Minor Chest Pain After Vaccine?

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  • nooshi713
    nooshi713 Posts: 4,877 Member
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    kshama2001 wrote: »
    nooshi713 wrote: »
    Speakeasy76 wrote: »
    darreneatschicken wrote: »
    I had an ECG done today at the ER and the doctor said that I was fine. He implied that I was just experiencing anxiety.

    It could also be heartburn I think. For example, I noticed the pain flare up yesterday, while eating dinner.

    This infuriates me. Not because you went to the ER, ,but 1. You were only given an EKG to determine there was nothing wrong with your heart and 2. Multiple health care providers have implied that it's anxiety. It could be, but there are soany other things it could be as well--it's just a copout for them.

    I'm going to get on my soapbox here because this is something that is close to my heart (no pun intended). I'm telling you this not to worry you or make you think that this is what's going on, but to educate you and others as it appears medical professionals are still not educated. My otherwise perfectly healthy, hardly-ever-sick father passed away very unexpectedly and suddenly from an aortic dissection. Unfortunately for him there were no warning signs in his case and my mom found him dead on the floor. In the actor John Ritter's case, he was having chest pains and taken to the ER. He was given an EKG and sent away because it was normal, probably even told it was anxiety. The problem is that an EKG only can determine if someone is having a heart attack, and is normal in someone who is having an aortic dissection. You may know that John Ritter passed away later (that same day, actually), also from an aortic dissection (as did the actor Alan Thicke).

    Again, I highly doubt this is what's going on with you, but for anyone experiencing chest pain I highly encourage you to ask for an echocardiogram, or at least seek out a 2md opinion from a cardiologist.

    As an ER provider who sees chest pain patients all of the time at our STEMI center, I can say that an Echo and cardiology consultation is not indicated for young people with chest pain, no risk factors, and normal EKGs. If we called cardiology on this case, they would laugh at us. There aren’t enough resources to do full cardiac work ups on low risk patients to try to catch one in a million problems. If we did this on all our young low risk chest pains, we would have no room for the very sick and dying or people who are actually having heart attacks. People who are not in health care don’t understand how it works and have very unrealistic expectations. A simple EKG, maybe chest X-ray are the standard of care for young and low risk patients. If his oxygen was low or heart rate persistently elevated, he might warrant a ddimer lab test.

    @nooshi713: I currently get care from the VA Boston system and previously got it through VA Miami. My experience is that these VA systems have been generous, perhaps overly generous, with testing. (An exception is for female-specific care - don't get me started, lol.)

    I'm 54 and am fairly sure my chest pain is anxiety, but none of my many medical providers will say that definitively, so that increases my anxiety. I had multiple EKGs last year while dealing with an anemia crisis, plus an ECHO for the chest pain. I was offered a stress test but declined because I exercise all the time and my heart never does anything funny (see below) and the particular location, deep in Boston, is very stressful to get to. Also, the pain went away when political and financial situations resolved positively, which lent credence to the anxiety cause of the pain. Now the pain is back, but it could easily be due to new stressors.

    I think the stress test lab near me has opened back up, and am willing to go there, but wonder if this is the best test for me.

    My cardiologist already cancelled an appt I had earlier this month, July, and his secretary called yesterday to cancel my September reschedule appt. I complained vociferously and she's put a note in about my reoccurrence of chest pain and request for the stress test at the new location.

    I have a cardiologist because a few years back I was having more incidences of irregular heartbeat. I wore a monitor for two weeks and nothing unusual was found while exercising. My anemia had also gotten out of control at that time and the frequent irregular heartbeat went away when that resolved.

    I’m sorry to hear you have been dealing with this but I’m glad that the VA is looking into it. My husband is a veteran too and other than some scheduling issues and cancellations, his care has been good. A stress test is a good idea. For most, these tests can be done on an outpatient basis as it sounds like you have been doing. Just stay on top of it and call them back to reschedule. Those cancellations are frustrating.
  • kshama2001
    kshama2001 Posts: 27,906 Member
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    nooshi713 wrote: »
    kshama2001 wrote: »
    nooshi713 wrote: »
    Speakeasy76 wrote: »
    darreneatschicken wrote: »
    I had an ECG done today at the ER and the doctor said that I was fine. He implied that I was just experiencing anxiety.

    It could also be heartburn I think. For example, I noticed the pain flare up yesterday, while eating dinner.

    This infuriates me. Not because you went to the ER, ,but 1. You were only given an EKG to determine there was nothing wrong with your heart and 2. Multiple health care providers have implied that it's anxiety. It could be, but there are soany other things it could be as well--it's just a copout for them.

    I'm going to get on my soapbox here because this is something that is close to my heart (no pun intended). I'm telling you this not to worry you or make you think that this is what's going on, but to educate you and others as it appears medical professionals are still not educated. My otherwise perfectly healthy, hardly-ever-sick father passed away very unexpectedly and suddenly from an aortic dissection. Unfortunately for him there were no warning signs in his case and my mom found him dead on the floor. In the actor John Ritter's case, he was having chest pains and taken to the ER. He was given an EKG and sent away because it was normal, probably even told it was anxiety. The problem is that an EKG only can determine if someone is having a heart attack, and is normal in someone who is having an aortic dissection. You may know that John Ritter passed away later (that same day, actually), also from an aortic dissection (as did the actor Alan Thicke).

