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Various symptoms not limited to heart palpitations (Read 10373 times)

Grasshoppa

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Various symptoms not limited to heart palpitations
Feb 10^th, 2011, 3:32pm

I'd like to say hello to all, as this is my first post. I was recommended this place by a friend on an exercise forum.

Background on health - I've had high blood pressure as a kid of 13-17. I Got into working out (mostly weight lifting), and it eventually lowered to where I was taken off the medication.

While I had hypertension, I would go to a hospital for checkups, and was told I had an insignificant "extra passage way" if I recall correctly, but I'm not sure. It seemed not to be of concern judging by the response of the doctors. However I remember the stress test - near the end, some IV was inserted, and though I cannot remember specifics of the test, whatever was inserted put me in a 10 sec. period in which I struggled breathing, and my heart pumped as intensely as if I'd been running miles non stop. It was frightening.

During High School - Perhaps this is meaningful as well, though I've never mentioned it to a doctor. I can recall the end of my sophomore year in high school - we'd gone on a field trip to Six Flags Amusement park. I'm not entirely sure the following symptoms are related, but they began shortly after that even:

Heart palpitations
Heaviness on my left side
Pain while sleeping on my left side

I'd never before had those symptoms. I'd gone to the Emergency room, and they said it was anxiety. However, I've not been quite the same ever since, though nothing severe until recently.

More recently - Well, I've been lifting weights off and on for the past ~7 years. I was very serious at first, went into a long lull for about 2 years, and started again very seriously in 2008. I mean, I was following a high intensity program called "Max OT" ; never missed workouts, sound diet and all. Extremely intense reps at roughly ~90% Maximum. I was doing this for about 1 year and maybe 3 months, with pretty big strength gains and overall progress. So I can imagine the high intensity must have some side effects?

I'd gotten hooked, until my previous symptoms (called anxiety) seemed to disappear. I was relieved and felt the best I'd felt in years while on this program.

In October, my Grandfather died. My former doctor asked to theorize a stimulus for the more recent onset of anxiety. I'm not completely convinced though. We were somewhat close, but he was one of only two immediate family members who've died in my life.

Unfortunately, I had this weird incident shortly after my Grandfather's death in November of 09 while I was squatting, though I'm not exactly sure if it's related to my current problem either. Basically I felt this weird pain in the left Collar bone region. It didn't feel like a muscle pain at all, it felt different, and I can't even describe it, as it was like a year and some change ago. It was strong enough to make me stop squatting, but I wasn't too concerned other than that. Anyway, about a week after, I started getting these weird pains in my chest, and they began interfering with my work. Sharp pains, and sudden shortness of breath while trying to get to sleep - also palpitations. The pains were pretty strong, and I'd miss lots of work and sleep through Christmas even.

So, in fear, I went to the docs to get multiple tests done. Had stress test, blood tests, ekg, Echocardiogram...They said they couldn't find anything. Yet I kept going back to the doctor because the symptoms remained, though they got less painful as time went on. Eventually they said it was probably anxiety and they subscribed me anxiety medication. Xanax, but low dosage, taken as needed

Throughout it all, I'd also been having a fullness in my left side. Eating would make me uncomfortably breathless, even without much food. I can only describe it as feeling as though there isn't enough room in my upper abdomen. I feel as if my heart is palpitating through it all as well.

Fast forward to August - I had been doing a light routine without squats and the like for a few months, because I'm obsessed with lifting. Then I went back to a Max OT like program to see how I'd fare, and I'd been doing it again for like 2 months with big strength gains once again.

Suddenly, mid August, I got this sharp pain in my chest while sitting at my computer. Very sharp, and contemplated going to ER but was too afraid because of the past bad experience as a little kid with the IV. The sharp pain came with a new symptom - a pain (not numbness) in my left arm and right foot...I'd never had these before. The chest pains lasted about 3 weeks, but not as severe as the first. Once again it'd been hard to get to sleep, as I'd wake up with a sharp pain.

