Chest Pains | Arthritis Information

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I went to my regular doctor today for my blood pressure check (since the RD put me on Adalat for Reynauds, I have to have my blood pressure checked weekly... I'm low anyway and he didn't want it to get much lower).  Anyway, when I was with the nurse I mentioned that this morning, before I got out of bed, I had a pain in my chest and two nights ago I also had a pain in the chest.  I thought it was from all the meds I am on.  She told the Doctor, then they immediately hooked me up and did EKG.   Now, they scheduled me for a cardio guy tomorrow.  But she said the results of the EKG looked good, however wanted to just be sure.
Does anyone else have chest pains from any RA meds they are taking?   I'm sure it's all fine.  I just hate having to put another doctor into the mix!   Is costocrondritis something that occurs with these meds or with RA??   Thanks!

Costochondritis is an inflammatory disorder but also a symptom, it can be caused by injury or it can occur in otherwise healthy individuals for no apparent reason. (Just for fun?

Heartburn (caused by meds) can give some people a burning or stabbing chest pain.

Good luck with Cardio Guy!

I often will use an ice pack and that does help.

You're might not be the same thing; but it's something to think about.

Plus, with depression being a common "additive" with RA, anxiety can cause chest pain. With out you even KNOWING IT. That's what happened to me in high school. Just a thought.!!!!

RA causes all kinds of problems that can lead to chest pains. Costochronditis is the least serious. That means that the RA has affected the joints in your rib cage and breastbone, most specifically your breastbone. And, it really hurts!

You can also get pericarditis which is inflammation of the heart muscle itself or inflammation of your lungs. Both result in chest pains. Over time, RA can cause thickening of your heart muscles and your veins and arteries.

It is a very hard distinction for the doctors to make as to what is causing the problem. My Rheumy immediately sends me the Cardiologist. In fact, I met my Cardiologist before meeting my Rheumy.

Your EKG can be fine. The next thing that they will probably do is an Echocardiogram and a stress test. These tests are long, but not bad. They are expensive but vitally important.

The other thing to watch out for is problems with the lungs which also can present as chest pains. If you have any problems breathing or are having severe chest pains, especially since you've had problems in the last couple of days, go to the ER. Emphasize that you have RA and are scheduled to see a Cardiologist. The lung problems can be a blood clot, pleural effusion, etc.

Between the three doctors, Rheumy, Cardiologist and Pulmonologist, it seems to take all three to get to the "heart" of the problem. I've had pericarditis at least 2-3 times. They thought I had blood clots in the lungs twice (didn't) and I have had some pleural effusion. Along with that, I have developed high blood pressure and water retention. They had to treat all these things in order to improve things.

Keep in mind that heart problems do run in my family. So, I think that makes me especially vulnerable in this area.

I don't want to scare you because it likely a simple problem like costrochronditis. But because RA is so insidious, doctors have to take extra precautions and you must follow your own instincts as to whether you feel like something serious is happening.

I'm glad you are seeing the Cardiologist so soon. That is very good news.

Deanna,
Thanks so much for the reply.  I am sure it's just fine.  I am a smoker....  and I know the first words will be.......STOP!!!  But I haven't had lung problems ever before and don't plan on starting now Another thought, fibromyalsia??  I do have pain in the trigger areas as my RD pointed out, so maybe it is inflammation and will go away.
The stress is also a contributor, but I don't feel stressed.   Only when I think of stuff like heart problems.... which I have never had and doesn't run in my family....  Just a broken heart a few years ago Lynx...  If I have a visual of Russell Crowe, it would probably go off the charts too.... better think of something not so sexy!! 
Thanks gals!! 
Stress is a contributor! Hey, I'm telling you, if they come back and go "well, there's nothing wrong with you..." try to see someone about anxiety. I've had it for YEARS and had no idea that that's what it WAS. Once it was pointed out to me, I did the pill thing for a while, and decided that wasn't the route for me. I'm more of a "okay...that actually makes me nervous, breathe slow and steady, nothing to get excited about" kinda person. I just try to recognize what my triggers are, and either avoid them, or deal with them slowly, and when I'm feeling good.Katie... NO MORE PILLS FOR ME PLEASE!!  I also tried the 'pill thing'..cymbalta.. it made me depressed, so I got off that!  I'm such a good one at giving advise, I should listen to what I say to others.  Relax....breathe.... 

