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My HX: GERD, Hashimotos, Menapause Aug 2016, Female, Age 48,
Question: My HX: GERD, Hashimotos, Menapause Aug 2016, Female, Age 48, 30 yr smoker (1 pack/day). Have been losing several pounds per yr. Currently weigh only 98 pounds. Have noticed increase in fatigue over past few months. This past week I had no energy and sleep for 4 days straight. During that time I also had unexplained episodes of sweating and nausea. I went to work Friday and began having a burning chest pain with SOA on exertion, dull pain in my back, nausea, faintness and Tachycardia. My resting pulse the past few days has been 90-102. My pulse on exertion would reach 135. I tried antacids and zofran with no relief. The only thing that relieves my symptoms is lying down. Every time i sit up or move around I start having these symptoms again.
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Welcome to Ask a Doctor service!
I passed carefully through your question and would explain that it is important performing some tests in order to investigate for the possible cause underlying your complaints.
In this regard I would recommend performing a cardiac ultrasound and a resting ECG in order to examine your heart function and structure.
An exercise cardiac stress test or dobutamine stress echo would help investigate for the possible coronary artery disease, which could mimic this clinical situation ( considering the fact that the chest pain is triggered by physical exertion).
The next step would be examine your lungs. In this regard, a chest X ray study and pulmonary function tests would help exclude a lung issue.
Some blood lab tests are necessary too;
- complete blood count, PCR, ESR for inflammation
- thyroid hormone levels for possible imbalance
- blood electrolytes for possible imbalances
- cortisol plasma levels for possible adrenal gland dysfunction.
In the meantime I would recommend you to closely monitor your blood pressure values and heart rate in setting and standing up position, frequently during the day.
In case your blood pressure values drops more than 20 mm Hg from lying to standing up position or your heart rate increases more than 30bpm during standing up, this would raise suspicion of postural intolerance.
In such case I would recommend performing a Head up Tilt test to investigate for this possible disorder.
You should discuss with your doctor on the above tests!
Hope you will find this answer helpful!
I remain at your disposal for any further questions whenever you need!
Kind regards,
Dr.Ilir Sharka, Cardiologist
I would recommend as follows:
Detailed Answer:
Hello!
Welcome to Ask a Doctor service!
I passed carefully through your question and would explain that it is important performing some tests in order to investigate for the possible cause underlying your complaints.
In this regard I would recommend performing a cardiac ultrasound and a resting ECG in order to examine your heart function and structure.
An exercise cardiac stress test or dobutamine stress echo would help investigate for the possible coronary artery disease, which could mimic this clinical situation ( considering the fact that the chest pain is triggered by physical exertion).
The next step would be examine your lungs. In this regard, a chest X ray study and pulmonary function tests would help exclude a lung issue.
Some blood lab tests are necessary too;
- complete blood count, PCR, ESR for inflammation
- thyroid hormone levels for possible imbalance
- blood electrolytes for possible imbalances
- cortisol plasma levels for possible adrenal gland dysfunction.
In the meantime I would recommend you to closely monitor your blood pressure values and heart rate in setting and standing up position, frequently during the day.
In case your blood pressure values drops more than 20 mm Hg from lying to standing up position or your heart rate increases more than 30bpm during standing up, this would raise suspicion of postural intolerance.
In such case I would recommend performing a Head up Tilt test to investigate for this possible disorder.
You should discuss with your doctor on the above tests!
Hope you will find this answer helpful!
I remain at your disposal for any further questions whenever you need!
Kind regards,
Dr.Ilir Sharka, Cardiologist
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Kampana
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