Posted 3/13/2010 4:41 AM (GMT 0)
Brief history,
Age 26, female, smoker since age 14 (half pack/day), diagnosed with ADD in 8th grade, depression/anxiety (not sure when). Have had canker sores frequently since age 4 or 5.
Mother: Heart murmur (non-threatening). Father: High cholesterol. Half sister (Mother's daughter): High cholesterol. I was tested for high cholesterol in 2006 results were borderline high. Had many sore throats in later teen years. After age 18, developed malar rash, gets worse with heat. Also had frequent chest infections. Diagnosed in 2003 with mild intermittent asthma. No inhaler use since this time.
March 2009- Diagnosed with shingles, developed into postherpetic neuralgia. All symptoms have resolved.
November/December 2009- Had bad cough, went away at end of the month, returned in Middle of December. Diagnosed with bronchitis and pneumonia (meds: zpack, prednisone, albuterol inhaler). Weight 151. B/P 92/60
January 2010- Joined Biggest Loser at hubby's work. Was ready to start exercising and eating better. End of the month was beginning to feel chest pain while exercising. Also started tanning on a regular basis. (couple times per week)
Feb 4, 2010- Saw Physician's Assistant. EKG normal. Chest x-ray showed inflammation, possibly leftover from bronchitis, prescribed Advair. This helped with the chest pain. Stopped exercising at this time. Weight 142. B/P 96/60, Pulse 92.
Glucose normal, Urea Nitrogen 8, creatinine .86, GFR >59. CO2 was 32. All others were normal.
CBC: WBC 3.9, RBC 4.74 (Normal), ABS Granulocytes 1.8 and the rest were within normal range. Creatinine kinase 142. C reactive protein <5.
Feb 13, 2010- Started chantix on 2/8/2010. Early side effect of nausea and vomiting, loss of appetite. Although husband recently had a stomach bug or flu. Chest pain started on the 13th.
Feb 18, 2010- Went to ER for chest pain. Gave me potassium supplements and sent me on my way. Chest x-ray was clear. LABS: Normal EKG, said my heart was doing "funny things" possibly due to low potassium.
Chest x-ray normal.
D-Dimer 593
CBC within normal (standard) range.
Metabolic all normal with the exception of potassium at 3.4.
Followed up with primary care doc. He told me to stop chantix. A few days after I stopped chantix my chest pain went away. A few days later I took my kids for a wagon ride and felt chest pain only a few blocks away from my house. Had to cut the trip short. Visited my physician's assistant 2 days later on 3/4/2010.
March 4, 2010- PA wasn't sure what was causing the chest pain. Recommended echo and 48-hour holter. Also wanted to check thyroid levels which were normal. Echo revealed mild tricuspid regurgitation. Which they said was normal. Weight 139. B/P 100/72, Pulse 96
During the time I wore the holter monitor and while I was waiting for my results I have been experience more symptoms. Increase in sharp stomach pains in the upper part of my stomach on both sides but mostly the right. Sometimes a fullness or dull pain in right lower quadrant. It feels as though my neck is tight (no sore throat), almost like a choking feeling. My resting heart rate seems high at 96. I can feel my heart racing. Loss of appetite still remains to this day 3/12/2010 (cant finish a meal), as well as chest pain and stomach pain.
Holter revealed this:
#of supraventricular ectopics: 1
#of supraventricular isolated beats: 1
Avg Heart rate: 90
Max HR: 181 (during exercise)
Min HR: 47 (not sure when)
Longest RR: 1.480 secs (-12.800 mm)
ANALYSIS OF 48 HOUR SCAN FOR "CHEST PAIN, PALPITATIONS": Underlying rhythm is sinus/sinus arrhythmia. Heart rates range 47-181bpm, and average 90 bpm (35% tachycardia and 2% bradycardia). Maximum heart rate noted during time frame of 'lots of pain sharp, palpitations,squeezing, pressure S.O.B., pain scale 7".No ventricular ectopy noted.Supraventricular ectopy was rare with 1 isolated PAC, no couplets or runs noted.No long pauses or high grade AV blocks noted.The event marker was activated 484 times for varied symptoms of "pain sharp, palpitations, pressure, sharp arm pain, S.O.B., heart rate feels fast,pounding, squeezing, dizziness" these times were all seen with sinus rhythm/sinus tachycardia without ectopy.
DR. COMMENTS: Normal holter
My question is does this sound like Lupus? Could this flare up be caused by tanning if it is Lupus? I have an appointment on Tuesday with my REGULAR doctor in hopes to clear this up. Any advice is much appreciated. Sorry for the long post.
Thanks!