Cardiac involvement

[kellyptyler]

Yes, I started having heart problems the exact same time I started with the Auto Immune trouble. My T wave is totally inverted in my EKG, but my rheumy says they're not connected...meaning the heart and sjogrens.
My PCP sent me to a cardio doctor and because of the EKG he did a heart cath and said I have no blockages, but he will not look into it further. He just says I have an abnormal EKG...well, I never did before...not until the Sjogrens. So, I'm still waiting to see my new rheumy.

[Katybarstool]

Anita, did you find any more information about atherosclerosis at the conference? I'm asking because I have to do the treadmill test due to muscle weakness, and I'm a bit concerned.

Kathyx

[jazzlover]

I don't have CAD. I have A-fib and MVP with regurgitation. I also have a mild thickening of my heart wall, which my dr says is probably from SJS.

[anita]

Every one of my doctors (2 cardios & neuro/rheumy) at Hopkins say that Sjogren's (and other AI diseases) can increase atherosclerosis.  It also can be responsible for autonomic dysfunction (heart rate and BP problems), and cardiac vasospasms (both of which I have also).

Glad you are being worked up and getting the treadmill test.  Are they doing just the treadmill, or stress echo?  The stress echo is where you do the treadmill while hooked up, but they also do an echo before & immediately after to look for changes.   

Let us know how it comes out.

[Katybarstool]

Hi Anita

They are doing the stress echo. Interesting that heart rate and BP can be affected too. My heart rate is always fast, and my BP is high, even though I am taking meds for it.

Will let you know how it goes.

Kathyx

[mshistory]

I'm so glad this thread was bumped...I've been having chest pains (again) and given my age (32) I'm always tempted to blow it off as just inflammation. I sometimes get irregular heartbeats, and had one abnormal EKG that wasn't really alarming to my drs. I'm going to make sure my rheumy knows about it to see if I need to see a cardiologist.

[soycoffee]

Approximately fifteen years ago, I had noticeable symptoms of Sjögren's Syndrome -- dry mouth, particularly. But what the heck, there were no treatments, so why bother?

Two years ago, still no Sjögren's Syndrome diagnosis or discussion with any doctor, I started having stable angina when I walked uphill, not too often, always resolved if I stood still or walked slowly.

A year ago, I woke up with crushing chest pain, level 10, could barely take a step, called an ambulance to get to the ER. The upshot: It was an atrial fibrillation episode, that resolved with an electric shock to the heart. I was in the hospital two days, and back to teaching my class in four.

I also have mitral valve regurgitation as well as aortic stenosis, neither to any  highly critical degree. In addition, the left side of my heart is thickened. My cardiologist keeps reminding me that my heart is in terrific shape. Blood Pressure is normally about 110 over 62 first thing in the morning, or after resting. I could exercise regularly in the aerobic zone, with a couple of minute in the anerobic zone. At that time -- 1/2011 -- I passed a nuclear stress test with flying colors, by staying in the aerobic zone for the required length of time, less than my daily exercise amount.

I eat according the CHOLESTEROL DOWN book by Janet Bond Brill, a book that got an *average* of five-star reviews. It's simple, it's based on research, and it works. My cholesterol numbers were not fantastic, but triglycerides were okay, and my total plasma homocysteine is below 8, which is the middle of the range.

I also have the crease.  Used to have two, in one ear lobe, one in the other.

This was the picture from about June 2010 to June 2011. I'll have a checkup in two weeks. Not sure what has changed because of Sjögren's and lack of daily workouts on the exercise bike. I'm still on the diet, except less oatmeal.

Although my father died of heart disease before he was sixty, I don't feel as helpless about heart disease as I do about cancer.

Soycoffee

[Iris]

I didn't know Sjogren's could cause a fast heart rate.. Mine has always been fast, any where from 100 to 115 is normal for me.. I also have palpitations. Sometimes it can feel like a slight fluttering then other times it feels like it flip flops.. It's an uncomfortable feeling..

