Cardiac or not? Sending me to Cleveland Clinic

[modublin2210]

Okay I have posted several times on here before, 5'4", 110 lbs, 34 y.o. female, non smoker. I have been having issues every since I had my kid 2 years ago. Started 2 months after birth. Chest pains, left arm pains, jaw pains, shortness of breath some palpitations. I have had every cardiac test done. EKG's, blood work, nuclear treadmill stress test, echocardiogram, tilt table test, ct heart scan, ct scans of chest, abdomen, endoscope, holter monitor and most recently a heart cath. Everything is normal. I am wondering if something is going on with my hormones which is causing this. I will have a few good weeks then bam back to getting all the above mentioned problems. I can't go back to the ER as I don't feel they will do anything since I have gone through the ringer. I was on a low dose of beta blocker and low dose calcium channel blocker. After all my tests have came back normal they took me off of everything. they gave me ativan, buspar and valium. Buspar doesnt phase me, ativan helps some and I have yet to take the valium. I have an appointment with my gyno in a few weeks to see if it isn't something hormonal that is causing this. People have also suggested maybe microvascular disease. I do have a poor diet which I am working on. I am just so frustrated and scared and not sure what to do. I am with the best cardio group where I live. Does anyone have any suggestions or know anything related to women's cycles and this happening? thanks I need some help bad!!!
They are sending me to Cleveland Clinic for an evaluation, but I really hate waiting. I am in so much pain, not sure what to do.

[modublin2210]

Wish I could take nitro, but they won't give it to me.  You would think that if they gave it to me and it worked, wouldn't they have their answer.  I asked my cardiologist about the Prinzmetal, variant, and microvascular.  He said no he doesn't think it has anything to do with my heart.  He had me on such low doses of beta blocker and calcium channel blocker.  Wouldn't up the dosage because my blood pressure is already very low.  I know Cleveland Clinic will help me I hope, but I am waiting on my cardiologist to get the referral to schedule something.  I hate waiting especially when I have the jaw pain all day long some days, arm pain that comes and goes, chest pains that come and go, shortness of breath that come and go. Most of all when I am at rest or sitting at my job working.  I have also thought if they would order an MRI to check my spine, maybe that could be it. I have read where some people have had spine problems that mimic a heart attack. I can't keep running to the ER, and heck if I end up having a heart attack, I will never know.  Anyway thanks for all of your help and suggestions.  :)

[joanincarolina]

I would look into the issue of microvascular dysfunction the subject of which is still deep in research. It appears to be found primarily in women around menopause but no direct cause has been found to date and there may be many variables involved in the diagnosis. Hormones are one of the things researchers are looking at. In my case they feel my body has stopped providing adquate levels of nitric oxide to open up my tiny heart vessels ( not seen on any cath or test) when I have simple exertion, stress or cold/heat exposure. Nitrogylcerine works for me as does taking a xanax when an episode begins to prevent the heart's 'normal' response to 'fight or flight' and reaction to pain. I have had plenty of chest pain and all with negative testing and no change in any 12 lead EKG in hospital and long hours of Holter monitoring. The angina and your described symptoms can be called prinzmetal's (frequent at night, mine is not now because I am still in bed and covered by nitro), variant or atypical angina. Read my journal here at 'joanincarolina'. Cleveland knows about this condition. In the beginning,2005, I had plenty of times when  my 'same' exertions did not produce any signs, then wham, back to square one and wondering what the hell was happening. I'll be happy to answer your questions. Take the meds as prescribed, even valium/xanax; this is not in your head, but that type of medication can help with slowing your heart's response to stressors, even simple exertion. Joan.

[forrestmmiller]

Have the Doctors eliminated Prinzmetal Angina? It will not show on an EKG unless it is a 12 lead taken during the pain and before taking nitro. I made many trips to ER to be told it was GERD, Esophagus spasm, and my imagination. The pain would resolve by itself in 10 to 15 minutes and often happened at night.  It is a very rare condition and often missed in diagnosis.  

[dbayro]

Have you had your thryroid checked? I would see an endocrinologist for hormone testing.