Pericardits questions.. part 2...sorry so long

I guess what I would really like to know is there any other thing i should ask Dr. for if all my tests are negative so far but I still continue to have chest symptoms and can't sleep lying flat and now having some heart palpitations ( can colchicine cause that?)... would another round of bloodwork be helpful at all since it has been about 6.5 weeks since I had bloodwork done and I would have a baseline to compare it to....

I know anxiety could cause heart palpitations, but I feel my anxiety has been reduced as I have taken the past 2 weeks off work just trying to relax and also was hoping my symptoms might ease up if i wasn't constantly being bombarded by people at work trying to diagnosis me and ask how I was doing since I work in a medical office. I am open to any suggestions or advice anyone can offer or alternate diagnosis.

As I sit here typing with my chest feeling like it is fluttering, I feel like I am sure it is my heart and maybe its just not bad enough to show on tests at this point, but not sure what to do now. My other concern really has to do with my job as it is very physical and I move x-ray equipment constantly working in a busy Orthopedic office x-raying lots of older patients who need hip and knees replaced and they are often large and can't move. It's not a low- activity job and I wonder if that will be detrimental to my recovery process if i continue to do it since there is not a way to make it less physical. I think that is another reason i would really like to get a solid diagnosis so I can do what is best for helping myself recover. Thoughts anyone?? Thanks !! Amber

Well my regular Dr. passed me to a Pulmonologist who I just saw again today for 2nd time and he concluded after my pulmonary function test that my lungs are really good and that I might need a holter monitor from cardiologist for the palpitation issue so I am seeing one next week on Wedneday.

I saw one 3 weeks ago and he was not helpful, the Dr. I saw today knows him and agreed I needed someone with a better bedside manner so now I am seeing another one in same office that several people have highly recommended. I don't know if you saw my first post that I am a fitness instructor and basically lucky enough to have lived my entire life with no health issues and took no meds and ever since i came down with whatever virus at end of March this year, my weird chest symptoms started shortly after that.

I do have moderate level anxiety at this point...that could be factoring into the palpitations too perhaps, not being able to exercise making me crazy I think.

I feel pressure in my mid chest when I lay flat that is why I don't think it is just anxiety. Pleurisy, no, reflux, no, hiatal hernia, no.. would show on ct of chest so I don't have that and it's not my lungs and I don't have right symptoms for chostrochondritis either or gallbladder as far as I can tell.

Pulmonologist said I could have inflammation in heart that doesn't show up on tests and also said maybe some irregular heart rhythm that just developed..I still think its probably pericarditis but just not bad enough to show on tests, although the other weird thing is the meds ( ibuprofen and colchicine) seem to do nothing to make it feel better.... as in...why can't I lay flat in bed for a month plus????

I have not had a stress echo, just a regular one. I will be seeing the hopefully more help Cardiologist in a week and go from there. I wasn't have the palpitations at the time of seeing the Cardiologist 3 weeks ago. That is a fairly new thing.

The funny thing is the first time I saw the Pulmonologist he was going with pericarditis as a diagnosis then I see the Cardiologist and he says...maybe it's your lungs! lol.. but now we have ruled out lungs. so moving on....thanks for replying!

Well, I have not been exercising at all save a few walks around the park and have read a lot of that not being a good thing. I don't think my body will allow it anyways, my heart feels like its gets going really quickly. The weird thing about my situation is that I don't present with chest pain like many people with Pericarditis more of the pressure feeling and the whole laying down thing has been ongoing for 7 weeks at least. I think that is part of the reason the Drs. so far are confused because I don't have the pain. I hope the next Cardio doc is more helpful, I have heard good things from Drs in my office who send patients to him.

My palpitations are new in the past couple weeks and it basically feels like I just feel my heart moving inside my chest. I was not having that before, I really notice it when I am sitting still. I am doing an experiment right now with stopping ibuprofen to see if it makes my symptoms worse. The Pulmonologist told me to try it since i don't feel it is making things better. I have had so many people tell me I might have pericarditis that i pretty much convinced I do at this point but also just because it makes the most sense to me since i was sick and my symptoms came on a week or so after my fever- but all around that time I exercised really strenuously.

Don't know if it is just due to anxiety/taking ibuprofen/colchicine but my BP at Dr was 146/92 and last year at this time it was 116/74. Just something I have noticed. Never had BP issues before this. Thanks for responding, I will take a look at the article you sent.
Amber

Hi Kitt,

I am well read on pericarditis at this point, but I will look at the link. lol. The cardiologist didn't have a good bedside manner and I am actually the one who requested the colchicine. I am firing him and seeing another one in the same office

I can tell that my regular Dr. does not think I have Pericarditis and I think everyone else is just unsure because I haven't had any tests that showed anything at all. One of the Orthopedic drs I work with planted the seed in my head of pericarditis back at the beginning of April when I went to him saying I didn't feel right and the saga has went on from there..... I am actually going to beg the new Dr. to do more bloodwork since it's been almost 2 months since I had the original bloodwork done, my weird symptoms have not improved. I just haven't presented typical pain symptoms, more a complain of a weird pressure in chest feeling when I was sitting and discomfort laying flat so I have been sleeping propped up.

