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Suggest Treatment For Heart Palpitations, Migraine And Abdominal Bloating

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Posted on Sat, 2 Apr 2016
Question: Hi there. I'm a 24 yrs old male from Vietnam. My story will quite long. Please read it in your spare time.

One year ago the symptoms started. I feel pain in my left check. But I always ignores it because it comes then go fast. I usually get hypertension for nothing. I just lay there then my heart start palpitation. Then a day, the hypertension get worst. My friend took me to the hospital. They gave me some drugs to do with the hypertension. I feel better of course. But a few hours later, it comes again then my left chest hurts. Then I suddenly had blood in my stool(fresh blood, red color, drop by drop).So I have to come a public hospital when they did several checks. They think maybe there's some problem with my heart. But after multi checks then the outcome is there's nothing wrong with my heart.

They diagnosed me for "muscle pain for unknown reason" and give me some drugs. But the symptoms was still there. One of my cousin is a doctor. So she suggested me that's maybe the problem with my stomach and acid from the gastroesophageal reflux can cause chest pain. Then I go to a private hospital to do stomach endoscopy. The result is "multiple red dot in stomach". So they gave me some stomach medicine for 3 months. I feel better this time. The chest pain reduces. But hypertension and heart palpitation is still there.

6 months ago, I couldn't stand it anymore. I feel pain in my chest, migraine headache, short breath and stomach bloating immediately after eating and numbness in my legs & thumbs and some sudden really really hurt in my leg bones. So I went to hospital one more time. The first doctor ordered me to do a abdominal ultrasound but no result. All are normal. Then a electro-mechanical tests. Now they found some "latency". Sorry I don't remember exactly the term. So they give me some calcium and vitamin D3 and multiple vitamin B. But the situation is not better so I have to go to the hospital again. Now they guide me to go to a sleep disorders doctor(because I told them that I can't sleep because of these symptoms) and a digestion doctor. The digestion doctor asked me to tell him all my symptoms then ordered a body CT scan. The outcome is nothing wrong. The 2nd doctor told me to do a full CBC test. Then the outcome is thalassemia minor(I attached here the result). They told me to go to another doctor(hematology), he ordered me to do some blood test and his conclusion is "beta thalassemia minor". But he told me that it doesn't need a treatment. He gave me some folic acid and multiple vitamin for month with a gym plan. I'm an web developer so I always in front of computer screen. I need more physical exercise. But the symptoms not gone. At this point I was too tired. I wanted to give up. Then one of my aunt(she's a doctor in infectious disease) told me that I should take some gastrointestinal antibiotics. I took and it works. 2 weeks of antibiotics and I feel really better. I can eat normally now. Heart palpitation and hypertension gone.No floating in stomach anymore. Migraine gone.

But I still feel pain in my leg and chest bone(xiphoid process). Every time I leaned forward, I feel something really really strange in the position of xiphoid process(sorry I don't know if I translate it correctly, not English speaker). And every time I inhale, I feel something like a bubble that break in that position.But the doctor told me that it's normal and try to forget it. (how can? everytime I inhale I hear it, it's not my imagination please...)

Then 3 last months, I had some new symptoms (the pain and strange feeling in xiphoid process are still there. I try to forget it but it still there). I had some kind of acne in my back(like 20 dots) and some in my upper chest. I had some fungal in my private part, it's gone now but the skin in that area becomes darker). My hair(includes public hair) start breaking.

Then 2 weeks ago, I found blood in my stool again. Then nose bleeding(a little of blood). So I go to the hospital(again, yes again) to do a CBC test(the doctor recommended me to do it if I find something strange). Then I found that PLT and MPV decrease compared to the result of 6 months ago. The MPV value is out of the range now. (I attached the report). I told the doctor about nose bleeding. But he only gave me folic acid and vitamin C. And 3 days ago. I had nose bleeding again. That's why I'm here now. What I have to do now? Should I give up and ignore all symptoms? I feel worse day by day but don't know what to do now.

p/s: I have flu for 1 month now, took 2 weeks of antibiotics but still coughing like hell and still feel pain in my chest & legs bone.
doctor
Answered by Dr. Ilir Sharka (6 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello,

Welcome on HCM!

I passed through your medical history and would say that your pain to the xiphoid process area doesn't represent any dangerous health condition. It is modulated by posture, so nothing serious (no heart issues involved).

