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   unexplained chest pain (Heart Disorders board)

28th September 2004
I've had constant chest pain, lightheadedness, and fatigue ever since I had a one time cocaine use over a year ago. I had never used illegal drugs before, or since, so I'm not sure if I snorted too much or if it was laced with something else. Everyday activities and little exertion have worsened my condition. Vasodilators such as nitroglycerin, cardizem, and zestril that I've taken have worsened my condition severely. Aspirin has made me feel worse. Being in the heat on a hot day has really made me much worse. My chest pain and lightheadedness are much worse when I'm sitting up or standing. I've noticed the appearance of veins in my arms and legs and swelled veins in my wrists and feet (especially when I'm standing). My chest pain is in the center of my chest and over my heart. It is a heavy pain and sometimes with very sharp pains in my chest and back. I was misdiagnosed with anxiety and took xanax ad zoloft which also made me worse. Xrays have showed normal. Ekgs have showed normal. Two echotests have shown nothing. Chest catscan has shown nothing. Stress test has shown nothing but it increased my chest pain severely. I'm currently so fatigued when I'm standing and the chest pain and lightheadedness are so bad that I'm bedridden. I know that I damaged some part of my cardiovascular system. I'm 33 years old with no family heart history. My blood pressure has been elevated ever since this started.
1st October 2004
levi,

You have a LOT of anxiety going on and of course I doubt that the cocaine +whatever else was snorted has anything at all to do with your condition.

Normally I'd be dismissive BUT the one thing that bothers me is that the chest pain increased markedly during the stress test. Was the stress test done with nuclear markers (injection) with a scan done immediately afterward (and probably before) to determine if any areas of your heart were being deprived of proper blood flow?
If the answer is no, why not arrange such a test?

Or, if you are pretty certain that it's not anxiety arrange for an angiogram...but that's a test you don't want to rush right in to though.

Do you regularly have pain and short windedness on exertion that's followed by rapid improvement with 5 monites rest? That's a snap STABLE angina diagnosis. If you have that regularly, I'd say angiography is warranted.

UNSTABLE angina (pain without exercise) has more elusive symptomatology and can be slippery to pin down without good testing.



Who prescribed the following:
[quote]Vasodilators such as nitroglycerin, cardizem, and zestril that I've taken have worsened my condition severely.
and for what condition? Nitroglycerine would only be prescribed for angina...who suspected that?
If nitro made your condition worse, then that points AWAY from angina...and back to mystery-land.
1st October 2004
I would like to say to T and zip2play that I appreciate your replies and insight. I need to emphasize that I don't have anxiety. I believe there are too many lazy doctors that, when faced with a difficult diagnosis, rely on anxiety as a means to an end. To disagree with zip2play, I know that the cocaine I snorted a year ago has everything to do with my condition. After snorting it my heart was beating way too fast for far too long. I really thought I was going to have a heart attack. Immediately after, I vomited several times, sweated profusely, and then passed out. I've had bad chest pain ever since then. I also had severe left arm pain for about two weeks after. I know I damaged something. I didn't see a doctor till two months later. My chest pain is constant. It is always there, even at rest. I was given nitroglycerin one time in Dec. '03 when I passed out and was taken to ER. My sisterinlaw told paramedics I was having chest pain. It made my pain much worse. I was prescribed cardizem in March '04 when doctor thought I may be having heart spasms. I only took it for 4 days because it was worsening my condition. I was prescribed zestril in July '04 for high blood pressure. I took it for 3 days and stopped, because again, it was making it worse. I live in Arizona and the heat has made it much worse. Heat also dilates blood vessels. My condition does improve after months and months of nothing but rest, but will worsen immediately after slight exertion, heat, sex, aspirin, and vasodilators. Other symptoms that I get are lightheadedness and fatigue (especially after sitting up or standing for a little while). I haven't noticed being shortwinded. I've noticed blood pooling in my hands and feet when vertical. The stress test that I took back in Dec. '03 was induced because I couldn't run on the treadmill. It showed heart was normal. I have also noticed that my heart rate increases above normal when standing. I have a couple of questions. If I have unstable angina, could it not show on an ekg or echo? If I have thrombosis (as T pointed out) could it occur in the chest. I've read about DVT but it occurs in the legs. If so,could thrombosis not show on an ekg or echo. I do admit that my problem is very difficult to diagnose but I know it's cardiovascular. Thanks for replies.
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