I was scared for my life - afterwards I'd get the reoccurring pain in my left arm and right foot. Doctor still thinks it's anxiety related...gives me more xanax pills...He also tried to set me up to test my nerves in my left arm, though I haven't gone. This time he's prescribed Xanax and a daily medication which I haven't yet tried (because of the side effects). I believe it's called Lexipro.

Currently - I have no intense pains, however the foot tightness/pain comes and goes, as do the left arm pains. I'm still short of breath and become uncomfortable when eating.

On top of that, it is not comfortable for me to exercise. Imagine tiring too early and feeling too much pressure in the neck. I also get this upper back discomfort when my heart is racing. It feels unnatural to run. I have anxiety, yes, just wondering whether this explains everything.

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Re: Various symptoms not limited to heart palpitations
Reply #1 - Feb 12^th, 2011, 4:24am

Okay, well initially I'm a bit perplexed because isometric exertion, ie weight-lifting, raises blood pressure rather than lowers it. Also, if you can recall, please tell me specifics about the hypertension with regard to persistent readings obtained by your pediatrician at the time.

The "extra passage way" is more formally known as an accessory pathway and consistent with a diagnosis of Wolf-Parkinson White Syndrome. WPWS is a congenital abnormality that produces variable symptoms of light-headedness, pectoral angina on exertion, palpitations, shortness of breath and episodic supra-ventricular tachycardia. It is rather common among congenital abnormalities and is of no real consequence.

The stress test described was most likely a chemical treadmill, where the drugs dipyridamole, dobutamine, and adenosine, are intravenously administered over about a 4-hour period to simulate the type of exertion otherwise generated by actually using a treadmill.

Indeed, anxiety can produce physical symptoms but if you have Wolf-Parkison White, which may or may not be the case, then the sensations could be a combination of the heart abnormality and anxiety. Again, even if you do have WPWS, it's not considered to be life-threatening. Major life events such as the death of a loved one can produce subsequent anxiety to levels capable of resulting in panic threshold events in many instances.

With respect to isometrics, weight-lifting must always be undertaken in moderation with sufficient time given for the body to rest in between your work-outs. Muscle and ligament injury is common and can produce pain symptoms which in some instances can become chronic in nature.

Additionally, by your directed comments to the symptoms of left arm pain and shortness of breath, you seem to be concerned that these symptoms and others mentioned raise the question of whether they are constitutional signs of an impending heart attack. You can relax from the standpoint of suffering a heart attack, but I would suggest that you seek referral to a cardiologist to determine whether you actually have an accessory pathway and Wolf-Parkinson White Syndrome, which could account for many of your symptoms.

Early satiety and sensations of bloating following meals can often be a sign of cholesystitis, or gall bladder problems. GI symptoms relating to stress and anxiety can also produce a similar symptom pattern and should be discussed with your doctor to determine whether tests are necessary. There are many treatments available for diminishing GI symptoms such as those described.

Generally, I see nothing here that suggests you have anything serious taking place but I do recommend that you follow through with your doctor's treatment plan. Trying to second-guess your difficulties and your doctor's assessment will only serve to make further assessments more difficult. In other words, take your medications and undergo the tests. If the medication doesn't work or the tests reveal nothing, then you at least know what it's not and in the world of medicine, that's very accurate in knowing where to proceed.

Best regards and Good Health

Best Regards and Good Health

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Grasshoppa

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Re: Various symptoms not limited to heart palpitations
Reply #2 - Feb 17^th, 2011, 4:33pm

Thank you for your help RLR

RLR wrote on Feb 12^th, 2011, 4:24am:

Yes, well it is odd that my blood pressure went down (or at least was not high. Unfortunately I can't recall the exact readings.

RLR wrote on Feb 12^th, 2011, 4:24am:

The "extra passage way" is more formally known as an accessory pathway and consistent with a diagnosis of Wolf-Parkinson White Syndrome. WPWS is a congenital abnormality that produces variable symptoms of light-headedness, pectoral angina on exertion, palpitations, shortness of breath and episodic supra-ventricular tachycardia. It is rather common among congenital abnormalities and is of no real consequence.

