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Does page syndrome increase the risk of heart attack?

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Posted on Tue, 17 Mar 2015
Question: Hello,
I was diagnosed with Page Syndrome after being treated for a heart attack and have several more incidences. I was set on a different path and was tested for Pheochromocytoma which proved negative.
Is this condition connected to my heart and what are my risks? Very little is provided about Page's syndrome.
My maternal family has history of dying young with heart attack and I am concerned that Page's Syndrome is connected to this.
Since I have no heart condition, how is Page Syndrome connected. My bp is and always been 117/79 to 123/80. However I had a few episodes that were unexplained where I had a crisis hypertension and my BP spiked to 190/110 and up to 200 with heart rate of 115. While on atenenol my HR is in the 50's. What are my risks and will I need to be on atenenol for life and please explain Page's Syndrome. Is this a cardiology issue? Thanks, XXXXXXX
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
Page syndrome exerts a high risk for heart attack

Detailed Answer:
Hello!
I understand your concern! Thank you for your question on HCM!
There is no sufficient data regarding your concern.
I would say that there are no evident clinical studies for the relationship between Page syndrome and heart attack.
But there exist some few clinical cases which show the clear evidence of a link between Page syndrome and hear attack and hypertension. To conclude that is a vasoconstrictor syndrome called pseudo pheocromocytoma. As such it implies a special high risc for heart ischemia and attack.
You said that have a family history for hear attacks.
I would like to ask you if they had similar accompanying symptoms like flushes,poliuria ,episodic hypertension ,etc .
Did they perform histamine subcutaneous test or measurement of katekolamine metabolites?
My recommendations at this point are to continue the appropriate strict treatment for hypertension; to fight risc factors for coronary artery disease.
I would also recommend a brain MRI to clarify the diencephalon involvement as the offending cause of this rare syndrome.
Hope to have answered your questions and to have been helpful to you. !
If you have additional information feel free to ask me!
Best regards Dr Iliri
Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. Ilir Sharka (7 hours later)
Hello Dr Sharka,

I have no idea what other symptoms presented at the time. I do flush easily.
The first time I experienced this was several years ago when I woke from a deep sleep and thought I might be having a heart attack. When the paramedics arrived, my bp was over 160. My Bp has and always been 120/80 or below. The next time was July 2014 and I pulled over and called 911 and my bp was over 200/110 with a heart rate of 115. I just felt different and felt a pressure on my chest. I was rushed to the hospital and treated for a cardiac event and provided with an angiogram. No blockage or heart damage was discovered. The ambulance arrived in 3 minutes and treated me for a heart attack. They said words like "angina" "unstable angina" and "slow flow pneumona" the lower smaller descending arteries but was sent home after a few days with no follow-up. I had several more episodes and went to emerg several more times but each time they sent me home saying my angiogram was fine. However in September 2014 - I ended up in emerg in a small town hosptial and my bp was up to 197/110 and heart rate of 115. I was driving at the time and enjoying some beauitiful scenery. It was that Doctor who suggested I get tested for the Pheochromocytoma which sent me on a different path from my heart. A Doctor named Dr. XXXXXXX Spence from London XXXXXXX diagnosed me with Page Syndrome after the urine and blood test. I am assuming he saw something in my blood. When I have these "surges", I can feel my bp rise (even though many say you can't) and my heart rate speeds up erratically. This has happened while gardening, driving, asleep and finally in stressful situations. The atenenol has helped the symptoms but I feel like I was diagnosed with this and given medication with no real understanding of it and the causes and what I can do including dietary changes. It seems most emergency doctors don't know about Page's Syndrome.
It should be noted in July 2014, my tropins were raised in my blood work which indicated a "cardiac event" and an angiogram was provided. I was given baby aspirin, nitrogen, oxygen, heparin and warfin. Again no indication of heart issues. I have these random and sudden spikes of extremely high Bp and heart rate that comes on suddenly. Is this panic attacks? If so, why not diagnose me with that? I am just confused. My family Doctor is not one for making referrals so she sees my angiogram is fine with no follow-up so requesting an MRI might be a challenge. Can you make referrals?
Thanks, XXXXXXX
doctor
Answered by Dr. Ilir Sharka (3 hours later)
Brief Answer:
Page's syndrome is a very rare disease

Detailed Answer:
Hello! Thank you for your information about your disease.
You are right when saying that most of doctors in the emergency services don't know about Page's disease. You have really been lucky to have been consulted by Dr.Spence who has been able to diagnose you with such a rare disorder. This disorder is caused by an exceeded production of dopamine causing these symptoms. The diagnosis iis made by the measurement of some specific substances in your blood. That is how Dr.Spence has probably diagnosed you.
Differently from pheocromocytoma in this disorder high HTA crisis is associated with the flushing (in pheocromocytoma you would have pallor instead ).
About MRI:I recommended it to study your diencephalon structure ( hypothalamus ) which dysfunction is thought to be the cause of this disorder. But I think it will probably not change your treatment.
About the treatment:atenolol is ok. I would also recommend propranolol which blocks both alfa and beta adrenergic receptors. The fact that it has improved your situation is another argument in favour of Page's syndrome. You should continue taking it.
Anxiety and stress are common features of this disorder. I recommend you to consult with a psychiatrist. An antidepressant or anxiolytic drug may be helpful to you.
Hope to have answered all your questions and been helpful to you!
Best wishes Dr iliri
Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. Ilir Sharka

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Practicing since :2001

Answered : 7717 Questions

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Does page syndrome increase the risk of heart attack?

Brief Answer: Page syndrome exerts a high risk for heart attack Detailed Answer: Hello! I understand your concern! Thank you for your question on HCM! There is no sufficient data regarding your concern. I would say that there are no evident clinical studies for the relationship between Page syndrome and heart attack. But there exist some few clinical cases which show the clear evidence of a link between Page syndrome and hear attack and hypertension. To conclude that is a vasoconstrictor syndrome called pseudo pheocromocytoma. As such it implies a special high risc for heart ischemia and attack. You said that have a family history for hear attacks. I would like to ask you if they had similar accompanying symptoms like flushes,poliuria ,episodic hypertension ,etc . Did they perform histamine subcutaneous test or measurement of katekolamine metabolites? My recommendations at this point are to continue the appropriate strict treatment for hypertension; to fight risc factors for coronary artery disease. I would also recommend a brain MRI to clarify the diencephalon involvement as the offending cause of this rare syndrome. Hope to have answered your questions and to have been helpful to you. ! If you have additional information feel free to ask me! Best regards Dr Iliri