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I have pleurisy????? I have pleurisy?????

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Unread 04-16-2003, 12:10 PM
I have pleurisy?????

I know this has nothing to do with my surgery (at least I hope it doesn't!), but I don't know where else to post it.

I woke up at 5:15 yesterday morning with horrible chest pain that radiated into my left arm, my back, and my jaw. I thought I was having a heart attack. I was so scared!!! (I'm only 40!!)

My brother took me to the ER, where they ran blood tests, did a chest x-ray, and EKG, and also did a pulmonary embolism test. I was given three Morphin injections for the pain, the last of which made me nauseated.

I was in the ER for almost 8 hours. As it turns out, the doctor really doesn't know what is causing my pain. According to all the tests, it's not my heart, thank goodness! He thinks it might be pleurisy (can't spell that!), though I really don't have any other symptoms, such as coughing or pain when breathing. My blood pressure was also high, and I'm having palpitations too. I was sent home with Vicodin, Pepsid for my stomach (there's nothing wrong with my stomach), and a medication which will lower my blood pressure. I was told to make an appointment with my doctor, but they can't get me in until June 10!

Now for the question: I have non-refundable tickets to fly to Jacksonville Friday to visit my kids and my grandkids. I haven't seen them since August, and I'm really looking forward to going. However, my mom thinks that I shouldn't go at all, just in case something happens while I'm gone. (She still thinks it's my heart.) I'm at work now, and the Vicodine just wore off and the horrible pain is back again! (I was trying to see if I could get by without taking the pain med, as it's making me sick to my stomach!) I feel so icky!! Not only am I hurting, but I'm nauseous as well, and the palpitations are back again. I get out of breath if I try to walk to the bathroom, right down the hall! It's all I can do to just sit here, but I can't afford to be off from work right now.

What would you do? Would you go ahead and go to Florida anyway? It's my oldest son's birthday Friday! I want to see my grandbabies!

I could just

Thanks and s,

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Unread 04-16-2003, 12:29 PM
I have pleurisy?????


I know pleurisy well...I went to the doc many many many moons ago thinking I was having a heart attack and was told this is what it was.

I have episodes rarely and mostly at night now laying down seems to bring them on at times. It's horrible isn't it? You can't catch a breath cause breathing in makes the pain worse...the pain is like someone is stabbing you just under your boob with a knife...Walking when one hits seems to be about the best thing to make it pass for me...that and pressing my fist into the area...it lasts for me about 3 min per attack and attacks last anywhere from one time to two days...sometimes it just doesn't go away and excersise seems to bring it on worse..

I found this for you....

What Is Pleurisy?

Pleurisy is a term used to describe the chest pain associated with inflammation of the pleura. The pleura consists of two thin layers of tissue. One layer lines the inside chest wall and the other covers the lungs. The tiny space between the two layers is called the pleural cavity. This cavity normally contains a small amount of lubricating fluid that allows the two layers to slide over each other when a person breathes. When the pleura becomes inflamed (pleuritis), the layers rub together, resulting in the pain of pleurisy. Fluid may build up in the pleural cavity (pleural effusion) and may increase the severity of the pain. The pain of pleurisy usually starts suddenly and often is described as a stabbing pain.
Most cases of pleurisy can be treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and pain medication. In severe cases, prescription cough or pain medications may be needed. The pain may be relieved by lying on the painful side or pressing a pillow against it.

There is some more info at WebMD....

I hope this helps sweetie!!!!! It is scarey when it happens isn't it?

tons of

Unread 04-16-2003, 12:31 PM
I have pleurisy?????

Oh (((Lisa))) I'm so sorry! But you know what we're going to say, right? No way should you be traveling so far from home when you're having such potentially serious problems and have no diagnosis yet. It's just too risky. I wouldn't recommend that you get on a plane right now. I'm not so sure you should be at work either, sweetie... I'm worried about you!

What you're describing sure doesn't sound like pleurisy, but I'm not an MD. Can you get another opinion? Did they do the EKG during the chest pain or after? The reason I'm asking is that what you describe sounds a lot like what happens when you have a spasm in your coronary artery... causes unstable angina symptoms, like that severe chest pain radiating out into the arm and up into the neck and jaw, but it may not show up in an EKG unless you do it during the worst of the pain.