    Again, I highly doubt this is what's going on with you, but for anyone experiencing chest pain I highly encourage you to ask for an echocardiogram, or at least seek out a 2md opinion from a cardiologist.

    As an ER provider who sees chest pain patients all of the time at our STEMI center, I can say that an Echo and cardiology consultation is not indicated for young people with chest pain, no risk factors, and normal EKGs. If we called cardiology on this case, they would laugh at us. There aren’t enough resources to do full cardiac work ups on low risk patients to try to catch one in a million problems. If we did this on all our young low risk chest pains, we would have no room for the very sick and dying or people who are actually having heart attacks. People who are not in health care don’t understand how it works and have very unrealistic expectations. A simple EKG, maybe chest X-ray are the standard of care for young and low risk patients. If his oxygen was low or heart rate persistently elevated, he might warrant a ddimer lab test.

    @nooshi713: I currently get care from the VA Boston system and previously got it through VA Miami. My experience is that these VA systems have been generous, perhaps overly generous, with testing. (An exception is for female-specific care - don't get me started, lol.)

    I'm 54 and am fairly sure my chest pain is anxiety, but none of my many medical providers will say that definitively, so that increases my anxiety. I had multiple EKGs last year while dealing with an anemia crisis, plus an ECHO for the chest pain. I was offered a stress test but declined because I exercise all the time and my heart never does anything funny (see below) and the particular location, deep in Boston, is very stressful to get to. Also, the pain went away when political and financial situations resolved positively, which lent credence to the anxiety cause of the pain. Now the pain is back, but it could easily be due to new stressors.

    I think the stress test lab near me has opened back up, and am willing to go there, but wonder if this is the best test for me.

    My cardiologist already cancelled an appt I had earlier this month, July, and his secretary called yesterday to cancel my September reschedule appt. I complained vociferously and she's put a note in about my reoccurrence of chest pain and request for the stress test at the new location.

    I have a cardiologist because a few years back I was having more incidences of irregular heartbeat. I wore a monitor for two weeks and nothing unusual was found while exercising. My anemia had also gotten out of control at that time and the frequent irregular heartbeat went away when that resolved.

    I’m sorry to hear you have been dealing with this but I’m glad that the VA is looking into it. My husband is a veteran too and other than some scheduling issues and cancellations, his care has been good. A stress test is a good idea. For most, these tests can be done on an outpatient basis as it sounds like you have been doing. Just stay on top of it and call them back to reschedule. Those cancellations are frustrating.

    Thanks!
  • rheddmobile
    rheddmobile Posts: 6,840 Member
    Options
    kshama2001 wrote: »
    nooshi713 wrote: »
    Speakeasy76 wrote: »
    darreneatschicken wrote: »
    I had an ECG done today at the ER and the doctor said that I was fine. He implied that I was just experiencing anxiety.

    It could also be heartburn I think. For example, I noticed the pain flare up yesterday, while eating dinner.

    This infuriates me. Not because you went to the ER, ,but 1. You were only given an EKG to determine there was nothing wrong with your heart and 2. Multiple health care providers have implied that it's anxiety. It could be, but there are soany other things it could be as well--it's just a copout for them.

    I'm going to get on my soapbox here because this is something that is close to my heart (no pun intended). I'm telling you this not to worry you or make you think that this is what's going on, but to educate you and others as it appears medical professionals are still not educated. My otherwise perfectly healthy, hardly-ever-sick father passed away very unexpectedly and suddenly from an aortic dissection. Unfortunately for him there were no warning signs in his case and my mom found him dead on the floor. In the actor John Ritter's case, he was having chest pains and taken to the ER. He was given an EKG and sent away because it was normal, probably even told it was anxiety. The problem is that an EKG only can determine if someone is having a heart attack, and is normal in someone who is having an aortic dissection. You may know that John Ritter passed away later (that same day, actually), also from an aortic dissection (as did the actor Alan Thicke).

    Again, I highly doubt this is what's going on with you, but for anyone experiencing chest pain I highly encourage you to ask for an echocardiogram, or at least seek out a 2md opinion from a cardiologist.

    As an ER provider who sees chest pain patients all of the time at our STEMI center, I can say that an Echo and cardiology consultation is not indicated for young people with chest pain, no risk factors, and normal EKGs. If we called cardiology on this case, they would laugh at us. There aren’t enough resources to do full cardiac work ups on low risk patients to try to catch one in a million problems. If we did this on all our young low risk chest pains, we would have no room for the very sick and dying or people who are actually having heart attacks. People who are not in health care don’t understand how it works and have very unrealistic expectations. A simple EKG, maybe chest X-ray are the standard of care for young and low risk patients. If his oxygen was low or heart rate persistently elevated, he might warrant a ddimer lab test.

