?Pericarditis?

[felpeyu2]

I had several flares with chest/shoulders/stomach pain (I wrote about them several months ago). Acute pain lasted for some hours. Disconfort lasted several days. I had the last flare the day before yesterday. Well, not the day. The night. The pain wasn't excruciating and was only in the sternum. Not shoulders nor stomach. The pain is very big if I am lying on the bed. So I have to sit. Breathing hurts, so I try to breath in a shallow way. The pain lasted several hours as usual. Then only the disconfort remains (like a minor pain over the chest).

But this night I noticed this: when I laid over my left side, I heard a strange sound from the heart (It happens to me that sometimes I hear the beats of my own heart when I lay over my left side, but they are usually normal). But this time it sounded like a beat and like an asthma breathing all at the same time. I listened to the pericardial friction rub sound in a youtube video and I think what I listened from my heart was quite the same.

I read that a cause for pericarditis is systemic inflammatory disorders, but not specifically Sjogren.

[bluegardenia]

sorry to feel your concern and worries ,my suggestion is to go to a doctor and stop googling. have you been to a cardio lately?

[felpeyu2]

Thanks for your reply. Yes. I had a cardio test several months ago when I had one of these flares. The doctors said they didn't see anything wrong with my heart, so I suppose it is not a very serious heart issue. I had other tests then and the outcome was the same: apparently nothing was wrong with me. But the reality is that I was in pain.

In a month I have an appointment with my rheumatologist so I can ask him, but I know that these kind of illness show different symptoms to different patients and I thought interesting to know if someone had similar symptoms to my own.

[Linda196]

Several months ago you may not have had pericarditis, and in another month it may have resolved, but right now, if there is inflammation severe enough to cause a pericardial rub (or something similar) to the untrained ear, you should be seen.

Pericarditis is not "not a very serious heart issue" since it can cause conduction disruption (changes in the pathway of the electrical stimulus of the heart) or rhythm disturbances (tachycardic rhythm), or mask more serious cardiac conditions. It can also, in severe cases, cause scarring, constriction or effusion  of the pericardium and the underlying cardiac muscle.

Not trying to scare you, but as my cardiologist told me, even if you're pretty sure your chest pain is a flare of peri or chondritis (I have both) you better get it checked because you don't know without an ECG what your heart is actually up to!

[finallyadx]

Just throwing this out there, not a dr nor am I a medical professional, but I had pleurisy a few months ago with very similar aches and pains as you are describing and had a strange sound (Or so I thought it was anyway), so I went to the drs and was diagnosed with pleurisy. 

Any pain/discomfort in the chest should be checked out anyway.  Some issues require antibiotics and others require further investigation to get to the bottom of things. 

Keep us posted.  Sending positive thoughts your way.

[cccourt1942]

Felpeyu,
    You are suffering costochondritis.  I have zero doubt.  All I had to see was "sternum".  Our local SjS group had a speaker last month (rheumy) who did NOT list a topic.  Her topic was Sjogren's.  Well, I thought, what good is this to people with SjS?    Was I ever wrong.  She went thru as full a list of "possible" SjS related conditions.  One she did NOT have was costochondritis.  During q and a, a woman asked about a sternum pain which had been ruled out from being a heart attack several times, and been to ER for pain twice.  She'd suffered these attacks about 15 years.  The speaker answered immediately "costochondritis."  The audience member wanted more info, but there were about 50 of us...with many raised hands. 

I found the woman after and told her my story: About 30 years ago I first had "the" pain.  The nurse at my school drove me to the doctor.  I was diagnosed with pleurisy.  About 20 years ago I was sent to a pulmonologist (chest pains/shallow, chronic cough): dx: mild reactive airway disease.  About 10 years ago I found myself at my GP's for chest pains--EKGs were done immediately. Always negative.  Four years ago: SjS dx.  By the time I was dxed, I almost ignored the chest discomforts.  I have a pilates machine and was convinced I wasn't doing enough work on my obliques. 

Within months of SjS dx, I asked my GP (I was in her office for something else) and asked about the chest (now moved toward lower, left waist and wrapped around waist area) pain--and she simply said costochondritis.  She gave me what I thought was a megadose of prednisone.  Because I was moving, she gave me about 40 mg extra.   She explained I might have another attack before I got established with a doctor, and a new doctor might doubt (or not understand about) costochondritis explanation/dx.  That extra amount lasted me thru about 2 attacks..and about 1 1/2 yrs after I was completely established with my drs, costo listed as a condition in my profile, I had an attack late at night.  I thought it was costo, and told the ER drs. what it was.  Because it's in your chest (you can say sternum 20 times--they hear chest) they bring the crash cart in.  You will learn to get flat on your back and breathe as shallowly as you can.  The deep breaths expand your rib cage and cause more pain.  With that attack I was in the ER two days in a row.  Why?  The ER can't prescribe the prednisone: only a pain injection ===which lasts nearly 24 hours.  Well, each of my physicians said I had to see them for the prednisone Rx.  (which is a dosage of 10mg pills taken @ 40 per day /3 days, 30 for 3 , 20 at 3, etc.) 

Got the attention of my neurologist who sent an Rx to me in ER for the prednisone.  Couldn't send electronically as the direction field didn't allow enough characters.  I always thought that was funny.  About a year later, on a vacation, I had another attack.  By this time I carried a copy of what it was, but I was in NYC.  I told my dtr good thing about ER in nyc is they know what costo is.  They still have to do the heart stuff..as the pain causes heart rate to elevate.  btw: by that time I also was carrying that megadose burst with me...and showed it to the doctors.  They knew immediately. 

I figured out what I do to exacerbate it.  As I told the woman to whom I was speaking--she said "that is EXACTLY what I was doing".

Go to Dr. Wikipedia.  Excellent description of the condition.  btw: It often accompanies Sjoggies, but many people without SjS suffer this oft undiagnosed PAINFUL condition.

Good luck dear, and welcome,
Courtenay

[jazzlover]

Agree with court .. for what it's worth.

Be sure to get checked for Lyme disease via Igenex Lab too.

[irish]

There is a lot of chondro with autoimmune disease, but chest pain always needs to be ruled out. If you can see your usual doctor it sure helps to cut down on extra tests. Irish