AboutDavid Richardson Expertise Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.
Experience Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.
Organizations Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..
Publications Circulation, American Heart Journal, Hypertension.
Education/Credentials M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.
Awards and Honors Gold Heartt Award from American Heart Association in 1995.
Question Hello,
27 yo-female,Thoracic Syringomyelia (T4-T9)-2mm,Chiari 0,Ehlers Danlos Syndrome, Cranial Settling( MRI of brain,cervical,thoracic and Lumbar spine 2008)
Ht. 5’7, 133lbs
Experiencing: Jaw pain, face pain, on and off chest pains, particularly under left breast (apical region), and weird twitching under left breast/ kind of bubbling feeling.
I have been experiencing jaw pain and weird chest pains. I first noticed this in 2006 after I had finished smoking a cigarette.( I unfortunately started smoking at 17 yo) It felt like my jaw was full of pressure and just felt really weird..It continued for weeks to where I would try heat and cold to help...I took this as a scare and quit smoking. I probably smoked a pack a day since 20 years old.….When I stopped smoking it seemed that these pains stopped. Over the year it began happening if I was upset or if I would walk up the stairs....I went to my doc and had some tests done...In the past couple of years I've had probably 10 EKG's, 3 Echos, 3 holter monitors, and I had an exercise stress test w/echo in November 2007 (when I was 17 weeks pregnant). No one could find anything...and the cardiologist I saw in November of 2007, said he probably thought I had a very sensitive sympathetic nervous system...
Well I just continued on with that I am healthy and there is nothing wrong with me… in May 2008 I delivered my son via c-section..no problems...I still continued to have this jaw pain...especially with exertion and with any emotion..such as fear or anger....Also I had a couple of slips where I smoked a couple of cigarettes and that seemed to induce this pain too. Well recently ...I started getting these things (I call them episodes) when just at rest...I would feel a small twinge (nothing painful) under my left breast and then I would feel burning in back of my neck to the back of my head and front of my face and jaw....I would also feel like I have to burp...sometimes I get very hot..I would take Tylenol and it would eventually go away within an hour..If I would walk up the stairs, especially with my son in my arms( he weighs about 20 pounds), the pain would start in the jaw(fullness, painful) and work its way to my face then wind up staying in the back of my head for the rest of the day…I went to see a Neuro in NY for my Syringomyelia and he thought it could be possible that increased CSF could cause this pain…So I pop Tylenol and try and really do not want to take pain killers if I can deal with it…
However..within the last 2 weeks I am in daily pain and the pain is very different and new....The constant burning in the back of neck and between shoulders and the jaw pain, and I have never experienced these episodes like this before...I am not a person to see a physician for a little pain…I’ll tough it out for weeks if I can before I make an appointment. I refuse to take pain meds after my C-section until 2 days after when I took some Motrin…So this is really bothering me…
So I went to the ER this past Friday...I had this constant facial, jaw pain, and this pain in my right biceps going down from my shoulder to elbow…So I knew I had to check it out at least, because not normal for me...They did cardiac enzyme tests, along with other blood work, EKG, Heart monitor for 4 hours, BP checks, Chest X-ray, and the doctor wanted to do a CTA of my Aorta...Everything came back normal...She said she was concerned about aortic dissection..but everything checked out okay... So I went home and now two days later I am feeling shooting pains from the back of my head to my jaw (by my ear and cheek)...I am also feeling this twitching feeling under my left breast that happens in a pattern...I don't get what is going on...I am having pains in my shoulders and arms....I just don't feel like this is normal....The only thing I am thinking is that maybe there is something wrong inside one or both of my coronary arteries. Is possible that all my chain smoking has left me with some kind of angina attacks, even though I have quit now for over 3 years. I am not having SOB, or dizziness....Can you please tell me or let what would be a wise path to take to further investigate these symptoms or have I done everything to rule out cardiac problems. I am trying to stay relaxed and not get upset over this...but this is just not normal for me...
Trish
Answer Dear Trish,
A negative stress test monitored by echo gives you 95% likelihood of no heart attack or cardiac death for at least 7 years. And you're far too young to have clogging of coronary arteries anyway. It's not heart. Syringomyelia seems an adequate cause for all your pain. It's okay to take Motrin or ibuprofen as much as you want, or Tylenol up to 3 grams a day.
Why doesn't everyone consider wyringomyelia as the cause of your pain?
Please write back if this note doesn't answer all your questions.