When I try to decrease my MTX....like right now it happens often so I know mine is from inflamation.

When it started we increased my MTX and that took care of it for a pretty long time. You minght ask your RD if this too could be your problem.

Lovie,
You are probably right with the inflammation being the trigger.  My hands are very swollen and throbbing in the morning when I wake up, add that to the bad headache and it's a horrible combo.  I will check with the rheumy.   Thanks!
I saw the cardio guy today.  I'm sooo confused.   After waiting over one hour, he took my blood pressure...  150/92... now, this is the confusing part...  I have always had LOW blood pressure..  2 days ago at my regular doctor is was 114/62 (which is about normal for me...  mostly 110/60.  He said I had high blood pressure, did a ECG and it came out abnormal (2 days ago it was normal). It said I had probable septal infarction, right ventricular hypertrophy and abnormal changes due to myocardial ischemia.... what does that mean???  He also did an ultrasound and wants me to come in for a 5 hour stress test next month.

He never mentioned that it could be due to RA, costocronditis or anything else.  I think I'll call my RD and see what his take is.   I'm sure I was stressed from waiting so long before I saw him, but never, ever have I had high blood pressure.  He said since I live in the mountains, blood pressure is lower there (are you kidding???)... 
I had a very small pain today, only lasted a couple seconds, but I'm sure it's just inflammation.  I'm just confused by this guy.  What do you think?? 
No, he's not kidding about the mountian blood pressure thing. It sounds silly, but think about how packages have cooking time differences for people in the mountians! The pressure difference REALLY is there. I think you have an infection in your chest. Not nessicarily your LUNGS per say, but your *chest* I think. LoL google it!Also...  the potato chip bags are full of air and ready to burst up here, then I go DTH (down the hill) and they are deflated!
I will google all this infarction stuff... thanks!

Vicki,

Sorry that your visit was so distressing. Prednisone can give you high blood pressure. Multiple doctor visits can do it too. Really. I'm not kidding.

I'm not familar with those particular things. And, remember he is not looking at this from the viewpoint of a Rheumy but a Cardiologist. But RA can hurt your heart because it can be inflamed just like your joints and over time that can cause damage.

However, as distressing as all this sounds, at least they are on top of it. My younger brother has had two heart attacks. I don't know if you saw the pictures of him in the truck accident. He had his second attack there. The first one was when he was 40 and they had to put in a stent.

You want them to catch these problems now before some kind incident occurs.

Many times they have given me such scary news in the beginning and when they finally got all the tests done it was take a couple more pils and see me in a year. Hopefully, that is what it will turn out for you.

I know you must be scared though. But now you know you must take this seriously and that is going to save your life.

I hope that whatever they find requires only minor treatment. My thoughts are with you.

Sweetie;

Try not to get too upset.....but please take this serious. I was hoping; like me it was just due to inflamation....but it sounds like something else is involved also. It could be inflammation too; but those test wouldn't have should all this just because you were anxious.

Definately continue to follow up with this issue. My ex-husband had a major heart attach at 37 this spring. He never saw it coming.

My thoughts and prayers are with you.

Vickilee,
I am going through the exact same thing (without the pain). My
blood pressure has always been low, but I was on prednisone
from April till end of Sept. Now it is high 155/99 yesterday, 146/
102 on Wednesday. My blood work all came back normal, so
now they are looking at other things (like renal artery
problems). Naturally, I was freaking out, but my FIL, who is a
doc, said that the prdnisone probably is the cause, even if my
blood work is normal. It can cause a lot of fluid retention which
raises blood pressure. I'm starting a diuretic today, so hopefully
that helps. I noticed you were still on prednisone, so maybe you
are having the same problems. I hope everything goes well.

I am also having problems with chest pain. It started about  10 days ago, just  very painful  under  my boob and right at the sternum. Because I have heart issues I immediately took nitro, and when it didn't help the pain I knew  that for me it wasnt heart related. 

I've had pleurisy several times and it isnt that kind of pain. My gallbladder is gone, so it isn't that. When I saw the Rheumy on tuesday we talked about it and she thinks it is either costochronditis or a pulled muscle from   all the vomiting I had with that gastro flu about 3 weeks ago. I'm getting xrays on monday to figure out what's going on, and til then, heat, and gentle massage seem to help.