    @nooshi713: I currently get care from the VA Boston system and previously got it through VA Miami. My experience is that these VA systems have been generous, perhaps overly generous, with testing. (An exception is for female-specific care - don't get me started, lol.)

    I'm 54 and am fairly sure my chest pain is anxiety, but none of my many medical providers will say that definitively, so that increases my anxiety. I had multiple EKGs last year while dealing with an anemia crisis, plus an ECHO for the chest pain. I was offered a stress test but declined because I exercise all the time and my heart never does anything funny (see below) and the particular location, deep in Boston, is very stressful to get to. Also, the pain went away when political and financial situations resolved positively, which lent credence to the anxiety cause of the pain. Now the pain is back, but it could easily be due to new stressors.

    I think the stress test lab near me has opened back up, and am willing to go there, but wonder if this is the best test for me.

    My cardiologist already cancelled an appt I had earlier this month, July, and his secretary called yesterday to cancel my September reschedule appt. I complained vociferously and she's put a note in about my reoccurrence of chest pain and request for the stress test at the new location.

    I have a cardiologist because a few years back I was having more incidences of irregular heartbeat. I wore a monitor for two weeks and nothing unusual was found while exercising. My anemia had also gotten out of control at that time and the frequent irregular heartbeat went away when that resolved.

    For what it’s worth when I had serious anemia, the anemia itself gave me chest pain especially while standing because my muscles weren’t getting the oxygen they wanted.
  • Speakeasy76
    Speakeasy76 Posts: 961 Member
    Options
    nooshi713 wrote: »
    Speakeasy76 wrote: »
    nooshi713 wrote: »
    Speakeasy76 wrote: »
    darreneatschicken wrote: »
    I had an ECG done today at the ER and the doctor said that I was fine. He implied that I was just experiencing anxiety.

    It could also be heartburn I think. For example, I noticed the pain flare up yesterday, while eating dinner.

    This infuriates me. Not because you went to the ER, ,but 1. You were only given an EKG to determine there was nothing wrong with your heart and 2. Multiple health care providers have implied that it's anxiety. It could be, but there are soany other things it could be as well--it's just a copout for them.

    I'm going to get on my soapbox here because this is something that is close to my heart (no pun intended). I'm telling you this not to worry you or make you think that this is what's going on, but to educate you and others as it appears medical professionals are still not educated. My otherwise perfectly healthy, hardly-ever-sick father passed away very unexpectedly and suddenly from an aortic dissection. Unfortunately for him there were no warning signs in his case and my mom found him dead on the floor. In the actor John Ritter's case, he was having chest pains and taken to the ER. He was given an EKG and sent away because it was normal, probably even told it was anxiety. The problem is that an EKG only can determine if someone is having a heart attack, and is normal in someone who is having an aortic dissection. You may know that John Ritter passed away later (that same day, actually), also from an aortic dissection (as did the actor Alan Thicke).

    Again, I highly doubt this is what's going on with you, but for anyone experiencing chest pain I highly encourage you to ask for an echocardiogram, or at least seek out a 2md opinion from a cardiologist.

    As an ER provider who sees chest pain patients all of the time at our STEMI center, I can say that an Echo and cardiology consultation is not indicated for young people with chest pain, no risk factors, and normal EKGs. If we called cardiology on this case, they would laugh at us. There aren’t enough resources to do full cardiac work ups on low risk patients to try to catch one in a million problems. If we did this on all our young low risk chest pains, we would have no room for the very sick and dying or people who are actually having heart attacks. People who are not in health care don’t understand how it works and have very unrealistic expectations. A simple EKG, maybe chest X-ray are the standard of care for young and low risk patients. If his oxygen was low or heart rate persistently elevated, he might warrant a ddimer lab test.

    I'm not sure this is supposed to make people feel better (especially someone close to this), being told we don't understand how health care works and have "very unrealistic expectations." I understand health care resources are limited and cannot run every single test under the sun, but what exactly constitutes "low risk?" Are the chances really one in a million? The chances of an aortic dissection are 2 in 10000, most common in men ages 40-70. Often times (as in the case of my dad), someone wouldn't even know they are at risk until they had one--my dad was literally told 9 months prior to his death by his physician that he was the "healthiest 64-year old he's ever seen" with no history of high cholesterol or high blood pressure. The only reasons my brothers and I know we are at risk (ages 38-51) is because our father passed away from it.

    I understand your frustration as an ER provider when people want all kind of tests to be run with limited resources and that not every test can be run. I get that it must be very frustrating to hear people complain about ER medical professionals and that your job is very demanding. However, telling someone that they have "very unrealistic expectations" without acknowledging their loss and personal experience with a diagnosis that is (according to reports from 2017) missed in about 1 out of 6 cases in the ER, maybe isn't the best way to increase understanding of your perspective.

    You are referring to aortic dissection, which is not a concern in a young person with chest pain after receiving a vaccine. The worst case scenario for someone like the OP is a pericarditis, myocarditis, or blood clot of some kind. We work people up for aortic dissection in the ER regularly. We also work people up for pulmonary emboli. There are many factors used to determine someone’s risk. The OP does not fit the profile for that and it is doubtful anyone would work him up for a dissection.

