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Suggest Treatment For Chest Discomfort And Pain While On A Beta Blocker
Question: Hello,
I am a 23 year old female. Survived rare brain cancer, was diagnosed two years ago but now cancer free. Since the radiation and chemotherapy I have lost some hearing in both ears and have had fainting or black out spells. The cardiologist thinks I have P.O.T.S and no other heart conditions, although I have been having chest pain and palpatations when only I exert myself in the slightest. All tests have been normal, except a few EKGs that were described as "crappy." by ER doctors, yet nothing found. After lots of different dosages tried with a beta blocker, I thought things were finally under control but now I'm having more chest discomfort, new arm and shoulder tingling and achiness, and chest pain when it's cold outside or I feel cold. I thought the medicine was working (has been for a month with only tolerable minor discomfort ) but for 3 days I've felt terrible. I've been given Nitro and have never needed to use it more than once a day and the last three days I've needed to take it it twice each day, and still having bouts of pain..Need to know what this possibly could be. Starting to worry although I doubt I'm having a heart attack. Just not trying to go to the hospital if I don't have to because of all I have been through.
I am a 23 year old female. Survived rare brain cancer, was diagnosed two years ago but now cancer free. Since the radiation and chemotherapy I have lost some hearing in both ears and have had fainting or black out spells. The cardiologist thinks I have P.O.T.S and no other heart conditions, although I have been having chest pain and palpatations when only I exert myself in the slightest. All tests have been normal, except a few EKGs that were described as "crappy." by ER doctors, yet nothing found. After lots of different dosages tried with a beta blocker, I thought things were finally under control but now I'm having more chest discomfort, new arm and shoulder tingling and achiness, and chest pain when it's cold outside or I feel cold. I thought the medicine was working (has been for a month with only tolerable minor discomfort ) but for 3 days I've felt terrible. I've been given Nitro and have never needed to use it more than once a day and the last three days I've needed to take it it twice each day, and still having bouts of pain..Need to know what this possibly could be. Starting to worry although I doubt I'm having a heart attack. Just not trying to go to the hospital if I don't have to because of all I have been through.
Brief Answer:
A cardiac evaluation is justified in your case .
Detailed Answer:
Hello , I am Dr Mody and I would be addressing your concern .
I would take time to congratulate your will for being so strong .
I went through the history in detail , Now post brain surgery the radiation is generally localised and so that should nit affect the heart , however chemotherapy may cause a a lot of heart related issues if not monitored .
1) Post chemotherapy there may be affection of the heart muscle which may cause cardiomyopathy ( dilated more common ) , whereby heart dilates and may give various ecg changes particular lot of missed beats and irregular firing.
Though POTS and for ecg changes beta blocker remains the treatment of choice , still I believe that the cause behind it should be evaluated
2) A 2 D Echo cardiography to know exact status of heart , 24 hours holter monitoring to know the pattern of ecg and treating the same and if needed furthur investigation like Cardiac MRI with coronary evaluation is justified in your case.
3) Nitrates helping you relieve the pain points towards a probable Cardiac related pain , though it would reassure you its not heart attack .
By all means even when I understand you hating to go to the hospital a proper evaluation is strongly recommended.
I can help you better if you can upload any of the reports and more details like time of tumor , ecg recording , all medications tried .
Let me know if any clarification needed and I would be happy to help.
Regards Dr Priyank Mody
A cardiac evaluation is justified in your case .
Detailed Answer:
Hello , I am Dr Mody and I would be addressing your concern .
I would take time to congratulate your will for being so strong .
I went through the history in detail , Now post brain surgery the radiation is generally localised and so that should nit affect the heart , however chemotherapy may cause a a lot of heart related issues if not monitored .
1) Post chemotherapy there may be affection of the heart muscle which may cause cardiomyopathy ( dilated more common ) , whereby heart dilates and may give various ecg changes particular lot of missed beats and irregular firing.
Though POTS and for ecg changes beta blocker remains the treatment of choice , still I believe that the cause behind it should be evaluated
2) A 2 D Echo cardiography to know exact status of heart , 24 hours holter monitoring to know the pattern of ecg and treating the same and if needed furthur investigation like Cardiac MRI with coronary evaluation is justified in your case.
3) Nitrates helping you relieve the pain points towards a probable Cardiac related pain , though it would reassure you its not heart attack .
By all means even when I understand you hating to go to the hospital a proper evaluation is strongly recommended.
I can help you better if you can upload any of the reports and more details like time of tumor , ecg recording , all medications tried .
Let me know if any clarification needed and I would be happy to help.
Regards Dr Priyank Mody
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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