Kathy, it sure sounds like the costochronditis, especially your description of the location. I do the same thing, take the nitro and see if it helps. However, over time, I've started to be able to distinguish between the two a bit. The nitro does help but I rarely have to take right now. But I do have some heart problems.

When I got bronchitis last year, they figured that I did the same thing, bruising my ribs from the really sharp coughing spells. Also, when they did the lung tests a couple of years ago, that really hurt that area. I went to the ER even though I didn't think it was a heart attack. The ER doc told me that area of the rib cage can get so fragile, mostly because of prednisone, that it can actually break in some patients who have a Pulmonary Function Test.

The good thing about it is that it does seem to heal up and not cause problems unless irritated by being sick or the weather. It might take a couple of weeks though it that is what it is. And yep, it hurts!

Vickilee, my blood pressure has always been low, too. So much so, that after I delivered my daughter, when my blood pressure dropped to 90/60, the doctors freaked. I told them it was normal. I've been on Prednisone for about a year, now, and my blood pressure is creeping up and up. I go see my GP next week, and we're going to have to talk this over. I hate to take MORE medicine, and I'm trying very hard to get off the prednisone, but I'm still at 5 1/2 mg. I don't know if I can dump it completely.

There are just so many things involved in RA - none of them good.

Whatever you do, make sure you really know what's going on. Don't settle for assumptions. With your heart, that could be deadly.
Thanks everyone for all the love and support.  I was so sceptical about the cardio doc, that I went into my regular MD this morning, with a copy of the ECG and asked the nurse if she would take my blood pressure.  Sure enough, it was only 120/62 (as it has been for years.... even with the prednisone I have never had it elevated).  I showed her the test and asked how in just ONE day could that test be so different from the one they took.  She was going to give it to the doctor to look at and said she understands my scepticism.   Sometimes I feel doctors look at the BIG picture.... bill the insurance.... bill the insurance...  the patient won't know if we 'adjust' this..

  Maybe I am being silly, however, the nurse agreed with me.   I told her that I'd be very happy to try another cardio guy, but this one left me cold.  (Plus, it was freezing in his office, and when I got there, they had a large screen TV on with I Love Lucy... no reading materials, the examination room was overcrowded with too many things, so you couldn't even wash your hands (the sink was blocked)... first sign..doesn't the doctor wash hands between patients????    Second sign, he asked about my RA while he was doing the blood pressure, so I was quiet and didn't answer him because I think he should be listening to the heart beat????  right???  Also, he never brought the RA up again. 
I just had a bad feeling right away from him. 
I will see what my doctor tells me to do, which I hope, is see someone else!! 
And...  I thought if you had high blood pressure, you shouldn't live in high altitudes???  Which contradicts what the cardio guy said about having lower blood pressure in the mountains!

I won't just brush this off, I know that it's important, but I don't want to be 'taken in' by a doctor. 
Also.....  one more thing.... his scale (which is just like a 'home scale', not a doctor scale, registered that I had dropped 3 lbs. in one day...  I know I haven't!!  Maybe 1 lb...  oh well... 

If the Cardio made you feel uncomfortable with his treatment, then you absolutely should take steps to find someone you are comfortable with. I just love my Cardiologist which I think is very important when you are facing serious tests. He and his staff have a calming influence. I also know that he treats patients on almost every medical plan. So, money is not his prime motive. He always listens to me and takes even minor things seriously.

I think a different Cardiologist is a good idea and cannot see a reason that you doctor shouldn't send you to one. However, there are heart problems that can cause large fluctuations in blood pressure and heart rate. Just be sure that you don't ignore the symptoms.

Thanks Deanna,
I know it's important, but I have never ever had any heart probs and it doesn't run in the family.  I would think that a cardiologist's office would try to be 'stress free', but this one wasn't!!   I'll be sure to keep on top of my regular doctor and get a different referral.  I'm leaving Sunday morning to fly to Sacramento and 'trick-or-treat' with my granddaughter (14 mos old)...  back on Friday!  When I'm there, I always tend to do more than I should.... like crawl on the floor....pick her up  .... can't get enough of her!!!  
Well being a former cardiac nurse I can't sit by and keep quiet.  Frankly this report is really scary.  I would NOT downplay it.  I am not trying to freak you out but you shouldn't get a false sense of security because your ekg looked normal the other day and your blood pressure today was normal (I suspect that the stress of waiting, concern and a cold waiting room accounted for your high reading at the cardio's office).  Also not having any cardiac problems in your family doesn't count either. 

