re: General Questions
Post by bigcountry on Mar 1^st, 2013, 10:06am

Just my 2 cents....you said "I had to move a bunch of computers at work for about an hour which was very strenuous. I constantly thought about my pulse and how I was feeling as this is the first serious workout I've done in months. I have only been doing walking as its all I have been comfortable doing."

Thoughts are energy. How could you not feel bad and get stressed when ALL YOU THOUGHT ABOUT WAS YOUR PULSE AND HOW YOU ARE FEELING" You are putting yourself under tremendous stress....when you do that it affects the physiological processes in your body, breathing becomes shallow and erratic, pulse rate increases, stress hormones released and a HOLE CASCADE OF EVENTS UNFOLD creating the feelings you have.

Next time just enjoy the day....dont think about your heart, how you feel etc.

The difference between ALL OF US and people who dont have anxiety is they dont constantly beat the crap out of themselves mentally and emotionally!

Hope this helps!

Title: Re: General Questions
Post by JimmyJames on Mar 2^nd, 2013, 7:17pm

Good advice bigcountry! :)

Title: Re: General Questions
Post by RLR on Mar 11^th, 2013, 5:04pm

Okay, I've read your posting and concern. There is nothing of your symptoms to necessarily suggest that you are experiencing pectoral angina as a consequence of exertion. Most incidents are associated with musculoskeletal strain.

The sensation of dyspnea, or shortness of breath, is more likely due to muscle strain as well. Furthermore, it's important to realize that beta-blocker therapy, ie Toprol, tends to produce a capitated effect on cardiac force and thereby limits the amount of work the heart will produce during exertion. This restriction can make you feel a somewhat breathless and yet does not constitute actual air starvation or any type of cardiovascular risk. It merely limits the response by the heart to exertion.

The fact that corticosteroid therapy like budesonide can cause mild tachycardia in some patients is not necessarily something that needs to be treated, but the cessation of beta-blocker therapy while under corticosteroid treatment could result in rebound tachycardia in some patients. Regardless, it does not constitute a risk to your heart or health. There's no rush in changing your prescriptions at this point and is more prudent to simply continue your medications as prescribed until about 10 days following corticosteroid therapy before weaning from the Toprol.

You'll be just fine.

Best regards,

Rutheford Rane, MD (ret.)