How is your lipid profile? Have you been diagnosed with high cholesterol or atherosclerosis? These are all things I would get checked out if they haven't already done so.

Again, I am not an MD. I'd urge you, though, to get yourself to an MD you trust and have some more tests done. Do not pass GO, do not fly to Jacksonville... your family will understand and I'm sure they would rather have you healthy than putting yourself in danger.

Please take care of yourself, and let us know what you find out, OK?
Lots of s,
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Unread 04-16-2003, 01:14 PM
I have pleurisy?????


I think I saw someone post around here with similar symptoms and it turned out to be esophagus problems. Are you having any problem swallowing or eating?

I had pleuresy many years ago and it hurt to breathe, but not badly enough for pain pills and no radiation of pain like what you are describing. It was secondary to pneumonia.

I sure hope you get some answers soon. Please push the point with your MD. Ask to speak with your doctor's nurse, if you have not already, and tell her what the problem is and that you are planning to go out of town and need to have your doctor clear you to do that (or not). Sometimes the appointment clerks just don't get it and will drag you out for awhile.

Best wishes on a speedy resolution and I hope you get your MDs approval to make your visit!!!

Unread 04-16-2003, 01:17 PM
Thanks Dawn and Linda,

Dawn, what you are describing is not at all what I am having, which makes me wonder if it really is pleurisy. The pain is an ache, not a stabbing pain, and it doesn't get worse when I breath or cough, it's a constant pressure/pain in the upper left part of my chest that radiates down my left arm, up into my left jaw, and all the way through into my back. (Right now, it feels as though someone is trying to push their way out of my chest, almost like my chest is going to explode!)

And it's a bad pain! I have a very high pain threshhold. When I had my surgery last May, I went 24 hours in the hospital without any pain meds, because the morphine was making me ill. I had two babies with NO pain meds at all!! But this HURTS!!!!! It's about an 8 on a 1 to 10 scale, while my surgery never got above a 4. (Plus, I think I may have a fever now. But there's no thermometer around here to check it with. Guess I'll have to wait until I get home tonight to check.)

Linda, they did the EKG twice, once when I first got there, and then again when the pain returned and I was having palpitations. They also did blood tests, which would show enzymes in my blood if heart muscles had been damaged. I know my cholesterol is high, and my blood pressure is high too. Plus, I desperately need to lose weight!! But I've always been healthy, except for last year when I had surgery.

I'm thinking though if it was my heart, wouldn't I have already keeled over dead by now? It's been 33 hours since it first started.

You may be right about my trip to Florida. I'll see how I feel tomorrow.


Unread 04-16-2003, 02:41 PM
I have pleurisy?????


Honey...if what is described in the WEbMD terms is not what you are having then I think I would have to go back to the ER and make them double check.....Have you called your reg doc yet? when is the soonest they can see you?

If it's not the pleurisy then they need to help you figure out what in the world is going on....

tons and tons of

Unread 04-16-2003, 03:06 PM
Please, Please, Please get a second opinion!!!

I don't want to scare you but this sounds more heart related to me. Cardiac enzymes will show if you are having a heart attack but they won't show if you have a clogged artery. My father in law just had a quintuple bypass in Oct of last year and had all the same tests you had, but his came back negative also. They finally did a cardiac catheterization and that is when they found the severe blockage in 5 arteries. Please don't sit there at work with this pain. Go directly to the ER. I don't know where you live, but if there is another hospital you could go to then I would go there. Do not let this go!!! You could DIE!!!
I am very concerned about you and want you to seek help immediately!!!


Unread 04-16-2003, 03:24 PM
I have pleurisy?????

(((((Lisa))))), here is some info. about heart disease and angina. It is possible to have angina and still have a normal EKG. I hope the DRs will not give up until they find out definitely the cause of your pain.

