Suspected Myocarditus but test results clear
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Hi. I wonder if anyone can help me please? Late January I started with sore throat symptoms, croaky voice and a cough and feeling tired. A week or so later the cough became wheezy and I started experiencing shortness of breath. By the next week I booked a doctors appointment as I could barely walk due to breathing difficulties. I also started with numbness and pins and needles in my legs and arms and chest and back pain.
I was started on steroids and antibiotics with suspected pneumonia or pleurisy. I had a chest xray which was clear.
2 days later my symptoms no better so I went to see the doctor again. This time the doctor suspected myocarditus and I was admitted to hospital.
I was in hospital 8 days and had another chest xray, an ultrasound of the heart, Numerous blood tests and a spirometry test. Apart from a small lymph node on my left lung, all the test results came back clear.
I was discharged with no answers other than clear of all the serious things, but I could have had pneumonia a few weeks before seeking treatment.
It is now 4 weeks since I was discharged from hospital and I am still experiencing chest and back pain and shortess of breath, especially when bending down and walking/talking for a while (15 mins or so).
I should add that I am 45 but consider my fitness levels to be more in line with a 30 year old. I have always been super fit and eaten healthily. I have never smoked and only drink alcohol within the recommended guidelines.
My apologies for the longwinded post, but I wanted to know if I could have still had this disease, or something similar, and that tests missed it.
I am also due to fly to Mexico this weekend. The doctor has said based on the test results being clear, I am fit to fly as long as I feel fit to travel.
Thanking anyone for your help.
Janine
0 likes, 2 replies
GillianA janine34099
Edited
Hi Janine,
If you, a normally healthy and fit person, are still having chest/back pain and shortness of breath, especially when you bend down or when you walk or talk for more than 15 minutes and this has been going on for 4 weeks after discharge from hospital for some sort of undiagnosed illness, something is not right and IMHO you need to ask your doctor to re-evaluate everything.
My suggestion would be to see your doctor as soon as you can, taking along a timeline listing all your symptoms, noting when each one started, got better, got worse, and/or went away. If you have copies of your test results, also note down the date and exact interpretation of all the tests you had so it shows what symptoms you had up to and during the time you had each test done.
Having this all clearly written down so your doctor can get the complete picture at a glance should help.
For example - assuming I have understood your note correctly - you don't mention cough since your discharge from hospital, so your doctor probably won't think ongoing pulmonary embolis is a likely explanation for your shortness of breath continuing for a month - unless you are having other symptoms such as swollen ankles with sore calves, or sliver hemorrhages in your nails. You do mention having a cough that progressed to wheezing and shortness of breath at the start of your illness, which was checked with chest X-ray and heart ultrasound - both normal - but you don't mention if your blood gases were checked, what your pulse and blood pressure and temperature were, and if pulmonary embolis was considered as a possibility. (Unfortunately, you need special tests to check for pulmonary embolis - chest X-ray can be normal in many people with pulmonary embolis, and ECG and cardiac ultrasound won't show the heart effects of pulmonary embolis in ~4/5 of cases, if I recall correctly.)
If your chest pain is central or over the left side of your chest when you breathe in, or if it you feel it in your left shoulder, or you feel it with each heartbeat, then that might make your doctor wonder about pericarditis (inflammation around the outside of the heart) and, given your shortness of breath, possibly pericardial effusion (fluid build-up around the heart). If you get short of breath lying down along with ankle swelling when you're up, your doctor may wonder how well your heart is working and listen to your lungs for crackles and look at your neck veins to see if they are overfull. You don't mention whether or not you've have a repeat chest x-ray, blood gases, cardiac ultrasound to look at fluid around the heart and measure heart function, cardiac stress test, or anything like that, to check on why your symptoms have persisted for 4 weeks since the last time you were tested?
This is just my opinion, but I would be really leery about flying to Mexico when I had chest pain and shortness of breath on light exertion (walking, talking) if these symptoms were unusual for me, I've had them for four weeks after an undiagnosed respiratory-type illness, and nobody knows why it is happening - especially given the fact airplane cabins have lower than normal air pressure and low oxygen levels. (Your doctor might be interested in the 2007 NEJM paper by Dr. Muhm and colleagues called "Effect of Aircraft-Cabin Altitude on Passenger Discomfort"? - the authors measured how blood oxygen levels drop in the air pressure levels that are found in aircraft cabins.)
I hope this helps -
janine34099
Posted
Hi Gillian.
Thank you so much for taking the time to reply to my post, and sharing such valuable information.
To answer the points raised, I should have mentioned that for the duration of my stay in hospital, my blood pressure, temperature and pulse and oxygen levels were fine. I also had a number of blood tests, all of which came back clear. They did give me double dose of the preventative blood clot shots but were confident I didnt have a clot after the blood tests came back clear. I also had a chest xray with and without contrast. Both were clear. As these tests all came back clear, they decided I didn't need the gas test.
I have kept a log of my pain and symptoms. I will go through these again with my GP tomorrow.
I was planning on cancelling the trip to Mexico last Thursday, but my GP reassured me that from a flying point of view, I was safe and not in any danger. He just needed to check me tomorrow to make sure I was fit and healthy enough to travel.
I really do thank you for your time and poignant comments. I will certainly be raising these tomorrow before making a final decision.
Thanks again.
Janine