Thanks, this relieves me a bit, but do you think this may cause that discomfort I get when I run? I just don't understand how this could go unnoticed in the stress test, which was taken roughly a year ago. At that time, it wasn't quite as bad, but I am winded easily, I'll have some weird nagging discomfort toward my back (this scares me) and I feel as if I shouldn't exert myself. It's gotten in the way of starting my cardio routine.

Is it possible that something could've been overlooked in all of these?

RLR wrote on Feb 12^th, 2011, 4:24am:

Additionally, by your directed comments to the symptoms of left arm pain and shortness of breath, you seem to be concerned that these symptoms and others mentioned raise the question of whether they are constitutional signs of an impending heart attack. You can relax from the standpoint of suffering a heart attack, but I would suggest that you seek referral to a cardiologist to determine whether you actually have an accessory pathway and Wolf-Parkinson White Syndrome, which could account for many of your symptoms.

The oddity is that I was actually referred to a cardiologist back when I had the stress test and echocardiogram. Is it possible that this would go unnoticed? Or is it likely that I don't actually have this? The cardiologist was actually baffled because he couldn't find anything wrong. I believe this is why it's all blamed on anxiety, but anxiety doesn't explain all of the symptoms.

Do you think my new doctor (whom I have yet to see) will send me to another cardiologist?

RLR wrote on Feb 12^th, 2011, 4:24am:

Early satiety and sensations of bloating following meals can often be a sign of cholesystitis, or gall bladder problems. GI symptoms relating to stress and anxiety can also produce a similar symptom pattern and should be discussed with your doctor to determine whether tests are necessary. There are many treatments available for diminishing GI symptoms such as those described.

Interesting, I will talk to my doctor about it. To describe it more thoroughly, it doesn't feel like I'm normally full; it's as if there's not enough room inside in general. I have no stomach pains. While I'm full I can feel my heart beating, as if it's doing so harder, and it's quite uncomfortable, as I feel short of breath.

My original fear was that maybe my heart was enlarged, thus taking up space in the body. It was that when I ate, it just took up more of that limited space that my heart took up.

I've been eating less, and avoid eating before bed to prevent restlessness. I tend to be so uncomfortable that I cannot sleep.

RLR wrote on Feb 12^th, 2011, 4:24am:

Generally, I see nothing here that suggests you have anything serious taking place but I do recommend that you follow through with your doctor's treatment plan. Trying to second-guess your difficulties and your doctor's assessment will only serve to make further assessments more difficult. In other words, take your medications and undergo the tests. If the medication doesn't work or the tests reveal nothing, then you at least know what it's not and in the world of medicine, that's very accurate in knowing where to proceed.

Best regards and Good Health

Thank you. From now on, I'll stick with my doctor's advice. I suppose it is silly for a patient to play the role of the doctor, but to my defense, I didn't feel better despite initially following the doctor's orders.

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Re: Various symptoms not limited to heart palpitations
Reply #3 - Feb 19^th, 2011, 5:41pm

Well, I would certainly inform your new physician that your symptoms have not abated and that you'd like to determine whether a condition such as Wolf-Parkinson White Syndrome needs to be ruled out.

Again, early satiety or feeling full inconsistent with the amount of food intake is a common symptom of cholesystis, duodemal stasis and even Irritable Bowel Syndrome. The shortness of breath is actually not respiratory at all, but merely the diaphragm being expanded against the lungs due to excess or trapped gas within the lumen of the intestines and/or stomach. Realize that an enlarged heart to even the most graphic extent, would not produce enough change to present a patient with compression of nearby organs.

I strongly suspect that a large percentage of your symptoms are associated with the somatoform features of anxiety. In other words, it's important to realize that anxiety and depression can induce physical symptoms that often marginally mimic other classical disorders or diseases and yet subsequent evaluation proves negative for any such presence.

Lastly, your statement in your own defense is non sequitur. Simply because symptoms persist following evaluation by a physician would not suggest increased accuracy by trying your own hand at it.

