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Nausea, vomiting, dehydration, chest pain, shortness of breath, myocarditis

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Cardiologist, Interventional
Practicing since : 1998
Answered : 424 Questions
Myocarditis - Heart Rhythm question
Dear Doctors,

28 year old male with no H.D. history, no family history (besides high chol.), good bp and good cholesterol, I don't smoke, good health, not obese

27 Dec 11 - wake up with severe nauseua and vomitting... severe dehydration and go to E.R. Kept overnight to monitor High WBC (which dropped) and hydration level (after 5 IV bags). Released next day

A day or two later I developed chest pains in various places around the left and left-center chest cavity.

A few nights later the chest pains still continuing on left chest. After a couple of nights where I felt like I had shortness of breath, I returned to E.R. EKG normal, b-dimer test came back neg.

Chest pains (same varied "left side") continue over days and i see Primary care. He does physical, says vitals and heart sounds normal, suggests not to worry about "atypical" chest pains based on history.

That night I developed a weird "strained" sensation in left chest that seemed to radiate to left shoulder. Ignored it based on previous medical advice. Previous chest pains have faded at this point.

The next night, I had similar sensations and returned to E.R.. EKG normal, a series of 5 tubes of blood were taken for tests, and chest x-rays were taken. All normal

3 days later I visited my Primary again with "unusual feeling" in left chest. On examination, he identifies a missed 10th heart unconcerned. For peace of mind, he orders 24 hour Holter and stress Echo.

I just completed a stress Echo/EKG and the cardiologists said "everything looks good". Still waiting on holter results. "Weird sensations" in left chest still come and go. Having trouble sleeping and waking up in middle of night frequently. I have been having problems with infrequent episodes of fatigue and lightheadedness as well.

1. Does this sound like myocarditis/pericarditis related arrythmia?

2. Is this arrythmia likely dangerous? How high are my chances of sudden cardiac death(real worry)?
Posted Fri, 13 Apr 2012 in Heart Rate and Rhythm Disorders
Answered by Dr. Prabhakar C Koregol 9 hours later

Thanks for the detailed and exhaustive history.

Though your history could possibly be related to pleural disease. Heart problem is very very less likely in. V/o your history examination ecg and stress ECG findings. The symptoms are not suggestive of arrhythmia and majority of the events post your gastric symptoms you seem to have developed lots of stress. Manifestation of the stress being obvious.

I think all you need at this stage is some counselling few medicines to relieve your stress.

Hope I answered your query.

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