Why Don’t All People with Long QT Syndrome Have an ICD?
An ICD is implanted into patients with long QT syndrome to recharge the heart should it go into sudden cardiac arrest.
So why aren’t ALL people with long QT syndrome given this implantable cardioverter device? (more…)
Why Playing Computer Video Games Makes Your Heart Pound
Do you find that nearly every time you sit down to play a video game on your computer, it isn’t long before you can feel the pounding of your heart? (more…)
Feeling Pulse in Finger Wherever You Press It: Is this Normal?
Have you noticed that sometimes, when your index or middle finger is against ANY part of your body, you feel a pulse—and you realize that this heartbeat is emanating from your fingertip? (more…)
Can Sleep Apnea Cause Chest Pain at Night?
If you’re having chest pain at night in bed, it sure would be more reassuring to know it’s from sleep apnea than a heart attack or heart disease.
Those who’ve never been tested for sleep apnea may by lying there, feeling the pain in their chest, trying to come up with less serious explanations than a bad heart.
One of those that might cross their mind is sleep apnea. It causes immediate symptoms such as gasping for breath overnight, as witnessed by others, as well as being awakened repeatedly by a choking sensation.
“Obstructive sleep apnea (OSA) is caused by complete or partial obstructions of one’s upper airway — there are repetitive episodes of shallow or stopped breathing during sleep, correlating with reductions of blood oxygen saturation,” says Morton Tavel, MD, Clinical Professor Emeritus of Medicine, Indiana University School of Medicine, and author of “Health Tips, Myths, and Tricks: A PHYSICIAN’S ADVICE.”
“These episodes of decreased breathing, called apneas (literally, ‘without breath’), typically last 20 to 40 seconds. OSA is almost always accompanied by snoring.
“Resulting symptoms during the daytime consist of excessive sleepiness and fatigue.”
In addition to those, the person with untreated OSA may suffer from irritability, impaired concentration and frequent napping that fails to recharge him – or her.
Morning headaches that vanish soon after getting up for the day are another well-documented symptom of untreated sleep apnea.
But can OSA cause chest pain, whether during the day or night?
©Lorra Garrick
“Individuals suffering from this disorder are often obese, have high blood pressure and commonly have heart disease,” continues Dr. Tavel.
“Although the heart disease, in itself, may cause chest pain described as angina, the OSA is not associated with this symptom.”
A paper in Mayo Clinic Proceedings (Loui et al, March 1994) describes the case of three obese people who were experiencing chest pain at night (and during the day though less prominently) – along with episodic shortness of breath and perceived heart palpitations.
A sleep study revealed severe OSA in all three of these subjects. But a catheter angiogram of their coronary arteries revealed less obstructive plaque buildup as would be expected for the degree of their reported symptoms.
The study authors could only conclude that when patients report chest pain, their doctor should pursue the possibility of sleep apnea by inquiring if the patient snores and suffers from excessive daytime grogginess.
The authors were not able to definitively affirm that untreated OSA directly causes chest pain.
Remember, the patients were obese and already had plaque buildup. The possibility that acid reflex overnight or during the day, as the cause of the chest pain, was not investigated.
Chest Pain and Untreated Sleep Apnea
• Untreated OSA is a risk factor for problems with the heart that can cause chest pain: coronary artery disease, chronic heart failure and atrial fibrillation.
• Thus, it wouldn’t be surprising if someone with bouts of nighttime chest pain is found to have both OSA and one of the three cardiac conditions mentioned above.
• Though obesity is a major risk factor for OSA, it’s not the only risk factor. This is why thin people, including women, can have this often misdiagnosed condition.
For example, a naturally small airway, excess pharyngeal tissue and/or large tongue base can cause an obstruction during sleep, when these tissues are very relaxed, leading to apnea.
• The episodes of ceased breathing overnight cause internal disruptions such as reduced blood oxygen and increased heart rate and blood pressure, but these would not cause chest pain.
Dr. Tavel’s medical research includes over 125 publications, editorials and book reviews in peer-reviewed national medical journals. He was formerly director of the cardiac rehabilitation program at St. Vincent Hospital in Indiana. mortontavel.com
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/airdone
Source: ncbi.nlm.nih.gov/pubmed/8133662
Can the “Good Cholesterol” HDL Ever Be Too High?
Can too much of a great thing ever be bad – at least when it comes to HDL cholesterol?
This is the “good” cholesterol that’s supposed to be high. But if it’s as high as a kite, does that mean more good or harm? (more…)
Can the Pain of a DVT Come and Go or Is It Constant?
Can that pain in your calf that keeps coming and going, on and off, possibly be a DVT?
A deep vein thrombosis classically causes calf pain that’s hard to ignore. (more…)
Left or Right Temple Pain Waking You Almost Every Night?
Can waking nearly every night with left or right temple pain mean an aneurysm or a brain tumor? (more…)
Weakness & Fatigue of Chronic Heart Failure vs. ALS: Comparison
Both chronic heart failure and ALS cause weakness and fatigue.
For both conditions, here is a detailed rundown of the differences and maybe some similarities between fatigue vs. weakness. (more…)
Does Elevated Troponin Always Mean a Heart Attack?
A person who’s diagnosed with a heart attack in the ER based on an elevated troponin result may not have had a heart attack after all.
The European Heart Journal has a 2018 study (Thygesen et al) that says “many doctors have not understood that elevated troponin levels in the blood are not sufficient to diagnose a heart attack.”
The paper explains that a heart attack causes injury to cardiac muscle. The protein troponin is used for cardiac muscle contraction.
But it’s released into the bloodstream upon injury to that specialized muscle.
A highly sensitive blood test will tell if there’s even the must subtle rise in troponin.
The reason that an abnormal level of troponin doesn’t always mean a heart attack is because there are other situations that injure cardiac muscle.
Does elevated troponin automatically mean the patient has had a heart attack?
“Not always, but the most common reason to order a troponin level is usually to rule out a heart attack,” says Christopher J. Hanifin, PA-C, who was previously a physician assistant in open heart surgery with Cardiothoracic Surgery of South Bend in South Bend, IN.
“Anything that severely stresses or damages the heart can cause an elevation of troponin, though not usually to the extent seen in a heart attack.
“Heart failure, trauma, pulmonary embolism and even kidney failure can lead to elevated troponin levels.” So can a body-wide infection (sepsis).
Correct identification for the reason of a rising troponin level is crucial because even different types of ischemia to the heart have different causes. Different causes mean different treatments.
One type might require antiplatelet drugs, while another treatment (for a different cause) may require beta blocker drugs.
In some cases, the cause of an elevated troponin result is not known, though the cause may be strongly suspected, such as chronic heart failure in an elderly patient.
Christopher J. Hanifin, PA-C, is currently Department Chair and Assistant Professor, Department of Physician Assistant, Seton Hall University, NJ.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Robert Kneschke
Source: sciencedaily.com/releases/2018/08/180825081713.htm
Undigested Red Food in Poops vs. Drops of Blood: Comparison
Red food clumps or particles in your poops can mimic the appearance of blood smears or clots from a disease.
Here’s how to tell whether the red you see is food vs. blood. (more…)