What Puts You at Risk
A number of factors place you at risk for heart disease. These factors are referred to as “cardiovascular risk factors.” Cardiovascular risk factors are either “non-alterable” (risks you cannot change) or “alterable” (risks you can change):

Family history
Ethnic background

High blood pressure
High cholesterol
Sedentary lifestyle
Estrogen loss at menopause
Signs & Symptoms in Women
The signs and symptoms of heart disease in women may look different than those in men. Men typically complain of crushing left-side (substernal) chest pain, which often radiates to the left arm. Women are more likely to have atypical chest pain that radiates to the jaw, neck, throat, shoulder or back. Other symptoms such as nausea, dizziness, lightheadedness and fatigue may be more likely to strike women as well.

American Heart and Lung Institute's OVERVIEW about


Angina is one of many causes of chest pain.
Angina is chest pain that is a result of inadequate oxygen supply to the heart muscle.
Angina can be caused by coronary artery disease or spasm of the coronary arteries.
EKG, exercise treadmill, stress echocardiography, stress thallium, and cardiac catheterization are important in the diagnosis of angina.
Treatment of angina includes rest, medications, angioplasty, and/or coronary artery bypass surgery.

Chest pain is a common symptom which can be caused by many different conditions. Some causes of chest pain require prompt medical attention, such as angina, heart attack, or tearing of the aorta. Other causes of chest pain can be evaluated electively, such as spasm of the esophagus, gallbladder attack, or inflammation of the chest wall. Therefore, an accurate diagnosis is important in providing proper treatment to patients with chest pain. The diagnosis and treatment of angina is discussed below, as well as the diagnosis of other causes of chest pain that can mimic angina.

What is angina?

Angina (angina pectoris - Latin for squeezing of the chest) is the chest discomfort that occurs when the blood oxygen supply to an area of the heart muscle does not meet the demand. In most cases, the lack of blood supply is due to a narrowing of the coronary arteries as a result of atherosclerosis (see below). Angina is usually felt as a squeezing, pressure, heaviness, tightening, or aching across the chest, particularly behind the breastbone. This pain often radiates to the neck, jaw, arms, back, or even the teeth. Patients may also complain of indigestion, heartburn, weakness, sweating, nausea, cramping, and shortness of breath. Angina usually occurs during exertion, severe emotional stress, or after a heavy meal. During these periods, the heart muscle demands more blood oxygen than the narrowed coronary arteries can deliver. Angina typically lasts from 1 to 15 minutes and is relieved by rest or by placing a nitroglycerin tablet under the tongue. Nitroglycerin relaxes the blood vessels and lowers blood pressure. Both resting and nitroglycerin decrease the heart muscle's demand for oxygen, thus relieving angina.

What causes angina?

The most common cause of angina is coronary artery disease. A less common cause of angina is spasm of the coronary arteries. Coronary arteries supply oxygenated blood to the heart muscle. Coronary artery disease develops as cholesterol is deposited in the artery wall, causing the formation of a hard, thick substance called cholesterol plaque. The accumulation of cholesterol plaque over time causes narrowing of the coronary arteries, a process called atherosclerosis. Atherosclerosis can be accelerated by smoking, high blood pressure, elevated cholesterol, and diabetes. When coronary arteries become narrowed by more than 50% to 70%, they can no longer meet the increased blood oxygen demand by the heart muscle during exercise or stress. Lack of oxygen to the heart muscle causes chest pain (angina).

The walls of the arteries are surrounded by muscle fibers. Rapid contraction of these muscle fibers causes a sudden narrowing (spasm) of the arteries. A spasm of the coronary arteries reduces blood to the heart muscle and causes angina. Angina as a result of a coronary artery spasm is called "variant" angina or Prinzmetal's angina. Prinzmetal's angina typically occurs at rest, usually in the early morning hours. Spasms can occur in normal coronary arteries as well as in those already narrowed by atherosclerosis.

Why is it important to establish the diagnosis of angina?

Angina is usually a warning sign of the presence of significant coronary artery disease. Patients with angina are at risk of developing a heart attack (myocardial infarction). A heart attack is the death of heart muscle precipitated by the complete blockage of a diseased coronary artery by a blood clot.

During angina, the lack of oxygen (ischemia) to the heart muscle is temporary and reversible. The lack of oxygen to the heart muscle resolves and the chest pain disappears when the patient rests. The muscle damage in a heart attack is permanent. The dead muscle turns into scar tissue with healing. A scarred heart cannot pump blood as efficiently as a normal heart, and can lead to heart failure.