Best regards and Good Health

Best Regards and Good Health

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Re: Various symptoms not limited to heart palpitations
Reply #4 - May 25^th, 2012, 11:37am

A little update:

I must admit, I have not been to a doctor's office in the past year. For the most part, I've been doing pretty well until recently. While I've had early satiety for this whole time, it has not interfered with my overall well being until about 3 months ago.

I have picked up weight lifting again, and with it, all of the symptoms are returning. This time, I am also experiencing discomfort in my upper left back as well as my neck, and it's scaring me.

I have ruled out that my intensity is too high, as I make a very conscious effort to work with a fairly low intensity for fear of these symptoms reoccurring. I cannot help but think doctors are simply not catching something, but I will schedule another appointment soon. It seems it is workout induced after all and it's quite depressing as working out is not only a hobby but also a source to build up my own esteem.

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Re: Various symptoms not limited to heart palpitations
Reply #5 - May 25^th, 2012, 3:50pm

Well if the symptoms are exercise-induced by virtue of their manifestation during the workout, then I would tell you here that it's more likely than not merely musculoskeletal in origin. Having said that, however, I'd point out here that your description is very lacking in specific detail regarding the discomfort in your left back and neck. Remember that this is the internet and lack of specificity even with direct evaluation can make for difficulty in offering suggestions. So what type of discomfort are you experiencing, how long is it lasting, does the discomfort produce or accompany any other symptoms, is there anything which relieves the discomfort and so on.

I'd also make brief mention here that people seldom pause to reflect upon the need to amplify their self-esteem and simply do so as a matter of compulsion in many instances. You need to ask yourself the question of why body-building or weight-lifting in particular is the antidote to poor self-esteem in your instance. In other words, what about your physique is inadequate to the extent you feel it necessary to compensate with body-building and far more importantly, what is it precisely about the consequences of body-building and weight-lifting that you feel represents the solution? It's certain not necessary to answer these questions on the open forum, or even address them at all by way of response. What is critical is that you learn how to perform effective introspection such that it alleviates the compelling need to change who you are in order to like what you see. In other words, wanting to change for personal achievement is separate from doing so as a compensatory effort. Do you see my point here?

While a great deal of such compelling changes are socially driven, they can sometimes take harbor much deeper within the psyche to the extent that one can become driven by the need to not only change themselves, but aggressively maintain or even over-compensate such change. While this point is somewhat off the topic you seek inquiry about, my professional background does extent beyond my former practice of neurology and I merely offer these discussion points for enlightenment.

Best regards,

Rutheford Rane, MD (ret.)

Best Regards and Good Health

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Re: Various symptoms not limited to heart palpitations
Reply #6 - May 25^th, 2012, 5:15pm

RLR wrote on May 25^th, 2012, 3:50pm:

You know, I'm always asked to describe this discomfort that I experience and I always feel as though my words can't explain it properly, but I will try anyway.

The back discomfort is not sharp at all, it is just a dull, nagging sensation in my upper left back that comes for long periods of time (maybe like an hour or so) and leaves. It is very dull, but it's accompanied by a general heaviness in my chest. I can't describe the heaviness in any other way, other than it just feels like there isn't quite enough room in my chest, and i feel heavier and short of breath.

The neck discomfort is quite similar to the back discomfort; quite dull and nagging. Accompanied by a feeling of "fullness" in my neck, as if my neck is tighter on that side. As if something is in the way that shouldn't be.

What I can say is that it doesn't feel much like my typical muscle soreness, as I'm very familiar with gym induced muscle soreness and even look forward to it as sort of a sign that I did a "good job" in the gym lol. But with all of these symptoms, I also have episodic light-headedness and shortness of breath simultaneously. Sometimes at work, usually not whilst at the gym. Heat makes it worse, as does eating something very filling.

What I can certainly say is, I do recall and miss the days when i felt perfectly normal. In high school, and even in 2008 through the beginning of 2009 in which i had been lifting weights quite seriously and with impressive results.