    We see so many people with chest pain or different symptoms after vaccines and it is impossible to work them all up, especially the young and otherwise healthy. I’m not minimizing your loss. I’m explaining the realities of working in healthcare and it is an unfortunate reality that many patients have unrealistic expectations.

    The risks for the type of rare and deadly blood clots after a vaccine that were in the news recently were somewhere in the range of 1-2 per million. That’s exceedingly rare. Even one in 10,000 is very rare and not every case will be caught. That’s reality. There will be occasional zebra cases that go missed. It is impossible to catch everything.

    I understand that an AD is not typically a concern for a young person after a vaccine, unless there are other markers that could indicate that as a possibility (since it can still happen in young people). I don't doubt that anxiety is often the case for several cases of chest pain. I also understand that it's impossible to catch everything in the ER, especially with those conditions that are more rare. My own 23-year old nephew was told in the ER that his chest pain was most likely anxiety, and despite having a grandfather who died from an AD, that was probably an accurate dx at the time. I also highly doubt the OP has an aortic dissection and was not meaning to imply that he does, but also that an EKG is only one measure of heart functioning.

    As you mentioned, though very rare, some of the other risks for vaccines like pericarditis couldn't be determined by an EKG. I'm not saying the ER should test for these, but am wondering if patients are just told everything is "fine" and not to worry about it( something that is NOT helpful at all if it truly is anxiety), or are given instructions to follow up within a certain amount of time if it persists.

    I admire ER medical personal, because I'm not the type of person who could make split-second decisions and would always be second-guessing myself, wondering "what if" it is one of the rare cases. I would want to do more, but knowing there were limitations in doing so. Having someone close to you die very suddenly and unexpectedly from something you'd never heard of before kind of makes you like that.
  • rheddmobile
    rheddmobile Posts: 6,840 Member
    Options
    Speakeasy76 wrote: »
    nooshi713 wrote: »
    Speakeasy76 wrote: »
    nooshi713 wrote: »
    Speakeasy76 wrote: »
    darreneatschicken wrote: »
    I had an ECG done today at the ER and the doctor said that I was fine. He implied that I was just experiencing anxiety.

    It could also be heartburn I think. For example, I noticed the pain flare up yesterday, while eating dinner.

    This infuriates me. Not because you went to the ER, ,but 1. You were only given an EKG to determine there was nothing wrong with your heart and 2. Multiple health care providers have implied that it's anxiety. It could be, but there are soany other things it could be as well--it's just a copout for them.

    I'm going to get on my soapbox here because this is something that is close to my heart (no pun intended). I'm telling you this not to worry you or make you think that this is what's going on, but to educate you and others as it appears medical professionals are still not educated. My otherwise perfectly healthy, hardly-ever-sick father passed away very unexpectedly and suddenly from an aortic dissection. Unfortunately for him there were no warning signs in his case and my mom found him dead on the floor. In the actor John Ritter's case, he was having chest pains and taken to the ER. He was given an EKG and sent away because it was normal, probably even told it was anxiety. The problem is that an EKG only can determine if someone is having a heart attack, and is normal in someone who is having an aortic dissection. You may know that John Ritter passed away later (that same day, actually), also from an aortic dissection (as did the actor Alan Thicke).

    Again, I highly doubt this is what's going on with you, but for anyone experiencing chest pain I highly encourage you to ask for an echocardiogram, or at least seek out a 2md opinion from a cardiologist.

    As an ER provider who sees chest pain patients all of the time at our STEMI center, I can say that an Echo and cardiology consultation is not indicated for young people with chest pain, no risk factors, and normal EKGs. If we called cardiology on this case, they would laugh at us. There aren’t enough resources to do full cardiac work ups on low risk patients to try to catch one in a million problems. If we did this on all our young low risk chest pains, we would have no room for the very sick and dying or people who are actually having heart attacks. People who are not in health care don’t understand how it works and have very unrealistic expectations. A simple EKG, maybe chest X-ray are the standard of care for young and low risk patients. If his oxygen was low or heart rate persistently elevated, he might warrant a ddimer lab test.

    I'm not sure this is supposed to make people feel better (especially someone close to this), being told we don't understand how health care works and have "very unrealistic expectations." I understand health care resources are limited and cannot run every single test under the sun, but what exactly constitutes "low risk?" Are the chances really one in a million? The chances of an aortic dissection are 2 in 10000, most common in men ages 40-70. Often times (as in the case of my dad), someone wouldn't even know they are at risk until they had one--my dad was literally told 9 months prior to his death by his physician that he was the "healthiest 64-year old he's ever seen" with no history of high cholesterol or high blood pressure. The only reasons my brothers and I know we are at risk (ages 38-51) is because our father passed away from it.

