Is this typical or unusual?

[canon4me]

Once in a while I will have a (1 or 2) sharp pains over my heart/pectoral muscle. Can't decide if it is musculoskeletal or heart-related in nature. It is enough though that it catches my attention though. Have had about 4 of these today. I had an AVR on 6/5/13 and have felt great lately other than an unrelated shoulder injury. I am up to a 15 minute fast warm up walk followed by an 18-20 minute jog with no problems. Do any of you have the occasional pain eminating in the chest region that seem to be unexplainable? Thanks in advance for your responses!

 

[Guyswell]

A short, sharp pain in the area of your pectoral muscle is probably a muscle spasm.

 

[Freddie]

Could be your nerve ending healing.

Never the less, when in doubt, get it checked out.

 

[tom in MO]

I had the same thing, still do now 18 months out, but much less often. I read some stuff about how this operation traumatizes your chest and the layers between the ribs and lungs. It can take a long time for some of that stuff to heal.

Personally I have had 4 surgeries and always had unusual pains after them way past the time I was "supposed to" so I don't sweat it any more.

 

[epstns]

I still have these pains - at 2 1/2 years out. Nowhere near as often, but they happen, and sometimes painful enough for me to groan when it hits. We've never found a cause, and no lingering issues, so I just deal with it when it happens. Scary at first, but after a while, no big deal.

 

[canon4me]

Thanks guys for the reassurance. These are like needle pains, not knifing pains. A dr. Told me once the bad pains are usually the dull pains that don't go away or linger for a short period of time. Those are usually the ones they are concerned about. I just don't like anything that is "new" or "different."

 

[escargome]

But canon you are "new" and "different" I hope the pain becomes less of a problem for you. But the new and improved (heartwise) person you are will soon take over. Hang in there. I'm five years out from my AVR and I still sometimes will get a pinch or a twinge on the left side of my chest. Best Wishes to you.

 

[canon4me]

Escargome, you are right. I am a new person. I am not the same person I was on 6/4/2013, the day before my surgery and I need or my body needs to adjust to the new body.

On an unrelated subject.....strep throat has swept through my office with three people now afflicted with it. Nobody told me until the end of today and I immediately called my family practitioner, got her nurse instead and explained I had a new valve. She told my doctor and she said even with no symptoms I was considered having been exposed to it and promptly prescribed antibiotics. I'm glad I caught this before the office closed for the weekend. The last friggen' thing I need to be dealing with is bacterial endocarditis. That WOULD put the fear of God into me! Always things to be thankful for. Always.

 

[Agian]

Canon, you were probably at risk of endocarditis even before the op. Should we be getting antibiotics if people around us have infections?

 

[pellicle]

Canon, you were probably at risk of endocarditis even before the op

Perhaps more so.

. Should we be getting antibiotics if people around us have infections?

No

The nature of airborne infections is quite different. To be honest you are more at risk from poor dental hygiene and then digging around with a toothpick to dislodge something.

Poor dental hygiene is considered a significant issue.

 

[pellicle]

Some research found this

Bacterial endocarditis occurs when bacteria in the bloodstream (bacteremia) lodge on abnormal heart valves or other damaged heart tissue. Certain bacteria normally live on parts of your body, such as the mouth and upper respiratory system, the intestinal and urinary tracts
, and the skin. Some surgical and dental procedures cause a brief bacteremia. Bacteremia is
common after many invasive procedures, but only certain bacteria commonly cause endocarditis.
Bacteria are the leading cause of infective endocarditis. Hence, infective endocarditis can more specifically be called bacterial endocarditis. Bacterial endocarditis, in turn, can be classified as either sub acute bacterial endocarditis (SBE) or acute bacterial endocarditis. In cases of sub acute bacterial endocarditis, infection is often with less virulent organisms, such as Streptococcus viridans. More invasive bacteria such as staphylococci result in a more fulminate, faster developing or acute bacterial endocarditis.

Many types of organism can cause infective endocarditis. These are generally isolated by blood culture, where the patient's blood is removed, and any growth is noted and identified. Alpha-haemolytic streptococci, that are present in the mouth will often be the organism isolated if a dental procedure caused the bacteraemia. If the bacteraemia was introduced through the skin, such as contamination in surgery, during catheterisation, or in an IV drug user, Staphylococcus aureus is common.

A third important cause of endocarditis is Enterococcus species. These bacteria enter the bloodstream as a consequence of abnormalities in the gastrointestinal or urinary tracts. Enterococcus species are increasingly recognized as causes of nosocomial or hospital-acquired endocarditis. This contrasts with alpha-haemolytic streptococci and Staphylococcus aureus which are causes of community-acquired endocarditis.

Some organism when isolated give valuable clues to the cause, as they tend to be specific. Candida albicans, a yeast, is associated with IV drug users and the immunocompromised. Pseudomonas species, which are very resilient organisms that thrive in water, are may contaminate street drugs that have been contaminated with drinking water. Streptococcus bovis, which is part of the natural flora of the bowel, tends to present when the patient has bowel cancer. HACEK organisms are a group of bacteria that live on the dental gums, and are associated with IV drug users who contaminate their needles with saliva.

Source(s):


http://heart-disease.health-cares.net/endocarditis-causes.php

 

[Agian]

I asked my cardiologist whether taking an antibiotic all the time is a good idea. It isn't, apparently. But being cautious is. So where do you draw the line? You might chew something hard and cause a little gum bleeding, do you then reach for the antibiotics? I'm not being a smartarse, they're questions that have crossed my mind.

 

[pellicle]

I asked my cardiologist whether taking an antibiotic all the time is a good idea. It isn't, apparently. But being cautious is. So where do you draw the line?

Knowing the bacteria involved makes it clear.

Unless you get skin bacteria into your mouth its unlikely you will be getting airborne infections of the bacteria that cause endocarditis

You might chew something hard and cause a little gum bleeding, do you then reach for the antibiotics? I'm not being a smartarse, they're questions that have crossed my mind.

Its not mouth cuts but sub-gignival bleedinig where swarms of nasties sit around in the plaque of uncleaned teeth.

http://publications.nice.org.uk/prophylaxis-against-infective-endocarditis-cg64

In the absence of a robust evidence base, antibiotic prophylaxis has been given empirically to patients with a wide range of cardiac conditions including a history of rheumatic fever. The efficacy of this regimen in humans has never been properly investigated and clinical practice has been dictated by clinical guidelines based on expert opinion.

Recent guidelines by the British Society for Antimicrobial Chemotherapy (Gould et al. 2006) and the American Heart Association (Wilson et al. 2007) have challenged existing dogma by highlighting the prevalence of bacteraemias that arise from everyday activities such as toothbrushing, the lack of association between episodes of IE and prior interventional procedures, and the lack of efficacy of antibiotic prophylaxis regimens.

So, in a nutshell worry more about driving in your car or crossing the road than getting endocarditis from someone who is sick near you.

 

[canon4me]

I would be facing a difficult task telling my brother not to take antibiotics because he had a bad case of strep that developed into Rheumatic Heart Fever, damaged some valves and he nearly died. He also had pneumonia and nephritis at the same time.

 

[pellicle]

The key word is strep. Anyway, I was answering about people around you being sick, not you being sick

But if someone beside you had a cold I would not be reaching for the antibiotics ... but hell why not?

 

[pellicle]

I go back to my point

Knowing the bacteria involved makes it clear.