Patient's Query
Hello doctor,
I am attaching a Word document detailing the symptoms of my cardiac issues. I have been experiencing these symptoms for the past seven months, starting when I ended up in A&E. The document outlines the issues and the tests conducted so far. Currently, I experience chest pain on the left-hand side under the breast, which comes and goes. It feels more like an ache than tightness. Additionally, I have intermittent pain in my left arm, along with lightheadedness and a woozy sensation, especially when walking or standing.
I would like to get your thoughts and advice on what the possible issue could be, as well as any recommendations for further tests.
Hello,
Welcome to icliniq.com.
I have carefully reviewed your concern and would like to explain that your recent clinical symptoms may be related to the use of THC (Tetrahydrocannabinol), alcohol, and cocaine. These are potent stimulants that can lead to blood electrolyte imbalances, heart rhythm disturbances, and central nervous system symptoms. Additionally, they may cause coronary blood flow disturbances and cardiac ischemia. In excessive amounts, these substances can result in life-threatening cardiac arrhythmias and myocardial infarction. Therefore, I strongly recommend avoiding these substances in the future to safeguard your health.
To clarify any potential myocardial damage, I advise discussing with your doctor the possibility of performing a cardiac ultrasound and, if feasible, a cardiac magnetic resonance imaging (MRI) test.
I hope this information has been helpful.
Please feel free to reach out with any further questions.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
Yes, it does seem that the symptoms are related to the substances mentioned, as they subsided in the past but returned after further alcohol or cocaine use. However, it has now been over a month since my last drug use, and I am still experiencing chest pain, lightheadedness, and other symptoms. I had a cardiac ultrasound (echocardiogram) done about two months ago, but it did not reveal any issues. At the time, my symptoms had subsided, though they have since returned following alcohol or cocaine use.
Do you think it would be worthwhile to ask for a cardiac MRI? Or would you recommend any other tests? All my symptoms seem to point to a cardiac problem, yet none of the tests I have undergone have identified anything, which is frustrating. This is why I am hesitant to return to my doctor—he has already referred me to a cardiologist, and I am unsure what else can be done at this point.
Hello,
Welcome back to icliniq.com.
Reviewing the results of your previous cardiac tests is an excellent starting point, as they serve as a reference when assessing your current cardiovascular condition. If chest pain occurred within the past few days, checking cardiac enzymes such as CK-MB and Troponin would be a valuable step to detect any myocardial injury or damage.
Additionally, a new cardiac ultrasound, combined with exercise or pharmacological stress testing, could provide more specific and sensitive insights into potential areas of cardiac ischemia. As for a cardiac magnetic resonance imaging (MRI) test, my answer is yes, it is the most sensitive and specific tool for detecting even small myocardial lesions or other structural cardiac abnormalities. I would strongly recommend considering a cardiac MRI, especially if other tests do not yield definitive results.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
Am I correct in understanding that, based on your response, you suspect my issue might be cardiac ischemia? If so, is there any possibility that it could subside on its own, considering that my symptoms have resolved on their own in the past? If cardiac ischemia is detected in tests, would it necessarily require a surgical procedure? The idea of heart surgery at 26 feels quite daunting.
I have been prescribed Metoprolol, but I only take it on an as-needed basis, such as before important meetings or presentations. Will Metoprolol help in my situation?
Hello,
Welcome back to icliniq.com.
I do not believe you are experiencing a clinically significant cardiac ischemia syndrome. However, since you have been using substances that can cause severe cardiac disorders, including ischemia, it is essential to rule out any such findings. This is why I recommended the tests mentioned earlier. The most effective strategy to prevent these cardiac issues is to stop using those stimulants in the future.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
I went back to my doctor, and he is referring me to a cardiologist again. I just have a question: When I initially ended up in the hospital after taking the THC capsules, which triggered all these symptoms, the emergency medicine doctor said she was not convinced I was having a heart attack—but it must have been quite close.
I do not have the actual report to attach, but I can try to request it from the hospital. All I know is that it was the scariest experience of my life. I believe my heart rate was around 190 bpm, accompanied by unbearable chest pain. At the hospital, I was hooked up to a monitor, had blood tests, and underwent a chest X-ray. All of these tests came back normal. They gave me Diazepam twice and discharged me about five hours later when my heart rate had reduced to 100 bpm.
Since then, I have had multiple ECGs, 24-hour Holter monitoring, and an echocardiogram. Given that all these tests have been normal, would it be accurate to say that my initial hospital visit did not result in any heart damage? For example, since a heart attack causes heart muscle damage, a similar damage would have been detected on an echocardiogram, ECG, or blood tests?
Hello,
Welcome back to icliniq.com.
Let me explain that you are correct—significant cardiac issues, such as myocardial infarction (heart attack) or myocardial injury, would have been detected by the cardiac tests you have already undergone. You can take some reassurance in the fact that all these tests returned normal results.
However, it is important to note that the tests performed may not detect a transient coronary vessel spasm caused by cocaine, as such a spasm could have resolved by the time you arrived at the ER. The excessive tachycardia you experienced also raises concerns about the potential effects of THC.
I strongly recommend avoiding the use of these stimulants in the future, as they can pose serious risks and may lead to permanent cardiac damage.
I hope this helps you.
Thank you.
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Answered byDr. Ilir Sharka
Medically reviewed byDr. Nithila. A
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