    I understand your frustration as an ER provider when people want all kind of tests to be run with limited resources and that not every test can be run. I get that it must be very frustrating to hear people complain about ER medical professionals and that your job is very demanding. However, telling someone that they have "very unrealistic expectations" without acknowledging their loss and personal experience with a diagnosis that is (according to reports from 2017) missed in about 1 out of 6 cases in the ER, maybe isn't the best way to increase understanding of your perspective.

    You are referring to aortic dissection, which is not a concern in a young person with chest pain after receiving a vaccine. The worst case scenario for someone like the OP is a pericarditis, myocarditis, or blood clot of some kind. We work people up for aortic dissection in the ER regularly. We also work people up for pulmonary emboli. There are many factors used to determine someone’s risk. The OP does not fit the profile for that and it is doubtful anyone would work him up for a dissection.

    We see so many people with chest pain or different symptoms after vaccines and it is impossible to work them all up, especially the young and otherwise healthy. I’m not minimizing your loss. I’m explaining the realities of working in healthcare and it is an unfortunate reality that many patients have unrealistic expectations.

    The risks for the type of rare and deadly blood clots after a vaccine that were in the news recently were somewhere in the range of 1-2 per million. That’s exceedingly rare. Even one in 10,000 is very rare and not every case will be caught. That’s reality. There will be occasional zebra cases that go missed. It is impossible to catch everything.

    I understand that an AD is not typically a concern for a young person after a vaccine, unless there are other markers that could indicate that as a possibility (since it can still happen in young people). I don't doubt that anxiety is often the case for several cases of chest pain. I also understand that it's impossible to catch everything in the ER, especially with those conditions that are more rare. My own 23-year old nephew was told in the ER that his chest pain was most likely anxiety, and despite having a grandfather who died from an AD, that was probably an accurate dx at the time. I also highly doubt the OP has an aortic dissection and was not meaning to imply that he does, but also that an EKG is only one measure of heart functioning.

    As you mentioned, though very rare, some of the other risks for vaccines like pericarditis couldn't be determined by an EKG. I'm not saying the ER should test for these, but am wondering if patients are just told everything is "fine" and not to worry about it( something that is NOT helpful at all if it truly is anxiety), or are given instructions to follow up within a certain amount of time if it persists.

    I admire ER medical personal, because I'm not the type of person who could make split-second decisions and would always be second-guessing myself, wondering "what if" it is one of the rare cases. I would want to do more, but knowing there were limitations in doing so. Having someone close to you die very suddenly and unexpectedly from something you'd never heard of before kind of makes you like that.
    It’s pretty standard ER procedure to run bloodwork for even a young patient with heart pain, which will rule out blood clots and an ongoing heart attack (doesn’t show really recent heart attacks which is why they will keep you for 90 minutes and test again.) Blood work would also show inflammation associated with myo and pericarditis, and I’m assuming in the case of someone recently vaxxed they would look for that. The OP doesn’t specifically say no blood work was run in addition to the EKG - at least where I live it would be highly unusual if it wasn’t.
  • nooshi713
    nooshi713 Posts: 4,877 Member
    Options
    Speakeasy76 wrote: »
    nooshi713 wrote: »
    Speakeasy76 wrote: »
    nooshi713 wrote: »
    Speakeasy76 wrote: »
    darreneatschicken wrote: »
    I had an ECG done today at the ER and the doctor said that I was fine. He implied that I was just experiencing anxiety.

    It could also be heartburn I think. For example, I noticed the pain flare up yesterday, while eating dinner.

    This infuriates me. Not because you went to the ER, ,but 1. You were only given an EKG to determine there was nothing wrong with your heart and 2. Multiple health care providers have implied that it's anxiety. It could be, but there are soany other things it could be as well--it's just a copout for them.

    I'm going to get on my soapbox here because this is something that is close to my heart (no pun intended). I'm telling you this not to worry you or make you think that this is what's going on, but to educate you and others as it appears medical professionals are still not educated. My otherwise perfectly healthy, hardly-ever-sick father passed away very unexpectedly and suddenly from an aortic dissection. Unfortunately for him there were no warning signs in his case and my mom found him dead on the floor. In the actor John Ritter's case, he was having chest pains and taken to the ER. He was given an EKG and sent away because it was normal, probably even told it was anxiety. The problem is that an EKG only can determine if someone is having a heart attack, and is normal in someone who is having an aortic dissection. You may know that John Ritter passed away later (that same day, actually), also from an aortic dissection (as did the actor Alan Thicke).

    Again, I highly doubt this is what's going on with you, but for anyone experiencing chest pain I highly encourage you to ask for an echocardiogram, or at least seek out a 2md opinion from a cardiologist.

    As an ER provider who sees chest pain patients all of the time at our STEMI center, I can say that an Echo and cardiology consultation is not indicated for young people with chest pain, no risk factors, and normal EKGs. If we called cardiology on this case, they would laugh at us. There aren’t enough resources to do full cardiac work ups on low risk patients to try to catch one in a million problems. If we did this on all our young low risk chest pains, we would have no room for the very sick and dying or people who are actually having heart attacks. People who are not in health care don’t understand how it works and have very unrealistic expectations. A simple EKG, maybe chest X-ray are the standard of care for young and low risk patients. If his oxygen was low or heart rate persistently elevated, he might warrant a ddimer lab test.