Up to 25% of patients with significant coronary artery disease have no symptoms at all, even though they clearly lack adequate blood and oxygen supply to the heart muscle. These patients have "silent" angina. They have the same risk of heart attack as those with symptoms of angina.

How is angina diagnosed?

The resting electrocardiogram (EKG) is a recording of the electrical activity of the heart muscle, and can detect heart muscle which is in need of oxygen. The resting EKG is useful in showing the changes which are caused by a heart attack. It is less useful in patients with angina, since the chest pain and lack of oxygen supply to the heart only become evident during exertion or excitement.

In patients with a normal resting EKG, exercise treadmill or bicycle testing can be useful screening tools for coronary artery disease. During an exercise treadmill test, EKG recordings of the heart are performed continuously as the patient undergoes increasing levels of exercise. The occurrence of chest pain during exercise can be correlated with changes on the EKG which demonstrate the lack of oxygen to the heart muscle. When the patient rests, the angina and the changes on the EKG which indicate lack of oxygen to the heart can both disappear. The accuracy of exercise treadmill tests in the diagnosis of significant coronary artery disease is 60% to 70%.

If the exercise treadmill test does not show signs of coronary artery disease, a nuclear agent (thallium) can be given intravenously during exercise treadmill tests. The addition of thallium allows nuclear imaging of blood flow to different regions of the heart, using an external camera. A reduced blood flow in an area of the heart during exercise, with normal blood flow to the area at rest, signifies significant artery narrowing in that region of the heart.

Stress echocardiography combines echocardiography (ultrasound imaging of the heart muscle) with exercise treadmill testing. Like the exercise thallium test, stress echocardiography is more accurate than an exercise treadmill test in detecting coronary artery disease. When a coronary artery is significantly narrowed, the heart muscle supplied by this artery does not contract as well as the rest of the heart muscle during exercise. Abnormalities in muscle contraction can be detected by echocardiography. Stress echocardiography and thallium stress tests are both about 80% to 85% accurate in detecting significant coronary artery disease.

When a patient cannot undergo exercise stress test because of neurologic or arthritic difficulties, medications can be injected intravenously to simulate the stress on the heart normally brought on by exercise. Heart imaging can be performed with a nuclear camera or echocardiography.

Cardiac catheterization with angiography (coronary arteriography) is a technique that allows x-ray pictures to be taken of the coronary arteries. It is the most accurate test to detect coronary artery narrowing. Small hollow plastic tubes (catheters) are advanced under x-ray guidance to the openings of the coronary arteries. Iodine contrast "dye," is then injected into the arteries while an x-ray video is recorded. Coronary arteriography gives the doctor a picture of the location and severity of coronary artery disease. This information can be important in helping doctors select treatment options.

What are other causes of chest pain?

In caring for patients with chest pain, the doctor distinguishes whether the pain is related to a lack of oxygen to the heart muscle (as in angina or heart attack), or is due to another process. Many conditions are considered that can cause chest pain which is similar to that of a heart attack or angina. Examples include the following:

Pleuritis- inflammation of the lining of the lung.
Pericarditis- inflammation of the lining of the heart.
Pulmonary embolism- a blood clot in the lung.
Pneumothorax- bursting of the tiny air sacs in the lung tissue.
Mitral valve prolapse - a valve abnormality occurring in the heart.
Aortic dissection - a tear up the wall of the aorta.
Costochondritis - inflammation of the cartilage at the end of the ribs next to the breastbone.
Rib fractures.
Nerve compression - external pressure on the nerves.
Shingles- nerve infection due to the herpes zoster virus.
Esophageal spasm and reflux - spasm of the esophagus and regurgitation of the stomach contents and acid into the esophagus.
Gallbladder attack ( gallstones).
Anxiety and panic attack.

Inflammation of the lining of the lungs (pleuritis) causes sharp chest pain, which is aggravated by deep breathing and coughing. This condition is called pleurisy. Patients often notice a shortness of breath, in part due to their shallow breathing to minimize chest pain. Viral infections are the most common causes of pleurisy. Other systemic inflammatory conditions, such as systemic lupus, can also cause pleurisy.

Inflammation of the lining around the heart is called pericarditis. Symptoms of pericarditis are similar to that of pleuritis.

