Pain in heart

No pain

by AgentX86 - 2021-03-19 23:42:34

I obviously don't know what sort of pain you're experiencing.  If it's like muscle pain or coming from your ribcage it may take some time.  It's a different thing but after 6-1/2 years I still get some dull pain from my sternotomy.  My pacemaker surgery made it worse but I still have some three years after that.  Particularly the day after exercise, this sort of thing can happen because you were breathing hard and your muscles aren't happy.  It's no different than your legs after a good cardio workout.

If it's a deeper or sharper pain in your collar bone or down your arm, particularly, see your doctor ASAP.  When in doubt, see your cardiologist.

'Heart' pain is pretty vague

by crustyg - 2021-03-20 06:51:43

As Agent so wisely says your description of your symptoms is vague.

I had recurring twinges over my heart for months after implantation, and it took me a while to recognise that they were from the PM pocket.  Talking to a very experienced EP-tech, he told me that he'd only ever seen one PM patient who could actually feel heart pain from a lead.

Of course, everyone with a PM (except heart-transplant recipients) can still get heart pain from lack of blood supply through the coronary arteries - myocardial ischaemia - and many folk who end up with a PM do so precisely because of furred-up coronaries.

What you describe sounds a lot like delayed onset muscle stiffness (the DOMS), exactly like the ache in glutes/quads/biceps/triceps as we work out a little harder than our muscles are used to.  The DOMS are worst 48hr after exercise and they are a natural part of the body's healing and repair to any muscle that has been worked at, or beyond, the aerobic threshold at that time (the idea being to improve that threshold by growing new blood vessels into the exercising muscles).

Chest pain

by Gemita - 2021-03-20 07:02:42

Hi John,

Chest pain.  I think you have had this investigated in the past (gastric/heart related?) so I presume this is not imminently serious otherwise it should be checked.  As it seems to happen a day or two after vigorous exercise I would tend to think muscular rather than a serious cardiac cause.  But it would still raise the question of whether your exercise capacity is adequate (and this is where your pacemaker settings come in again).  If you are struggling to exercise with your current settings, you will have to work harder and this would obviously increase your level of chest discomfort following a vigorous exercise session.  

For example when I exercise during an arrhythmia episode, my ability to exert myself is much reduced.  Blood flow to my body is clearly affected by the irregularity of heart rhythm.  As I try to keep going, to push through I start to feel heart discomfort like you describe and increased throbbing from my palpitations.  Very quickly I am forced to stop.  A few days later my chest pain can be more noticeable, so I would suggest John that either you are not yet back to your normal ability to fully exercise or your settings are holding you back and you are having to work even harder to achieve your exercise goals?

The other possibility of course is that you are still experiencing some discomfort from the implant procedure, although I think from your description, this is unlikely.  My husband three years on is still having intermittent heart pain from his procedure, but his procedure was traumatic and caused a bleed so we cannot compare his ongoing symptoms with yours.  I still get some chest discomfort near my device, presumably from the procedure three years ago too, since my veins were traumatised during  lead implant.  I did though fortunately develop collateral veins around the device to overcome any narrowing/obstruction in a vein.  I still get what I feel is an ischaemic type pressure pain in one particular location from time to time, but I guess better having this problem than getting a total blockage and needing a stent to restore blood flow.

In your case, I still would look initially at pacemaker settings holding you back from achieving a good level of exercise, possibly resulting in your late chest pain symptoms.  At least it is not happening at the time of exercise which would worry me more for a heart cause?  Can you perhaps ask for another stress echo test to help sort out your pacemaker settings when things are more settled John?

Thanks all

by quikjraw - 2021-03-22 06:02:04

Thanks for all your comments.

It could be either the pocket then or my heart but probably muscular. It is definitely nowhere near my pocket and I can be quite rough near the pocket and it still does not hurt when it is touched.

I am having to work too hard during exercise so that makes sense and I suppose the lead is "screwed" into a muscle that is moving all the time and being stressed even more during exercise so it makes sense that until things fully bed in it might hurt a little longer. 

I know injuries can carry on hurting for many months after it has healed and a lead attachment is just a forced injury I suppose.

Therese - I have been waiting a little longer to get back to them about a follow up settings appointment. I am currently being treated for Helicobacter Pylori (I have had abdominal pain for almost a year now and they think it may be an ulcer and have tested positive for H Pylori) so was concentrating on getting that fixed first before I go back in but I think I will contact them this week.

thanks John