    I'm not sure this is supposed to make people feel better (especially someone close to this), being told we don't understand how health care works and have "very unrealistic expectations." I understand health care resources are limited and cannot run every single test under the sun, but what exactly constitutes "low risk?" Are the chances really one in a million? The chances of an aortic dissection are 2 in 10000, most common in men ages 40-70. Often times (as in the case of my dad), someone wouldn't even know they are at risk until they had one--my dad was literally told 9 months prior to his death by his physician that he was the "healthiest 64-year old he's ever seen" with no history of high cholesterol or high blood pressure. The only reasons my brothers and I know we are at risk (ages 38-51) is because our father passed away from it.

    I understand your frustration as an ER provider when people want all kind of tests to be run with limited resources and that not every test can be run. I get that it must be very frustrating to hear people complain about ER medical professionals and that your job is very demanding. However, telling someone that they have "very unrealistic expectations" without acknowledging their loss and personal experience with a diagnosis that is (according to reports from 2017) missed in about 1 out of 6 cases in the ER, maybe isn't the best way to increase understanding of your perspective.

    You are referring to aortic dissection, which is not a concern in a young person with chest pain after receiving a vaccine. The worst case scenario for someone like the OP is a pericarditis, myocarditis, or blood clot of some kind. We work people up for aortic dissection in the ER regularly. We also work people up for pulmonary emboli. There are many factors used to determine someone’s risk. The OP does not fit the profile for that and it is doubtful anyone would work him up for a dissection.

    We see so many people with chest pain or different symptoms after vaccines and it is impossible to work them all up, especially the young and otherwise healthy. I’m not minimizing your loss. I’m explaining the realities of working in healthcare and it is an unfortunate reality that many patients have unrealistic expectations.

    The risks for the type of rare and deadly blood clots after a vaccine that were in the news recently were somewhere in the range of 1-2 per million. That’s exceedingly rare. Even one in 10,000 is very rare and not every case will be caught. That’s reality. There will be occasional zebra cases that go missed. It is impossible to catch everything.

    I understand that an AD is not typically a concern for a young person after a vaccine, unless there are other markers that could indicate that as a possibility (since it can still happen in young people). I don't doubt that anxiety is often the case for several cases of chest pain. I also understand that it's impossible to catch everything in the ER, especially with those conditions that are more rare. My own 23-year old nephew was told in the ER that his chest pain was most likely anxiety, and despite having a grandfather who died from an AD, that was probably an accurate dx at the time. I also highly doubt the OP has an aortic dissection and was not meaning to imply that he does, but also that an EKG is only one measure of heart functioning.

    As you mentioned, though very rare, some of the other risks for vaccines like pericarditis couldn't be determined by an EKG. I'm not saying the ER should test for these, but am wondering if patients are just told everything is "fine" and not to worry about it( something that is NOT helpful at all if it truly is anxiety), or are given instructions to follow up within a certain amount of time if it persists.

    I admire ER medical personal, because I'm not the type of person who could make split-second decisions and would always be second-guessing myself, wondering "what if" it is one of the rare cases. I would want to do more, but knowing there were limitations in doing so. Having someone close to you die very suddenly and unexpectedly from something you'd never heard of before kind of makes you like that.

    There are many factors to consider. If a young person had abnormal vital signs or something concerning in the history then they would probably get more of a work up. We always tell people to follow up with their own doctor after leaving the ER. We also can’t assure them that everything is normal but can tell them that based on their vitals, history, risk profile, and any tests done that we doubt a life threatening condition at the moment. Also, it is not standard of care to do labs on chest pain patients if they are young with no risk factors. Some places do it and some don’t, but it is not the standard of care. Also, I’m sorry for your loss.
  • nooshi713
    nooshi713 Posts: 4,877 Member
    edited July 2021
    Options
    ythannah wrote: »
    nooshi713 wrote: »
    Speakeasy76 wrote: »
    darreneatschicken wrote: »
    I had an ECG done today at the ER and the doctor said that I was fine. He implied that I was just experiencing anxiety.

    It could also be heartburn I think. For example, I noticed the pain flare up yesterday, while eating dinner.

    This infuriates me. Not because you went to the ER, ,but 1. You were only given an EKG to determine there was nothing wrong with your heart and 2. Multiple health care providers have implied that it's anxiety. It could be, but there are soany other things it could be as well--it's just a copout for them.

    I'm going to get on my soapbox here because this is something that is close to my heart (no pun intended). I'm telling you this not to worry you or make you think that this is what's going on, but to educate you and others as it appears medical professionals are still not educated. My otherwise perfectly healthy, hardly-ever-sick father passed away very unexpectedly and suddenly from an aortic dissection. Unfortunately for him there were no warning signs in his case and my mom found him dead on the floor. In the actor John Ritter's case, he was having chest pains and taken to the ER. He was given an EKG and sent away because it was normal, probably even told it was anxiety. The problem is that an EKG only can determine if someone is having a heart attack, and is normal in someone who is having an aortic dissection. You may know that John Ritter passed away later (that same day, actually), also from an aortic dissection (as did the actor Alan Thicke).