A bacterial infection of the lung (pneumonia) causes fever and chest pain. Chest pain in bacterial pneumonia is due to an irritation or infection of the lining of the lung (pleura).

When blood clots travel from the veins of the pelvis or the lower extremities to the lung, the condition is called pulmonary embolism. Pulmonary embolism can cause death of lung tissue (pulmonary infarction). Pulmonary infarction can lead to irritation of the pleura, causing chest pain similar to pleurisy. Some common causes of blood clots in these veins include prolonged immobility, recent surgery, trauma to the legs, or pelvic infection.

The small sacs in the lung tissue can spontaneously burst, causing pneumothorax. Symptoms of pneumothorax include sudden, severe, sharp chest pain and shortness of breath. One common cause of pneumothorax is severe emphysema.

Mitral valve prolapse (MVP) can cause chest pain. Mitral valve prolapse is a common heart valve abnormality, affecting 5- 10% of the population. MVP is especially common among women between 20 to 40 years of age. Chest pain with MVP is usually sharp and can be prolonged. Unlike angina, chest pain with MVP rarely occurs during or after exercise, and may not respond to nitroglycerin.

The aorta is the major vessel delivering blood from the left ventricle to the rest of the body. Tearing of the aorta wall (aortic dissection) is a life- threatening emergency. Aortic dissection causes severe, unrelenting chest and back pain. Young adults with aortic dissection usually have Marfan's syndrome. Marfan's syndrome is an inherited disease in which an abnormal form of the structural protein called collagen causes weakness of the aortic wall. Older patients develop aortic dissection typically as a result of chronic, high blood pressure, in addition to generalized hardening of the arteries (atherosclerosis).

Pain originating from the chest wall may be due to muscle strain or spasm, costochondritis, or rib fractures. Chest wall pain is usually sharp and constant. It is usually worsened by movement, coughing, deep breathing, and direct pressure on the area. Muscle spasm and strain can result from vigorous, unusual twisting and bending. The joints between the ribs and cartilage next to the breastbone can become inflamed, a condition called costochondritis. Fractured ribs resulting from trauma or cancer involvement can cause significant chest pain. Common cancers that spread (metastasize) to the ribs include breast and prostate cancer.

Compression of the nerve roots by bone spurs as they exit the spinal cord can cause pain. Nerve compression can also cause weakness and numbness in the upper arm and chest. Nerve irritation also occurs with shingles (herpes zoster infection of the nerves), which can cause chest pain days before any typical rash appears.

The esophagus is the long muscular tube connecting the mouth to the stomach. Reflux, or regurgitation of stomach contents and acid into the esophagus can cause heart burn and chest pain. Spasm of the muscle of the esophagus can also cause chest pain which can be indistinguishable from chest pain caused by angina or a heart attack. The cause of esophageal muscle spasm is not known. Pain of esophageal spasm can respond to nitroglycerin in a similar manner as angina.

Gallstones can cause severe pain of the upper abdomen, back and chest. Gallbladder attacks can mimic the pain of angina and heart attack.

Anxiety, depression, and panic attacks are frequently associated with chest pain lasting from minutes to days. The pain can be sharp or dull. It is usually accompanied by shortness of breath, or the inability to take a deep breath. Emotional stress can aggravate chest pain, but the pain is generally not related to exertion, and is not relieved by nitroglycerin. These patients often breath too fast (hyperventilate), causing light-headedness and numbness and tingling in the lips and fingers. Coronary artery disease risk factors are typically absent in these patients. Since there is no test for panic attacks, patients with chest pain usually undergo tests to exclude coronary artery disease and other causes of chest pain.

How does the doctor make a diagnosis in patients with chest pain?

The first step in the diagnosis of chest pain is the doctor's physical examination of the patient. In patients with costochondritis and rib fracture, the affected areas are tender to external pressure. In patients with herpes zoster, the characteristic rash of shingles usually appears 1 to 3 days after the onset of the sharp, burning chest pain.