[angielyn]

I was diagnosed with Wolff Parkensons White Syndrome at 19yrs old. Had an ablation at 22yrs old. I was then told I had MVP as well. But for years all was fine. No tach. no skipping no nothing. When all this kicked in so did the heart again. I thought for sure the WPW came back. Went back to my cardio. and he said no, it didn't come back and they said it was PVC's and to pretty much just deal with it I do go twice a year and get an echo. just to make sure all is ok.

[jazzlover]

I didn't know Sjogren's could cause a fast heart rate.. Mine has always been fast, any where from 100 to 115 is normal for me.. I also have palpitations. Sometimes it can feel like a slight fluttering then other times it feels like it flip flops.. It's an uncomfortable feeling..

-

You need to see a cardiologist or your family doctor! You should NOT have continual tachycardia (100 beats or over). It is DAMAGING to the heart.

[Iris]

It's been that way all of my life.. Every doctor i've ever seen knows it.. I used to take Inderal for it but since I developed breathing problems I can't take it anymore.. They have never offered anything else for it..

[Belsey1]

I was just in ER this week for chest pain. After EKGs x-rays and blood work....followed by more blood work six hours later, the doctor dx me with an esophageal spasm.  He said it most closely mimics a heart attack.  I was just getting over an upper respiratory infection and I have read that the esph.spasm can follow URI.  Then he proceeded to tell me that my EKG shows changes since my last one there 5 years ago.  He said I have a partial right bundle branch block and it shows differences since my prior EKG, which also showed rbbb.  I don't have a lot of recall about the EKG five years ago, but it does seem like I talked to my PC doctor about a rbbb and he reviewed my EKG and said it was nothing to worry about.  I have looked it up online since my latest ER trip.  Some sites say nothing to worry about, others scare me.  Wondering whether to go back to PC and get referral to cardiologist....anyone have anything similar?

[anita]

If I were you, I'd ask for a referral to a cardiologist.  It is so typical of ER docs to say esophageal spasms when they don't know or something else isn't immediately explained from the EKG.  It's the 'catch-all' diagnosis for chest pain when it's NOT a heart attack.  Esophageal spasms do feel EXACTLY like a heart attack.  There is a test though to confirm.  The test is called Manometry.  They insert a probe into your esophagus (via nose) and measure any spasms (if they occur).

It might very well be esophageal spasms, but you should know...not guess.  Especially since you have the R-bbb history.  I would think it be best to have a more thorough cardio work up...like a stress echo or reg. echo to start with. 

So please consider getting a referral to a cardiologist...to assess the changes in the R-bbb and further evaluate your chest pain. 

I was told once that it was esophageal spasms (because they couldn't see anything else on the EKG).  I had the esophageal manometry and it was completely negative.  Then my stress echo was positive.  After a heart catheter...and my other history, it made for a better diagnosis of cardiac vasospasms.  Still spasms, but of the main arteries not esophagus.  Although, treatment is very similar...long acting nitrates or nitro, and a calcium channel blocker.

[jazzlover]

It's been that way all of my life.. Every doctor i've ever seen knows it.. I used to take Inderal for it but since I developed breathing problems I can't take it anymore.. They have never offered anything else for it..

maybe Verapamil would be good?

[angielyn]

Let me tell you something I found out. Before I was diagnosed with WPW and had my ablation I had been to the ER and they said all was fine with an EKG. The last ER visit I argued with them. I was NOT fine by any means. I was pregnant with twins and this was NOT good. I was fainting with fast heart rates, skipping beats, pounding chest etc. I refused to leave until someone did something. Finally they had an actual cardiologist come look at me and my EKG. Right then and there I was diagnosed with WPW. I was then switched to a specialist who dealt with it. He told me that there are a lot of people who have WPW and if a Dr. (ER or Primary) doesn't know what to look for they will not see it.

I'm not in any way saying this is what anyone has, but things can be missed if not seen by a specialist. Wolf Parkinsons white syndrome isn't very common but commonly missed.