    Again, I highly doubt this is what's going on with you, but for anyone experiencing chest pain I highly encourage you to ask for an echocardiogram, or at least seek out a 2md opinion from a cardiologist.

    As an ER provider who sees chest pain patients all of the time at our STEMI center, I can say that an Echo and cardiology consultation is not indicated for young people with chest pain, no risk factors, and normal EKGs. If we called cardiology on this case, they would laugh at us. There aren’t enough resources to do full cardiac work ups on low risk patients to try to catch one in a million problems. If we did this on all our young low risk chest pains, we would have no room for the very sick and dying or people who are actually having heart attacks. People who are not in health care don’t understand how it works and have very unrealistic expectations. A simple EKG, maybe chest X-ray are the standard of care for young and low risk patients. If his oxygen was low or heart rate persistently elevated, he might warrant a ddimer lab test.

    At the other end of the age spectrum, all chest pain is treated like a possible heart attack. :D

    Last fall (age 56) I went to ER because I had been experiencing chest pain for the past month and it was steadily worsening. As it was completely movement-generated pain I thought I had pulled a muscle, badly. I was very specific when asked about my symptoms that it was related to movement, that it was STERNUM pain, and the length of time I'd had it (if I'd been having a heart attack I would have been dead long since). It probably doesn't help that I do have MVP with regurgitation.

    Nope. The first thing they did was testing for a heart attack. Although they also did a chest X ray, which was why I went to ER in the first place rather than try to get a phone appointment with my dr six weeks down the road to get the X ray req. The eventual diagnosis was costochondritis... harmless but incredibly painful.

    Incidentally, it flared up again about a week before my first vaccination. Had it reoccurred after the shot, I might well have blamed the vaccine for it. :|

    Yeah it is very true that we have to be a lot more careful as the patient gets older, although your age would not be considered old at all. 🥰

    You just reminded me…..I had chostochondritis before and it was so painful I thought I was dying.
  • ythannah
    ythannah Posts: 4,365 Member
    Options
    nooshi713 wrote: »
    ythannah wrote: »
    nooshi713 wrote: »
    Speakeasy76 wrote: »
    darreneatschicken wrote: »
    I had an ECG done today at the ER and the doctor said that I was fine. He implied that I was just experiencing anxiety.

    It could also be heartburn I think. For example, I noticed the pain flare up yesterday, while eating dinner.

    This infuriates me. Not because you went to the ER, ,but 1. You were only given an EKG to determine there was nothing wrong with your heart and 2. Multiple health care providers have implied that it's anxiety. It could be, but there are soany other things it could be as well--it's just a copout for them.

    I'm going to get on my soapbox here because this is something that is close to my heart (no pun intended). I'm telling you this not to worry you or make you think that this is what's going on, but to educate you and others as it appears medical professionals are still not educated. My otherwise perfectly healthy, hardly-ever-sick father passed away very unexpectedly and suddenly from an aortic dissection. Unfortunately for him there were no warning signs in his case and my mom found him dead on the floor. In the actor John Ritter's case, he was having chest pains and taken to the ER. He was given an EKG and sent away because it was normal, probably even told it was anxiety. The problem is that an EKG only can determine if someone is having a heart attack, and is normal in someone who is having an aortic dissection. You may know that John Ritter passed away later (that same day, actually), also from an aortic dissection (as did the actor Alan Thicke).

    Again, I highly doubt this is what's going on with you, but for anyone experiencing chest pain I highly encourage you to ask for an echocardiogram, or at least seek out a 2md opinion from a cardiologist.

    As an ER provider who sees chest pain patients all of the time at our STEMI center, I can say that an Echo and cardiology consultation is not indicated for young people with chest pain, no risk factors, and normal EKGs. If we called cardiology on this case, they would laugh at us. There aren’t enough resources to do full cardiac work ups on low risk patients to try to catch one in a million problems. If we did this on all our young low risk chest pains, we would have no room for the very sick and dying or people who are actually having heart attacks. People who are not in health care don’t understand how it works and have very unrealistic expectations. A simple EKG, maybe chest X-ray are the standard of care for young and low risk patients. If his oxygen was low or heart rate persistently elevated, he might warrant a ddimer lab test.

    At the other end of the age spectrum, all chest pain is treated like a possible heart attack. :D

    Last fall (age 56) I went to ER because I had been experiencing chest pain for the past month and it was steadily worsening. As it was completely movement-generated pain I thought I had pulled a muscle, badly. I was very specific when asked about my symptoms that it was related to movement, that it was STERNUM pain, and the length of time I'd had it (if I'd been having a heart attack I would have been dead long since). It probably doesn't help that I do have MVP with regurgitation.

    Nope. The first thing they did was testing for a heart attack. Although they also did a chest X ray, which was why I went to ER in the first place rather than try to get a phone appointment with my dr six weeks down the road to get the X ray req. The eventual diagnosis was costochondritis... harmless but incredibly painful.