Quote:

I'd also make brief mention here that people seldom pause to reflect upon the need to amplify their self-esteem and simply do so as a matter of compulsion in many instances. You need to ask yourself the question of why body-building or weight-lifting in particular is the antidote to poor self-esteem in your instance. In other words, what about your physique is inadequate to the extent you feel it necessary to compensate with body-building and far more importantly, what is it precisely about the consequences of body-building and weight-lifting that you feel represents the solution? It's certain not necessary to answer these questions on the open forum, or even address them at all by way of response. What is critical is that you learn how to perform effective introspection such that it alleviates the compelling need to change who you are in order to like what you see. In other words, wanting to change for personal achievement is separate from doing so as a compensatory effort. Do you see my point here?

Yes, I understand. I can address this briefly and frankly. I will admit that it is compensatory but it is just as much a hobby that i genuinely enjoy. Compensatory in a sense because of my social ineptitude, and my previous (lack of) luck with females. And it's quite fulfilling when people make compliments on your progress, male or female. And in a way, it's the personal need to be good or great at something, as I have limited in skills and hobbies. Dropped a few even that I used to love but have since lost interest. This hobby seems to have multiple benefits i.e. health, looks, personal achievement.

Quote:

While a great deal of such compelling changes are socially driven, they can sometimes take harbor much deeper within the psyche to the extent that one can become driven by the need to not only change themselves, but aggressively maintain or even over-compensate such change. While this point is somewhat off the topic you seek inquiry about, my professional background does extent beyond my former practice of neurology and I merely offer these discussion points for enlightenment.

Best regards,

Rutheford Rane, MD (ret.)

I don't mind sharing all of this with you. Believe it or not I have questioned the need to compensate extensively.

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Re: Various symptoms not limited to heart palpitations
Reply #7 - May 29^th, 2012, 4:21pm

The description regarding the discomfort on exertion would still lead me to consider something called Wolf-Parkinson White Syndrome, but the fact remains that it's a very recognizable disorder and a cardiologist would not have overlooked it. With a negative stress test, particularly one so recent, the secondary consideration would be based upon my comments regarding musculoskeletal pain.

Feeling short of breath can be very misleading and it's always important to distinguish true dyspnea, or air starvation, from other underlying causes. In otherwise healthy persons, much of what causes the perception of shortness of breath is actually pressure against the lower border of the diaphragm due to gas or air trapped in the intestinal lumen, which compromises the ability of the diaphragmatic muscles to fully extend downward to achieve full tidal respiration. It can produce shallow breathing and even light-headedness due to the mild blood gas imbalance that breathing in such a manner can produce. So a GI disturbance is not out of the realm of possibility where the shortness of breath is of concern. True dyspnea most often produces very labored breathing rather than a mere sensation of shortness of breath and the patient can visibly be observed using the upper accessory muscles in the attempt to effortfully improve respiration.

I would also point out here that signs of muscular pain absolutely do not indicate a good job but rather signs of exceeding the threshold of the body's capacity to do work at specific levels. Build-up of lactic acid, burning sensations and/or pain on flexion are all signs of muscular fatigue. It has long been a cliche in the gym that no pain, no gain is the creed of bodybuilders, but I will tell you here that in virtually all instances the attainment of muscular density and definition of the type observed in all true bodybuilders is the consequence of growth hormones and anabolic steroid supplement. Such metamorphic changes induce a competitive drive in many such individuals, men and women, to achieve sometimes remarkable examples well beyond what normal genetic expressions induce.

I'll leave further comments alone concerning any strivings to be compensatory, but will close by sharing the insight that capturing the attention and attraction by certain persons who find bodybuilding appealing also generate repulsion by those who are less attracted.

A man can live an entire lifetime seeking admiration, only to discover too late that affection is won with far less toil and sacrifice. Being revered is far more lonely than being loved.

I'll soon be 93 years of age and I'll simply share with you that changing your own perceptions will bring far great riches than seeking to change the perception of others.

As for your health concerns, I'd suggest that if the pains and aches continue to plague you during your workouts, then having them performed while wearing a Holter monitor will put to rest any concerns you may have that the origin of the problem is heart related.

Best regards,

Rutheford Rane, MD (ret.)

Best Regards and Good Health

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