chest pain/short breath after pacemaker

I am 60 yr old female with dual lead pacemaker implanted Feb. 20, 2007. During surgery I felt pain, (same pain I experienced with cardiolite test). I spoke up, they said it was just them testing the pacemaker and NO, I would not feel that again - BUT I do - It is the same pain I feel when they test it. I feel it and it causes me to stop walking (rest) only after walking accross a parking lot, next door to the neighbors, or even the vibrations when riding in the car. It will stop when I stop the activity. It is painful in my chest, throat, neck and across my shoulders. The pain is an 8 or 9 and stops me in my tracks. The Dr. tells me there is nothing wrong, no reason for this. He did disconnect the bottom lead and lower my heart rate to 55, but that didn't help. His only solution is to take it out and send me on my way. I am not convinced that something can't be adjusted to stop this. Before I could walk 45 min. Now, I can't do five. Or perhaps there is something else they are missing. I also have a murmer, which they tell me is not a problem. I want a second opinion, but don't know where to look. Any suggestions, ideas or help?? Sincerely - elma


3 Comments

Hello

by Christmmpace - 2007-04-12 01:04:16

I've had all your problems two weeks ago and I was admitted to the hospital. They did test after test and found nothing. They said that my heart looks good. You might want your doctor to do a Stress Test. Also keep watch of your blood pressure. It's always safe to keep your vitals in check. I've been feeling this pain for about four months now. They're telling me it could be muscle problems. I made an appointment to see an Orthopedic (Bones and Joints).

To be sure that you're not having heart complications you should seek further help. If your doctor does not want to take your complaints serious then go to a different Doctor and have yourself checked out. It's really hard to function with these kinds of pain and discomforts. I hope you found a better Doctor soon. Take care and God bless you.

Christmmpace

Pain

by lenora - 2007-04-12 03:04:58

You should have an echocardiogram to rule out pericardial effusion and pericarditis if you haven't already. Pericarditis can develop after heart surgery, sometimes even as a delayed reaction weeks later. The inflammation causes chest pain and as it progresses fluid builds up in the pericardial sac, pressing on the heart and causing shortness of breath. The pain of pericarditis can often be relieved by sitting up and leaning forward. You said your pain is 8 or 9 on the pain scale. Is it sharp pain, a dull ache, or pressure? Does the pain increase or decrease when you lie down? Do you have temperature or dry cough? I'm concerned about the shortness of breath also, because chest pain plus shortness of breath mean something important is being overlooked. A chest CT would also be a good idea. You're certainly within your rights to ask for a second opinion. Just speak up and tell your cardiologist you want one. You won't hurt his feelings! Discuss this with your primary MD and have him arrange a consult with another cardiologist. Lenora

Pain

by SMITTY - 2007-04-12 05:04:12

Hi Elma,

You have some suggestions already, but none of those parallel what I'm thinking so you may as well have another to think about.

Based what you describe and that the pain comes with activity I have to say your pacemaker could be the culprit. My thought is that the PM is dormant until you get active and the pacemaker kicks in, and what you are feeling is stray impulses from you PM. (Just for the record, is the Rate Response feature on your PM activated?) If the pain is generated by the PM it would be intermittent pain, but the intervals would be in sync with your heart beat. If this is a steady pain once it starts, there is little likelihood that it is caused the way I think it could be.

My experience with PM generated pain (and I have had more than just al little of that) was always that the pain would be in perfect sync with my heart beat and it would come in groups of 3 to 10+ heart beats. These pain groups were often enough that there were some days I could have said they were constant. The pain was sharp, and in fact I most often described the pain as being about the intensity of a bee sting. I never applied a number to it but if I had it would have been a least an 8. I recall once that I was sitting and watching TV and the pain started and it was especially intense and before I realized it I had jumped up from chair and started walking as fast as I could to try to get away from it, I guess. Fortunately for me the pain subsided a little before I got out of the house. That was when I put in a call to my doctor and made an appointment to have the thing turned off.

Like you, I was told many times my problem was not my pacemaker as it was working perfectly. Funny thing though, when it was turned off, my pain went away. My PM had to be restarted a couple of years later and by then I had a couple doctors, including a new EP, who understood that a PM could do what I described. Of course the 50+ tests I had undergone by then had all failed to show anything else. So their job was easier. They isolated a nerve (with more tests) that was being “stimulated” thereby causing the pain. That nerve was deadened with an injection and so far (yes, my fingers are crossed as I say this) the pain has not returned.

Now, the suggestions you receive may be refined a little if you could answer the questions put to you by Christmmpace and Lenora. In the meantime, I agree it is time to see another doctor. To be brutally frank, the one you have maybe a good surgeon, but it
sounds like he may have flunked pacemaker technology, or whatever they call it where they teach how pacemakers work.

You say you want a second opinion but don’t now where to look. If you are not comfortable telling the doctor that implanted your PM you would like a second opinion, ask the hospital where you got the PM if they can give you the name of an electrophysiologist. And you do want an electrophysiologist, not a just a cardiologist. If that doesn’t work, tell us the part of the country in which you live and I’m sure one or more of us can offer you some names.

I wish you the best,

Smitty

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