    Incidentally, it flared up again about a week before my first vaccination. Had it reoccurred after the shot, I might well have blamed the vaccine for it. :|

    Yeah it is very true that we have to be a lot more careful as the patient gets older, although your age would not be considered old at all. 🥰

    You just reminded me…..I had chostochondritis before and it was so painful I thought I was dying.

    <3

    I'm amazed that something benign can hurt SO much. Breathing is painful enough, but sneezing is pure agony. I was not impressed to get it again during the height of spring allergies.
  • Speakeasy76
    Speakeasy76 Posts: 961 Member
    Options
    ythannah wrote: »
    nooshi713 wrote: »
    Speakeasy76 wrote: »
    darreneatschicken wrote: »
    I had an ECG done today at the ER and the doctor said that I was fine. He implied that I was just experiencing anxiety.

    It could also be heartburn I think. For example, I noticed the pain flare up yesterday, while eating dinner.

    This infuriates me. Not because you went to the ER, ,but 1. You were only given an EKG to determine there was nothing wrong with your heart and 2. Multiple health care providers have implied that it's anxiety. It could be, but there are soany other things it could be as well--it's just a copout for them.

    I'm going to get on my soapbox here because this is something that is close to my heart (no pun intended). I'm telling you this not to worry you or make you think that this is what's going on, but to educate you and others as it appears medical professionals are still not educated. My otherwise perfectly healthy, hardly-ever-sick father passed away very unexpectedly and suddenly from an aortic dissection. Unfortunately for him there were no warning signs in his case and my mom found him dead on the floor. In the actor John Ritter's case, he was having chest pains and taken to the ER. He was given an EKG and sent away because it was normal, probably even told it was anxiety. The problem is that an EKG only can determine if someone is having a heart attack, and is normal in someone who is having an aortic dissection. You may know that John Ritter passed away later (that same day, actually), also from an aortic dissection (as did the actor Alan Thicke).

    Again, I highly doubt this is what's going on with you, but for anyone experiencing chest pain I highly encourage you to ask for an echocardiogram, or at least seek out a 2md opinion from a cardiologist.

    As an ER provider who sees chest pain patients all of the time at our STEMI center, I can say that an Echo and cardiology consultation is not indicated for young people with chest pain, no risk factors, and normal EKGs. If we called cardiology on this case, they would laugh at us. There aren’t enough resources to do full cardiac work ups on low risk patients to try to catch one in a million problems. If we did this on all our young low risk chest pains, we would have no room for the very sick and dying or people who are actually having heart attacks. People who are not in health care don’t understand how it works and have very unrealistic expectations. A simple EKG, maybe chest X-ray are the standard of care for young and low risk patients. If his oxygen was low or heart rate persistently elevated, he might warrant a ddimer lab test.

    At the other end of the age spectrum, all chest pain is treated like a possible heart attack. :D

    Last fall (age 56) I went to ER because I had been experiencing chest pain for the past month and it was steadily worsening. As it was completely movement-generated pain I thought I had pulled a muscle, badly. I was very specific when asked about my symptoms that it was related to movement, that it was STERNUM pain, and the length of time I'd had it (if I'd been having a heart attack I would have been dead long since). It probably doesn't help that I do have MVP with regurgitation.

    Nope. The first thing they did was testing for a heart attack. Although they also did a chest X ray, which was why I went to ER in the first place rather than try to get a phone appointment with my dr six weeks down the road to get the X ray req. The eventual diagnosis was costochondritis... harmless but incredibly painful.

    Incidentally, it flared up again about a week before my first vaccination. Had it reoccurred after the shot, I might well have blamed the vaccine for it. :|

    I get episodes of chostochondritis, too, which is especially fun since any type of chest pain triggers a bit of anxiety due to my family history. However, I've had it for so long now I know what the pain is. Mine is triggered by muscle strain or illness. Coincidentally, it flared up after I got my first Covid vaccine.
  • siobhanaoife
    siobhanaoife Posts: 150 Member
    Options
    darreneatschicken wrote: »
    siobhanaoife wrote: »
    I had pericarditis after dose #2 of Pfizer. That involved chest pain, which gradually went away. It was scary.

    That's so scary. Glad to hear you're okay now. If you don't mind me asking, how long did it take for the pain to go away and did you have to take any medication?

    6-8 weeks for the pain to go completely away (near the end of that it was just a little twingy from time to time, that's why it's a little vague how long). Didn't take anything for the pain. Had a big set of cardiology workups, imaging, stress tests, etc. Have still got a residual intermittent arrythmia, which I'm taking a low dose of a beta blocker for; the hope is that it will go away over time.
  • KNoceros
    KNoceros Posts: 324 Member
    Options
    [
    Speakeasy76 wrote: »

    As you mentioned, though very rare, some of the other risks for vaccines like pericarditis couldn't be determined by an EKG

    Actually, pericarditis causes very specific and diagnostic changes on an ECG, if you know what you’re looking for.

    (UK Medical professional)

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