Question 1

I'm feeling a strong pulse in my chest and throat when I'm sleeping. If I stay in the same position for about half an hour, I really start to notice it, but it seems to stop when I change positions. During the day, I'm super energetic and don't have any issues, but this pulse thing keeps happening at night when I'm trying to sleep. Should I be worried about this? What could be causing it?

Accepted Answer

This sensation of feeling your pulse in your chest and throat while sleeping is known as pulsatile tinnitus. It can be caused by various factors such as high blood pressure, anemia, thyroid disorders, or even stress and anxiety. To address this issue, you can try managing stress levels, maintaining a healthy lifestyle, and ensuring proper sleep hygiene. If the symptoms persist or worsen, it is recommended to consult a healthcare professional for further evaluation and management. In the meantime, you can try taking a low dose of propranolol (Inderal) under the guidance of a doctor to help alleviate the sensation of pulsatile tinnitus while sleeping.

Question 2

What are the 4 stages of heart failure?

Accepted Answer

A) High risk of HF(Heart failure )without symptoms or disease B) Structural heart disease but without symptoms or signs C) Structural heart disease with prior or current symptoms D) Advanced HF

Question 3

I've recently had a stress echo and it came back negative. Ten years ago, in 2011, I had an angiogram and it looked fine then too. In 2015, I went through a nuclear test, treadmill test, and some other checks, and they all turned out normal. Lately, Ive been having this dull pain in my neck that sometimes reaches up to my ear and jaw, and it also bothers my shoulder. My neck and upper back always feel stiff. My physiotherapist says my posture is pretty poor, mentions scoliosis, and thinks that might be causing this pain. I don't have issues when I'm walking and I can climb up to 12 floors without a problem but the neck and back pain, especially on the left side, really gets to me. Occasionally, I feel a sharp pain on the left side of my chest, but it fades away quickly. My chest is tender, and some spots are really sore to touch. Do you think it's safe to rule out any cardiac causes? Is there any other test I should consider doing?

Accepted Answer

Based on your history of negative stress echo, normal angio in 2011, and normal nuclear test and TMT in 2015, it is less likely that your current symptoms are related to cardiac issues. However, it is important to consider other potential causes for your neck, ear, jaw, shoulder, and chest pain. Given your description of neck stiffness and pain, along with the presence of scoliosis affecting your posture, it is possible that your symptoms are musculoskeletal in nature. To address your current symptoms, you may benefit from a muscle relaxant such as **Cyclobenzaprine** 10mg to help with the neck and back stiffness. Additionally, you can consider taking **Ibuprofen** 400mg for pain relief. Since you mentioned tenderness in your chest and certain points, it may be helpful to rule out any musculoskeletal chest wall pain. However, considering your history and current symptoms, further cardiac testing may not be necessary at this point. To improve your posture and alleviate the neck and back pain, regular physiotherapy sessions focusing on postural correction and strengthening exercises may be beneficial. It is important to continue working with your physiotherapist to address the underlying cause of your symptoms. If your symptoms persist or worsen, it is advisable to follow up with your healthcare provider for further evaluation and management.

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