Sex:- Female, Age:- 45, Smoker. No family history of heart disease. Allergies:- NSAIDs & Alcohol (reactions vary but mostly rash, wheezing, tightening of chest, swelling, generally feeling unwell). Known medical conditions:- Asthma, Chronic Pain Syndrome, Chronic Fatigue Syndrome, Delayed Pressure Urticaria.
4th September 2010
I was laying in bed watching TV when suddenly my throat felt severely restricted and pain around my jaw. I felt faint and sick. I went into the bathroom and pain ran through my body that I can only describe as electrified barbed wire being pulled through my chest and down my left arm. I was sweating and felt like I was going to die. I was helped back into bed and 15 minutes later I felt absolutely fine as if nothing had happened.
11th September 2010
I was sitting down doing a jigsaw when again my throat and jaw felt constricted, I felt faint, had no pain in my chest but pain in my left arm and tingling in my fingers. I was sweating and felt nauseous. This time an ambulance was called and when paramedics arrived I again felt fine. While sitting in the ambulance I again started to feel bad and was given GTN spray.
Hospital discharge notes:- ECG was normal, Trop normal, CxR normal, Bruce protocol achieving METS 10.30, target heart rate of 164 bpm 93% of target heart rate. Cholesterol 5.2, HDL 0.8, LDL 3.5. Triglycerides 2. HB 13.3, normal U/E and LFTs. IP ETT normal. Prescribed daily aspirin and nitro spray. Diagnosis:- Possible angina.
(December 2009 – November 2010 I got a chest infection treated with Ventolin inhaler, Clenil inhaler and steroid tablets, which was followed by 13 further chest infections. During this time I suffered with heartburn and a constant rash on my chest. Up to this point I had never had heartburn. As I had not been given a true diagnosis by the hospital I “googled” all of my medications and saw the Clenil contained alcohol and the ventolin spray could cause heartburn. I went to the doctor who switched both of my inhalers to dry powder and prescribed proton inhibitors for 2 months. As soon as the inhalers were switched the rash went and the heartburn stopped.)
It was 2 weeks before another episode when sat quietly in a chair, as before starting with the constricting feeling in my neck and jaw. Took 1 spray of Nitro and felt normal within minutes.
Further episodes happened maybe once weekly, always when I was doing nothing, occasionally when I was asleep and all starting with the neck constriction pain and all over within 5-10 minutes.
This week they have become more frequent with some more sever than others. They happen 4 or more times a day, every day and some are lasting longer and not relieved with just one Nitro spray. I again have a rash but put that down to the spray containing alcohol. (I stopped taking the daily aspirin after 1 week because of the allergy and it making life unbearable). I contacted the doctor who dismisses it being anything to do with my heart because all of the tests I had were negative.
I am at my wits end, if it is not heartburn and not angina what is it?
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