Heart pain with physical exertion


I have had a biotrnik Edora for third degree complete av block for a bout a month.  I though i was going to be able to do some liftening especially with my right arm/hand.  I am finding it increasingly difficult to bend over and pick things up, like the occasional weed in the yard.  I also find carrying things with my right arm/hand causes pain in the heart and down the center of the chest where I assume (though I may be wrong) the wires are.  My device gets quite warm under the skin as well.  I was checked out two weeks in and I was fine.  I have not lifted my left arm to reach over my head at all though I have reached forward a bit.  Not stretching tho.  I cannot understand why I have so much chest tightness and soreness with activities. Th doctor said not to worry about chest pain except during exercise.  Is this exercise?Am I hurting my heart? Am I damaging the connection or the device?  Doctor also told me I have pacemaker syndrome where the pacemaker and my heart haven't adjusted to each other yet...

Any words of wisdom?  Donot want to bother the pacemaker clinic as my appointment is in two weeks.



by Penguin - 2023-07-02 20:45:37

It takes different people different amounts of time to get used to their implant and for any pain to die down.  For warm, inflamed skin try ice wrapped in a cloth or as an ice bag.  An over the counter pain killer such as ibuprofen or similar may help with any soreness. 

Reaching and stretching forward 'a bit' doesn't really qualify as 'exercise'. Stretching a bit won't pull a lead out or cause any harm as there is usually an amount of 'extra' lead coiled behind the device. Lead issues are fairly rare. Try not to worry about this very common concern unless you have a recurrence of your pre-implant symptoms and in the meantime keep your left shoulder moving by rolling it. 

'Pacemaker syndrome' is a strange descriptor for your doctor to use as PS usually describes a pacing induced condition which is quite different to the issues people commonly have when adjusting to a new device.  You are not alone in having problems adjusting though as it can take a while to accept the device, what it means for you and to deal with the emotions that a heart condition may cause. Take it slowly. 

Two weeks isn't long to wait and it may help to try distraction techniques - something you enjoy doing which is absorbing - or relaxation techniques whilst you wait for this appointment.  You could voice some of your concerns at your appointment for further reassurance. 

The concerns that you have described sound incredibly normal but should symptoms escalate see your doctor again. Signs of infection - high temperature, nausea, severe pain and a recurrence of your pre-implant symptoms are probably the most important signs that something may be wrong. 

I hope you feel better soon. 

"down the center of the chest"

by AgentX86 - 2023-07-02 22:06:16

A month isn't nearly enough time to assume that your body has healed completely.  It can take some time for everything to go back to normal and it's different for everyone.

Actual pain in the center of the chest isn't usually a heart issue.  Your doctors, evidently, have checked everything out and it's all normal.  It's certainly not unusual to have anxiety and to assume every twinge is the end of the world.  As long as your doctors know what's going on, try to relax.  It's going to take a while.

Leads don't go down the center of the chest, rather come from above, across/under the left collarbone and  across to the heart. As Penuine said, there is excess lead length coiled up under the device to give slack in the leads allowing movement.

Central chest pain on stretching

by Selwyn - 2023-07-03 13:53:41

Any period of inactivity results in soft tissues contracting. 

I would suggest some gradual  stretching exercises to eventually fully extend your range of movement. 

There are little joints between the ribs and breast bone that can stiffen or get inflammed ( Costochondritis) see https://www.nhs.uk/conditions/costochondritis/

You cannot damage your heart with stretching, even with pacemaker leads.Some of us even manage to swim front crawl. 

Normal healing produces inflammation - if this hotness, redness, swelling, pain is worsening over the pacemaker pocket, you need to see a medic.

Otherwise, take your time and go at things gradually.


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It is just over 10 years since a dual lead device was implanted for complete heart block. It has worked perfectly and I have traveled well near two million miles internationally since then.