Sharp Chest Pain in a Trucker

[mongothetrucker]

hey...

About 3 weeks ago, I felt a quick sharp pain in the center of my chest followed by a wave of pins and needles quickly going down my body and both legs. My first thought was blood clot passing through the heart.

Quick history... Hypertensive (metoprolol), overweight ( 6'0" 275lbs)... Trucker, so I wondered about DVT from sitting.

There were some lingering "odd feelings" and dizzyness.

thoughts?

[Dr Steve]

hey...

About 3 weeks ago, I felt a quick sharp pain in the center of my chest followed by a wave of pins and needles quickly going down my body and both legs. My first thought was blood clot passing through the heart.

Quick history... Hypertensive (metoprolol), overweight ( 6'0" 275lbs)... Trucker, so I wondered about DVT from sitting.

There were some lingering "odd feelings" and dizzyness.

thoughts?

Although I'm usually a nervous nellie, I'm doubtful on this one, Mongo! The reason is this: if you have a DVT (deep venous thrombosis, for the uninitiated) and it cuts loose, the only place for that clot to go is into the lungs. Remember, the venous blood supply enters the right side of the heart and then is pumped directly to the lungs for oxygenation. This would cause a "pulmonary embolism", the symptoms of which are generally sudden onset of sharp chest pain (which you had) and shortness of breath (which you didn't). You're absolutely right that people who sit in one position for a long time are at higher risk for DVT and pulmonary embolism.

http://facstaff.gpc.edu/~jaliff/hartflo2.gif

Although I doubt this was a pulmonary embolism, any kind of unexplained chest pain should be investigated. Heart pain isn't always dull, but it's infrequently sharp. You may have had a spasm of your esophagus, or spasm of a muscle between your ribs, all kinds of things. The weird tingling feeling going down your body is harder to explain...if you'd thrown an ARTERIAL blood clot big enough to cause symptoms, you'd expect some pretty bad results, like a blue leg or foot.

I occasionally have palpitations...this causes a weird jumping feeling in my chest that radiates to the rest of my body. I know there are no physical conduits in my body that explain those weird feelings, but there they are anyway. Perhaps it's just chi, as they say in traditional Chinese medicine. who knows?

Better part of valor is to tell your health care provider about this episode. He/she may or may not decide to work it up at this time, but it's best to give them the chance to decide as soon as possible.

Good luck and keep us in the loop.


your pal,


Steve

[mongothetrucker]

Thanks, Steve.

I also forgot to mention that a previous physician had me wear a monitor for 24 hours and said I could have SVT (super ventricular tachycardia- for the readers) I wondered if that may have been a slightly larger occurance.

I was a firefighter and an EMT for 9 years. You know as well as anyone that we make stubborn patients.

:D

[Dr Steve]

Thanks, Steve.

I also forgot to mention that a previous physician had me wear a monitor for 24 hours and said I could have SVT (super ventricular tachycardia- for the readers) I wondered if that may have been a slightly larger occurance.

I was a firefighter and an EMT for 9 years. You know as well as anyone that we make stubborn patients.

:D

yes, just as bad as MD's :-)

you bring up an interesting point...how do you diagnose something that only happens every once in awhile (like supraventricular tachycardia)?

If it's cardiac, and it happens every day, you can do a 24 hour "holter" monitor...this is a test that records EACH AND EVERY heart beat for 24 to 48 hours. A computer scans it afterward and tries to detect abnormal beats, and "runs" of abnormal beats.

Supraventricular tachycardia is translated thusly: SUPRA=above, so this is a tachycardia that arises in the heart above the level of the ventricles (the big pumpy parts). Tachy=fast and cardia=pertaining to the heart so tachycardia= fast heart beats. SVT is annoying, but rarely serious unless it just goes on and on and on (as opposed to "Ventricular tachycardia", which arises in the ventricles and can be life threatening). SVT is pretty easy to treat and diagnose if it lasts long enough for you to go to the ER and have someone do an EKG. Which is the other way to diagnose something like this...catch it while it's happening.

But what if it lasts 10 seconds and only occurs every month or so? Well, this is a case for an "event monitor", which is a device that you wear constantly, but it only records beats when you push a button on it. So you wait until you have an episode and hit the button and then they analyse it (over the phone, sometimes!)

But what if it happens only once, and never again?

Most doctors will say "FUGGETABOUTIT" if it didn't cause any damage the one time it happened, but usually only after a complete workup that may even include a stress test.

As always, check this stuff out with your regular doctor!


your pal,



Steve