Persistent Band of Tightness/Pain Since Shortly After Pacemaker Insertion
I am a new member who received a pacemaker six weeks ago for brief periods of intermittent complete heart block occuring infrequently. The pacemaker is set at DDI at 50. I am pacing less than 1% of the time. Beginning within a few days of the pacemaker insertion I started having periods of throbbing heaviness in the substernal and epigastric region. About 10 days after insertion this became continuous and became mildly painful. It has persisted since then.
I have a tight band like sensation at the level of the xiphoid process that goes around to the side more on the left on the right. It is intensely tight and mildly painful at times with a throbbing quality. I'm also quite tender on the chest wall in many points especially on the lower right rib cage. I find that any tightness or construction around my thorax or abdomen increases the symptoms and I can't tolerate my waistband, even though I have lost 30 pounds through diet and exercise.
The pain is relieved by Advil, but not the tightness. Lying on my stomach or right side or standing improves the symptoms, and lying on my back and sitting makes them worse.
I have had a cardiac work up with troponin and EKG. I have had an echocardiogram showing that everything is fine and I have no cardiac dysfunction and a normal ejection fraction. I've had an abdominal ultrasound which showed no abnormalities. My stress test was normal.
Does anyone have any ideas about what this could be? Could this be from phrenic nerve stimulation? It doesn't match the symptoms that I have read about ithis, but I can't think of anything else.
The symptoms are really significantly decreasing my quality-of-life. Prior to the diagnosis of complete heart block, I was misdiagnosed as having epilepsy for two years due to the pre-syncopal episodes and occasional brief seizure like activity. I am in fact very happy to have the pacemaker, since I'm now not on seizure meds and can drive again, so I don't think this is stress related.