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Is lower abdominal pain caused due to aortic coarctation and mitro valve abnormalities?

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Cardiologist, Interventional
Practicing since : 1996
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I am a 20 year old male with slight mitral valve problem but what is really bothering me is a constant, dull to sharp upper left quadrant abdominal pain, tingling hands with tight clothing, and my heart races when I urinate and I feel like my blood pressure rises too.
Posted Tue, 17 Apr 2012 in Hypertension and Heart Disease
Follow-up: Is lower abdominal pain caused due to aortic coarctation and mitro valve abnormalities? 7 minutes later
I first felt the pain in my upper left abdomen a year and a half ago when I was weight lifting- I felt like I had pushed too hard on a chest press and I have had the pain ever since. I also feel worse in hot weather. I have had a colonoscopy that was normal. thyroid tests normal. Could I possibly have an aortic coarctation as I have read that risk for this goes up if you have any mitro valve abnormalities. maybe that's why I feel my heart racing and blood pressure rising.
Answered by Dr. Raja Sekhar Varma 7 hours later
Hi Mr J2robinson,
Thank you for your query.

A slight mitral valve prolapse with no regurgitation is almost like a normal variation. It is very unlikely to produce any symptoms. Rarely, you might find a pricking pain below your left nipple which is quite harmless.

The pain that you feel in the upper left quadrant of the abdomen may also be muscular pain, since it was first felt during exercise, and possibly you might have pulled a muscle. Such pain can persist for months to years, if you continue weight-lifting or other exercise before the muscle injury has fully healed.

You might find that the pain might increase if you take a XXXXXXX breath or if you move that part of the body or sometimes, if you press on that area.

Gastric pain is another possibility but you would need an upper GI endoscopy for that; a colonoscopy which looks at the large intestine alone may not suffice.

Aortic coarctation usually manifests with higher BP in the upper limbs as compared to the lower limbs, with better muscular development of the upper half of the body as compared to the lower half. Pain (as described by you) due to coarctation is unusual.

However, an echocardiogram with Doppler should be able to detect the problem. If the imaging window is not good, you might need a CT angio or MR angio to confirm this. This is needed only if there is strong clinical suspicion based on a detailed physical examination.

The feeling of heart racing and BP rising should be objectively confirmed by a physician (actual recording of the heart rate and BP). These could be subjective phenomena that need not always be abnormal. Yes, many patients with mitral valve prolapse do report a sense of palpitations, which is usually more of an increased awareness of one's own normal heartbeats.

However, whether what you are feeling is normal or abnormal can easily be verified by actual recording of HR and BP by a qualified doctor(general physicain).

Hope this answer suffices. Feel free to get back to me for any further clarifications
Above answer was peer-reviewed by
Follow-up: Is lower abdominal pain caused due to aortic coarctation and mitro valve abnormalities? 14 hours later
But your didn't address the squeezing sensation I have in my hands and feet. Its like a rubber-band has been placed on my wrists and ankles that causes my hands and feet to feel like they are swelling and hurt. This to me sounds like some type of poor circulation or artery problem. How could this be related to the pain I feel in my upper left quadrant of abdomen. I feel like there is an artery that is tightened there causing constant pain.
Answered by Dr. Raja Sekhar Varma 19 hours later

Good to hear from you again.

The squeezing sensation may be unrelated to your cardiac condition. If an artery to the hand were to be blocked, you will have pain in that hand only and also, the pulses on that hand would be feeble.

If both hands and both feet have the same sensation, it is unlikely to be due to circulation problems or artery problems, since the blood vessels supplying these are separate.

If you are thinking of an ascending aorta (before the branches to the limbs arise), it will be detected in the echocardiogram, and in addition, you will have symptoms due to abnormal blood flow to all parts of the body.

A complete clinical examination of all the pulses of the body and segmental BP measurement in all 4 limbs will help to clarify the picture. If there is still any doubt, doppler evaluation of the arteries will be conclusive.

The squeezing pain may be more related to some types of neuropathy. Other possibilities can include Raynaud's phenomenon, muscular pains, small-vessel vasculitis, etc.

Also, this may not be related to the abdominal pain.

You may need a detailed clinical evaluation by a qualified physician; after his/her evaluation, the doctor may direct you to the concerned specialist for further investigations and treatment.

I wish you all the best for a speedy recovery.
Above answer was peer-reviewed by
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