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Palpitations after pregnancy

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Hi - I am a 37 year old female, I think I am in fairly good health. Exercise daily and my diet (although not fantastic) is not terrible. I have been having palpitations since my last pregnancy (born in July 2012) so have seen both ED doctors and normal GP's who say I have no issues with my heart and palpitations are benign. I have had an echo cardiogram (trivial mitral regurgitation), a 24 hr halter monitor and chest x rays but no one could see anything amiss so I was happy to let it go. Recently, however I have had flashes of jaw pain and a couple of sharp pains in my upper left chest that seems to radiate all the way to back. Also some on and off wrist pain (I do ride every day so I don't know if the wrist pain can be attributed to this) None of the pains last long - and they don't discriminate whether I am exercising or not. I was always thought that the jaw pain was a lack of oxygen to the heart but I am not out of breath when it occurs..is this correct? My blood pressure is normal (aside from when I am obsessing about when I am going to drop dead from a coronary!) but I think I am starting to panic about it thus making it worse, but I don't know what else to do as Dr's say all A-OK. If this was heart related would I not feel the pains the most when exercising and putting my heart under pressure? And would the pains last longer than less than a minute?

Category: Cardiologist

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Category: Cardiologist
 31 Doctors Online

Hello,

Thank you for your query at doctorspring.com.

The pain you describe is most probably not angina. Sharp pain not on exercise is unlikely to be angina pectoris. Jaw pain radiating to back and wrist could be neurological in origin. Another cause of pain radiating to back coild be anortic dissection butis unlikely given the description. So you can get a chest xray done followed by a ct scan to look for the aorta and if that is normal you can take a neurologist opinion regarding this pain.

It however doesn't seem to be arising due to coronary artery disease. It could all be due to anxiety as well though. But that we shall label it only after ruling the neurological and vascular cause of pain.

Hope this helps, please feel free to discuss further.
Regards
Dr Vivek Mahajan
DM Cardiology


Patient replied :

Wonderful thanks for your reply.. gives me some comfort. I have been referredffor a stress echo on Monday for completeness. If this comes back negative and i ask for a CT scan (which may also come back ok) then you think I can probably rule out the heart? I have been told only an angiogram is 100 percent but not something I would ever want (or any cardiologist would order for me!)


Thanks for the compliment.

If your stress echo is normal you dont need an angiography. Other option is ypu can undergo a ct coronary angiography along with ct of the aorta. In all probably your stress echo and ct aorta willcome as normal. I wouldn't have sent you for a stress echo because your description is not fitting into coronary artery disease causing angina. The ct of aorta is just to rule out and prove that all this maybe anxiety related. So relax. Get your stress echo or ct coronary angio and then rule out aortic disease by cy of aorta.. then we have all the proof to say you dont have serious cardiac issues.

Regards
Dr Vivek Mahajan
DM Cardiology


Patient replied :

Hello again

Thanks for your reply above. I have had the stress echo and the results are due any day. I felt fine during it, however today afte my usual lunchtime exercise (and lunch following - just a sandwich) my heart has remained elevated since 12.30pm (now 2.49pm) and I am feeling quite lethargic and tired with a very dry mouth. I have been drinking water continuially since I came back. I totally agree that the stress test will likely show nothing. I wonder if this is all caused by something else.


Hello,

Lets wait for your stress echo report and if that is fine we can be assured that all of it is non cardiac.

Regards


Dr. Vivek Mahajan
Category: Cardiologist
Experience: 
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
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