I recommend you to repeat the digestive endoscopy for reviewing your stomach mucosa conditions, whether additional therapy is necessary.

Regarding your nose and also rectal bleeding, they could not be explained by your platelets count, as it is not any abnormal decrease.

At this point, I recommend closely monitoring your blood pressure (which may predispose nose bleeding), and also consult a proctologist (surgeon) if rectal bleeding persists (to investigate for any possible hemorrhoid plexus abnormality).

You are right about your blood count test: a decreased MCV confirms microcytosis and hemoglobin electrophoresis could definitely clarify thalassemia minor issue.

You shouldn't worry too much. Besides intermittent vitamin and other microelements therapy, nothing else is necessary facing your satisfactory blood hemoglobin level.

So, just try to correct any possible vitamin or iron deficiency which may lead also to microcytosis.

Also, I recommend you to check your thyroid hormone levels, as they may have certain implications on blood profile, and overall clinical symptomatology.

As, you are having evidence of acne and mycosis, strong suspicions about a decrease immune response exist. You need to promptly treat any obvious cutaneous manifestation, as well as to maintain a high daily body hygiene.

Hope to have been helpful to you.

In case of any further uncertainties, feel free to ask me again.

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (4 hours later)
Hi bro! Thank you for your ansy. I just have some more question s. So is there any relation between the decrease of MPV and PLT with the decrease of my immune system? I'm afraid of the platelet count decrease because I think there's some correlation between my weak immune system and the platelet decrease. One more question is I'm coughing likes hell for a month now. I took 2 weeks of antibiotics but doesn't help. Any advice bro?
doctor
Answered by Dr. Ilir Sharka (3 hours later)
Brief Answer:
Opinion as follows:

Detailed Answer:
Hello again,

Platelet count and MPV when lowered enough may predispose to increased risk of bleeding, but no direct correlation has been found with immune system, which is a functionality of white blood cells (WBC), complement cascade, etc.

Your actual platelets cound and MPV do not pose any obvious risk.

There are some other predisposing factors for decreased immunity ability, such as chronic inflammation/infection, diabetes, chronic diseases, systemic disorders, etc.

Regarding your thyroid hormone levels, they seem to be OK.

So relax!

Wishing you a good health!

Regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (36 minutes later)
Thank you dude! But can I know what can be the cause for lowered MPV and PLT? And what can I do to improve it?

Best regards!
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
A direct blood smear by microscope is necessary.

Detailed Answer:
Hi,

There are several reasons affecting platelets production by the bone marrow, leading to low platelet count and mean volume (MPV).

But before considering such a conclusion as true, it is important to directly examine platelets count and characteristics as under certain conditions, platelets may clump together and falsely appear to be low in number and/or in size, giving false results on the automatic blood analyzer.

After that it is necessary to consult a hematologist.

Greetings!

Dr. Iliri
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9533 Questions

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Suggest Treatment For Heart Palpitations, Migraine And Abdominal Bloating

Brief Answer: I would explain as follows: Detailed Answer: Hello, Welcome on HCM! I passed through your medical history and would say that your pain to the xiphoid process area doesn't represent any dangerous health condition. It is modulated by posture, so nothing serious (no heart issues involved). I recommend you to repeat the digestive endoscopy for reviewing your stomach mucosa conditions, whether additional therapy is necessary. Regarding your nose and also rectal bleeding, they could not be explained by your platelets count, as it is not any abnormal decrease. At this point, I recommend closely monitoring your blood pressure (which may predispose nose bleeding), and also consult a proctologist (surgeon) if rectal bleeding persists (to investigate for any possible hemorrhoid plexus abnormality). You are right about your blood count test: a decreased MCV confirms microcytosis and hemoglobin electrophoresis could definitely clarify thalassemia minor issue. You shouldn't worry too much. Besides intermittent vitamin and other microelements therapy, nothing else is necessary facing your satisfactory blood hemoglobin level. So, just try to correct any possible vitamin or iron deficiency which may lead also to microcytosis. Also, I recommend you to check your thyroid hormone levels, as they may have certain implications on blood profile, and overall clinical symptomatology. As, you are having evidence of acne and mycosis, strong suspicions about a decrease immune response exist. You need to promptly treat any obvious cutaneous manifestation, as well as to maintain a high daily body hygiene. Hope to have been helpful to you. In case of any further uncertainties, feel free to ask me again. Kind regards, Dr. Iliri