The doctor listening to the lungs with a stethoscope can detect a scratchy, rubbing sound during breathing, suggesting pleurisy. A similar rubbing sound heard over the heart during heart beating can indicate pericarditis. The heart might have an extra clicking sound during heart contraction in patients with mitral valve prolapse. Decreased and abnormal sounds heard over the chest suggest pneumonia. The lack of breathing sounds or severe shortness of breath in a patient with a rib fracture can be a sign of a puncture of the lung, leading to pneumothorax. The finding of a swollen thigh or calf after surgery in a patient with shortness of breath and chest pain suggests blood clots in the leg and pulmonary embolism.

Many radiological techniques are available to the doctor in evaluating patients with chest pain. Chest x-rays are useful in detecting pneumonia, pneumothorax, rib fractures, and sometimes fluid along the lung lining due to pleurisy. Echocardiography uses ultrasound waves to make pictures of the heart and can help detect inflammation of the heart lining. It is also useful in detecting mitral valve prolapse. Ultrasound examination of the gallbladder is highly accurate for gallstones. X-ray motion pictures can be obtained of the esophagus after swallowing a chalky substance (barium) to detect spasm and other abnormalities of the esophagus.

In patients suspected of having a pulmonary embolism, an ultrasound study and other x-rays can be obtained to detect clots in the veins of the lower extremities. To identify blood clots in the lungs, nuclear isotopes are administered intravenously as well as by inhalation. Nuclear cameras are then used to detect uneven distribution of these nuclear isotopes in the lungs, indicating the presence of blood clots. Pulmonary angiography is sometimes needed to confirm the diagnosis of pulmonary emboli. During pulmonary angiography, contrast dye is injected through a small hollow plastic tube (catheter) into the pulmonary arteries while x-rays are taken.

The electrocardiogram (EKG) is a recording of the electrical activity of the heart. It is useful in showing the typical changes of pericarditis in up to 90% of patients.

Tearing (dissection) of the aorta usually is seen as a large aortic shadow on the chest x-ray. This diagnosis can be confirmed by a computed tomographic (CT) x-ray or magnetic resonance imaging (MRI). Angiography, a procedure which involves using contrast dye injected into the aorta, has been considered the most accurate test for aortic dissection. A newer technique called transesophageal echocardiography (TEE) appears to be as accurate as angiography in detecting aortic dissection. A small ultrasound probe is advanced into the mouth and down the esophagus while pictures are taken of the adjacent aorta.

What are the treatment options for angina patients?

Treatment options include rest, medications (nitroglycerin, beta-blockers, calcium channel blockers), percutaneous transluminal coronary angioplasty (PTCA), or coronary artery bypass graft surgery (CABG).

Resting, sublingual (placed under the tongue) nitroglycerin tablets, and nitroglycerin sprays all relieve angina by reducing the heart muscle's demand for oxygen. Nitroglycerin also relieves spasm of the coronary arteries and can redistribute coronary artery blood flow to areas that need it most. Short- acting nitroglycerin can be repeated at 5 minute intervals. When 3 doses of nitroglycerin fail to relieve the angina, further medical attention is recommended. Short-acting nitroglycerin can also be used prior to exertion to prevent angina.

Longer-acting nitroglycerin preparations, such as ISORDIL tablets, NITRO-DUR transdermal systems (patch form), and NITROL ointment are useful in preventing and reducing the frequency and intensity of episodes in patients with chronic angina. The use of nitroglycerin preparations can be limited by headaches and light-headedness due to an excess lowering of blood pressure.

Beta blockers relieve angina by inhibiting the effect of adrenaline on the heart. Inhibiting adrenaline decreases the heart rate, lowers the blood pressure, and reduces the pumping force of the heart muscle, all of which reduce the heart muscle's demand for oxygen. Examples of beta blockers include propranolol (INDERAL), metoprolol (LOPRESSOR), and atenolol (TENORMIN). Side effects include worsening of asthma, excess lowering of the heart rate and blood pressure, depression, fatigue, impotence, increased cholesterol levels, and shortness of breath due to diminished heart muscle function (congestive heart failure).

Calcium channel blockers relieve angina by lowering blood pressure, and reducing the pumping force of the heart muscle, thereby reducing muscle oxygen demand. Calcium channel blockers also relieve coronary artery spasm. Examples of calcium channel blockers include nifedipine (PROCARDIA), verapamil (CALAN), and diltiazem (CARDIAZEM). Verapamil and diltiazem also lower the heart rate. Side effects include swelling of the legs, excess lowering of the heart rate and blood pressure, and depressing heart muscle function, thereby causing an increased shortness of breath.

