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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does Chest Pain With Fluttering And Cough Need Cardiac Evaluation?

Had one episode of a fib brought on by dvt in leg and pulmonary embolism. Stopped heart twice before it regained normal rhythm. Had extensive testing done by cardiologist, including stress test with persantine and thalium. Result: small leak in one of my valves, but nothing to worry about. On pradaxa since March and have been having chest pain under breast bone annoying but not unbearable, accompanied by a flutter feeling, not intense like the 205 bpm I had with a fib and also .. I have a cough too. BP has been normal (take med) and heart rate around 60. Should I seek cardiac evaluation again?
Mon, 8 May 2017
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Pulmonologist,  's  Response
Hello
Thanks for posting at HCM.
I have gone through your history. Since you have been completely evaluated for the heart including a thallium and persantine scan, there is no need to seek a cardiac evaluation now. Since you had DVT with pulmonary embolism, it may be possible that some amount of lung tissue was affected by the embolism and infarcted. This may be the reason of cough and the chest pain.
Another reason for cough can be lung congestion brought on due to atrial fibrillation. But you have mentioned that you had only one episode of AF so i suppose, you have reverted to sinus rhythm.
In your case, I suspect there is a lung issue more than a heart involvement. I recommend a chest X ray initially and if it shows any abnormalities, a HRCT chest to look for lung issues.
Cardiac wise you need no evaluation except an ECG.
Wishing you good health
Regards.
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Does Chest Pain With Fluttering And Cough Need Cardiac Evaluation?

Hello Thanks for posting at HCM. I have gone through your history. Since you have been completely evaluated for the heart including a thallium and persantine scan, there is no need to seek a cardiac evaluation now. Since you had DVT with pulmonary embolism, it may be possible that some amount of lung tissue was affected by the embolism and infarcted. This may be the reason of cough and the chest pain. Another reason for cough can be lung congestion brought on due to atrial fibrillation. But you have mentioned that you had only one episode of AF so i suppose, you have reverted to sinus rhythm. In your case, I suspect there is a lung issue more than a heart involvement. I recommend a chest X ray initially and if it shows any abnormalities, a HRCT chest to look for lung issues. Cardiac wise you need no evaluation except an ECG. Wishing you good health Regards.