High blood pressure isn't a requirement with cardiac disease.  I see by your profile that you are almost 58.  Heart disease is STILL the leading cause of death in women.  I'd take it very easy until you have your stress test.  Flying to Sacremento sounds like more than I'd recommend.  Maybe I am wrong, but if this ekg report IS accurate then you should be doing basically nothing until you have further testing done. 

Chest pain, if it is related to heart disease, means that your heart is basically telling you that it is temporarily starving for oxygen.  If you think that just noticing whether or not you are having chest pain when doing something will be enough to protect you, then you are being naive. 

I hope I am WAY off base here, but assuming the cardiac report is correct (and why would they make it up?..billing insurance is NOT likely, though of course possible) then you have something going on here that needs your attention.  Wouldn't you rather err on the side of caution until you REALLY know what is going on?  There will be other Halloweens, assuming you take care of yourself now.

Please take care.
Jeanne
Jeanne,
Thank you for your post.  I'm glad you didn't sit still.  Of course I don't know what all that meant on the cardio report and if you think it sounds more serious, I will be sure to be more aware.  I really do think I'd like another doctor, a second opinion, and a more relaxed environment may help too.  My regular doc and my RD and so great.  When I get my flu shot tomorrow, I'll be sure to ask the doctor what she thinks too.
Doesn't the regular blood tests that I take every 2 months tell if your oxygen level in the blood is high or low?  I'm not sure which one it is, white or red counts?
The flight to Sacramento is only an hour.  And, I will be there with my son and daughter-in-law, which may be better for me than home, since I live alone.  
I'll be sure to clue them in also.  Thanks for being concerned Vicki, you better come back from this trip. :| That's all I have to say. No excuses. I don't wanna hear "oohhh, I had a heart attack" or "ohh, I had to see a doctor" You hear me? LOL I'm playin' How can I NOT come back,  I look forward to your silly and amusing posts!!!!    I'll even take pictures and send them to you so you can see I'm not lying on the floor waiting for someone to find me!!!!

Yeah and none of that "oh, I'm dead wanna see my coffin?" crap either..... :| You BEST send me pics! Hahaha my e-mail is avlb. on my lil profile here, but I'll post it for you as well. I have no shame. And a great spam blocker too...LOL

arriscolwell@gmail.com

Yes, Viki, please take care of yourself. My brother was not even aware that he had his second heart attack. He thought he was just having a panic attack. Well, it was stuck in tons of steel for two hours and he's claustrophobic.

Now, he has to see the Cardiologist every 6 months, no excuses.

Awfully glad that you are going to let your family know what's up. If you start to have problems during the flight though, speak up. I know it's short, but still. And, get someone to carry your luggage, etc. Baby that body.

Call ahead to your airlines and request assistance.  You can get a ride thru the airport to your gate and to the luggage area.  I did it when I had to fly back home when my Dad passed away.  I just had a high tibial osteotomy on my left knee and was completely non weight bearing.  I was also able to get thru the security points faster and did not have to wait in line. 

I completely understand how it is with grandkids.  I have one myself that I completely adore and that wears me out.  But it is worth every second of it.  Grandchildren are our reward for making it thru the teenage years with our kids lol.  Have a wonderful time with your family.

Just been thinking about you Vickilee and wondering how you are doing.

Jeanne
Hi All!!!
 I'm BACK!!  No problems... no chest pains...  feel pretty good and had a wonderful time with my granddaughter!  I am a little worn out from all the bending and chasing I did... but it sure is worth it.  The only problem I have is that my left side (not my heart) below my waist and the hips and left leg are very sore.  Other than that, and feeling a bit tired, I'm great.
Thanks for all the concern.  I still have the appt. for the stress test and plan on keeping it.  I guess it is a good thing to have the checkup, even tho I feel great.    Here I am, with Bella!! 

YAAAAAAAYYYYYY!!!!!!!!!!!!!!!!!!!!

So glad you had a good trip. Get yourself checked out! You shouldn't have all these random pains. And for so long.

Haha you're back not even a day and already getting yelled at. It's cause we love you!

Thanks Katie!!!!!     I missed all of you!!!   Now it will take me days to read all the posts I missed!  Oh.... You are very chatty Katie!!!  514 Posts... I am impressed!!!  I love all your trivia and nonsense!!  It keeps me amused.  
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