A recent study found that patients with high blood pressure taking short-acting calcium blockers (PROCARDIA, CARDIAZEM, and CALAN) had a higher rate of heart attacks. This has not been shown for the longer acting preparations (PROCARDIA-XL, CARDIAZEM-CD, and CALAN-SR) and has not been confirmed by other long-term studies. Until other studies are available, no conclusive statements can be made about the safety of these agents. Patients are urged to consult with their doctors before changing any of their angina medications.

When patients continue to have angina despite maximally tolerated combinations of nitroglycerin medications, beta-blockers and calcium-blockers, cardiac catheterization with coronary arteriography is indicated. Depending on the location and severity of the disease in the coronary arteries, patients can be referred for balloon angioplasty (percutaneous transluminal coronary angioplasty or PTCA) or coronary artery bypass graft surgery (CABG) to increase coronary artery blood flow.

What's new in the evaluation of angina?

A newly developed computerized x-ray scan (ultrafast CT scan) is highly accurate in detecting small amounts of calcium in the plaque of coronary arteries. If an ultrafast CT scan shows no calcium in the arteries, atherosclerotic coronary artery disease is unlikely. Therefore, ultrafast CT scanning is useful in evaluating chest pain in younger patients (men under 40 and women under 50 years old). Since young people do not normally have significant coronary artery plaque, a negative ultrafast CT scan makes the diagnosis of coronary artery disease unlikely. However, finding calcium by this method is less meaningful in older patients who are likely to have mild plaquing simply from the aging process.

Even though an ultrafast CT scan is useful in detecting calcium in plaque, it cannot determine whether the calcium-laden plaque actually causes artery narrowing and reduces blood flow. For example, a patient with a densely calcified plaque causing minimal or no artery narrowing will have a strongly positive ultrafast CT scan but a normal exercise treadmill test. In most patients who are suspected of having angina due to coronary artery disease, an exercise treadmill study is usually the first step in determining whether any plaque is clinically significant.

Magnetic resonance imaging (MRI), using magnetism and radio waves, can be used to image (produce a likeness of) the blood vessels. Currently, the larger vessels, such as the carotid arteries in the neck, can be imaged using this technique. Over the next 5 to 10 years, software and hardware improvements may allow screening of the heart's arteries with magnetic resonance testing.
I hope this info. helps in some way.
Unread 04-16-2003, 04:59 PM
I have pleurisy?????

Lisa, I did a Goggle search on menopause, chest pain, jaw
pain, and I found a website called NW Community Healthcare.
They discussed women having heart attacks and the symptoms:
chest pain, pressure, tightness or burning , shortness of breath,
with or without chest pain, radiating neck pain, jaw pain, or
arm pain, extreme fatigue, excessive perspiration, occasional
lightheadedness, and collapsing.
You have high blood pressure and high cholesterol
which puts you at a higher risk for heart disease. I think
you kept your ovaries and are not on HRT. Is it possible that
your ovaries have stopped functioning? Women at menopause
are at higher risk for heart disease.
What do you think about going to a different hospital, perhaps one with a heart institute?
I hope and pray this is nothing serious. However,
it seems like it would be prudent to further check this out
with the medical community. Good luck, and I am praying for you!
Unread 04-16-2003, 09:19 PM
I have pleurisy?????

Oh Lisa....I'm so sorry !!!

You didn't describe what I have felt. I've had mild cases of it all my life. Always, always was affected by just breathing. The mere in and out of oxygen is horrible. My brother had it to the extreme when growing up. He felt better under water for some reason and always retreated to the tub.

Your symtoms may be those of classic heart....especially for women. But Linda has given you a few other options!!! I also vote with her, to stay put and find the cause of this. You may miss one birthday....but that's all you'll miss. We want you around...so take good care. Please let us know how you are.

ps....remember, flying at 32,000 feet can put undue pressure on the lungs, heart etc. not to mention the quality of the plane air and the risk of what's in that air. I'm thinking flying would get you in worse trouble.

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