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All About FibromyalgiaA Guide for Patients and their Families$
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Daniel J. Wallace and Janice Brock Wallace

Print publication date: 2002

Print ISBN-13: 9780195147537

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780195147537.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 13 June 2021

Insights into Insides: Chest, Cardiovascular, and Other Concerns

Insights into Insides: Chest, Cardiovascular, and Other Concerns

Chapter:
11 Insights into Insides: Chest, Cardiovascular, and Other Concerns
Source:
All About Fibromyalgia
Author(s):

Daniel J. Wallace

Janice Brock Wallace

Publisher:
Oxford University Press
DOI:10.1093/oso/9780195147537.003.0018

Although some patients are concerned that their critical organs are involved in fibromyalgia, chest area symptoms infrequently are related to heart or lung disease. Palpitations, noncardiac chest pain, and subjective swelling or edema are important symptoms and signs of fibromyalgia. Reflux from the esophagus, gastrointestinal complaints, and female organ-related problems are also reviewed in this chapter in the context of fibromyalgia-associated concerns. The pounding in her chest was becoming unbearable, and Georgia was sure she would pass out. The sensation had been noticed before, but it usually stopped after several seconds. After several minutes, Georgia no longer felt lightheaded or dizzy. She broke into a cold sweat and heaved a sigh of relief. Her internist was aware of Georgia’s intermittent musculoskeletal aches and spasms and fatigue, which were managed with ibuprofen and occasional cyclobenzaprine (Flexeril) at night. When Georgia mentioned her fatigue to Dr. Baker, her comments were greeted with silence and not immediately pursued. Consequently, she drank four Diet Cokes to make it through the workday in addition to her morning coffee. Dr. Baker ordered a two-dimensional echocardiogram (a heart image in ultrasound) that demonstrated evidence of mitral valve prolapse. He told Georgia that the palpitations were brought on by drinking too much caffeine, and said that if she could not reduce her caffeine intake substantially, he would have to prescribe a beta-blocker to control her heart rate. The sense of having extra heartbeats, or palpitations, is reported in l0–20 percent of patients with fibromyalgia. Although heart disease, caffeine intake, anxiety, and other factors are associated with palpitations, many otherwise healthy young women have mitral valve prolapse. The prevalence of mitral valve prolapse is clearly increased in fibromyalgia. The mitral valve, one of the four valves of the heart that lies between its right-sided chambers, can become more floppy under ANS influence and produce palpitations. Patients feel as though they will pass out but rarely do. Mitral valve prolapse is also associated with chest pains and shortness of breath and can be easily diagnosed by a heart ultrasound known as a two-dimensional echocardiogram.

Keywords:   allodynia, beta-blockers, chest area symptoms, edema (swelling), fluid retention, genitourinary complaints, livedo reticularis, mitral valve prolapse, neurogenic vasodilation, palpitations

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