I have a constriction issue that Is a concern as well, since we have now ruled out lungs as being an issue. I feel a tightness when I get to maximum inspiration in the center of my chest. I caught my syptoms very early because I had been sick with some kind of virus... and since I normal feel quite good and healthy I am very in tune to the ways I don't feel right. I am actually doing an experimental stopping of meds to see if i get worse symptoms. It was at my drs suggestion. I am super healthy person otherwise....with the exception I also now have high blood pressure that i didn't have a year ago so that could be my genetics (both grandmas) or a combo of that, stress, meds etc... but suddenly I am staying in the 140's over 90's range.

The biggest reason I feel like I do have it is because of what I was doing when I got sick. I taught 6 aerobics classes, strenuous higher cardio ones, during the first 8 days of my illness and I had a low fever on one of the days (day 3) that i was not teaching a class that went away with some tylenol. Then I took a break from teaching and tried to do a class about 10 days later and when I finished I felt a lot of tightness right in the center of my chest... not in my lungs... they felt fine. This is information I am going to push with this new Dr. I really think no one is believing me because I am so healthy and then my tests are negative but I also started treating very early even without a definitive diagnosis so I had been on some kind of anti-inflammatory since shortly after I started feeling weird.

I don't know if a second round of bloodwork will show anything, but I was thinking maybe since I now am having heart palpitations..it might. That could be anxiety of course too. My regular dr. today said to monitor my heart palps and check my pulse when I am having them... if my pulse is regular and not racing it is probably a benign thing.

arf007,

Again, I am glad to read you know yourself well and you are going to continue to advocate for yourself. If you have been reading up on Pericarditis you know there is acute and chronic Pericarditis.  Pericarditis can progress to more serious conditions, including chronic forms of pericarditis and the most serious complication of pericarditis, cardiac tamponade.

Chronic pericarditis is a long-lasting inflammation resulting in either gradual fluid accumulation (effusive pericarditis) or slow thickening of the pericardium into scar-like tissue (constrictive pericarditis).

I know you most likely know this but as a gentle reminder be sure your new Cardiologist  performs a complete medical history and physical examination, and  orders  blood tests to make sure the kidneys are working properly, to assess for immune disorder, and to detect certain infections.

Your doctor will review your medical history, especially any history of recent infections, heart attack, chest trauma, chest surgery, and chronic diseases. Your doctor will also ask you to describe specific details about your chest pain, including its location, what triggers it (e.g., cough, swallowing, deep breath), how long it lasts, and what relieves it.

Your doctor will also listen through a stethoscope for scratchy sounds called a pericardial rub, which are produced by heart muscle rubbing against the inflamed pericardium. Blood tests will look for increased numbers of white blood cells and other substances that would suggest the presence of infection and inflammation in the body.

Your doctor may recommend that you have an electrocardiogram (ECG), a test that monitors the electrical activity of the heart. Characteristic changes of electrical activity occur with pericarditis, and an ECG will detect these changes. The ECG can also help to rule out pericarditis by suggesting other causes of chest pain, such as a recent or past heart attack.

I would suggest you ask your Dr. for a 2D-echocardiogram for a detailed view of your heart. An echocardiogram is a painless scan that uses sound waves to image structures in and around the heart. An echocardiogram easily detects accumulated fluid in the pericardial sac, which typically accompanies pericarditis.

Other tests that may help your doctor diagnose pericarditis include a CT scan, an MRI scan, a chest x-ray, pericardiocentesis, and pericardial biopsy. ^{Reference - PDR}

I am a ER/ICU nurse - retired now - but have 35 years experience so I know there are times we are tough patients. I only do what I did for my patients when it comes to myself - advocate.

Keep us posted. Also remember we are not medical professionals here in the forum - we are peers so never take the information you read here in place of your physicians.

Kindly,

Kitt

I am a newbe so I hope by now you have found the problem I went through all the tests and they all came back Ok they even did a ultrasound of my kidneys they said everything looks good but I still had a lot of pain and my doctor told me the same thing your doctor was telling you so doing my own research I asked him about doing A cardiac catheterization and that's when they found 11 blocked arteries at least 90 to98% blocked I had to have an urgent quadruple bypass surgery so don't stop asking questions until they find out what is causing you to feel the way you feel