问题
休·马丁斯问
当我躺下睡觉的时候，我突然感到一阵胸痛，逐渐演变成胸部的“颠簸”，让我无法入睡……会是什么呢?
大家好，我31岁，男性，很少运动，饮食均衡，不抽烟不喝酒。大约9个月前，我开始感到胸部奇怪的颤动“肿块”，结果证明是心脏搏动异常。从我醒来到上床睡觉，这种情况几乎持续了一整天。我开始服用受体阻滞剂，最终肿块消退到现在我只有很少的，只有几秒钟。可悲的是，一个相当恼人的症状出现了。当我躺在床上的时候，我的胸部会突然疼痛，通常是在胸骨周围，有时是在左边，其他人在右边。它们只持续一两秒钟，感觉相当尖锐，但不太强烈。它们也没有辐射，或者至少没有扩散到肩膀/脖子/手臂/下巴。当我即将入睡时，我感到胸口一阵震动，就像我的心脏被猛击了一下，然后猛地惊醒。这样重复了几次，直到我最终睡着。 Some nights it goes on for hours, others I don't have a single event. I notice that when I wake up in the morning, more often than not I feel my chest a bit dull or achy, a feeling that eventually goes away. Sometimes my heart seems to be beating a bit too fast as well (by resting rhythm is around 75 bpm). Now, I have done several ECGs this year and they all came out clean. I have also done 2 echos to my heart, which detected no abnormality in ejection fraction, valves or otherwise - except my left ventricle seems to be 1 mm larger than normal, but the doctor told me that was nothing to worry about, especially since the same thing has been detected when I was 17 years old. I had a Holter monitor that detected no frequent rhythm abnormalities, but this was before these night jolts started happening. I have no issues with blood pressure (usually around 120/75). I am on propanolol, 40 mg daily. Can this be all due to anxiety? I don't really have any other symptom (shortness of breath, fainting, enduring chest pain, sweating, etc) and when the chest pains come up during the day it seems to have nothing to do with exertion - sometimes they come up when I'm lazying on the couch, others when I come back from a brisk walk. Should I worry about a valve issue if my Echo was clean? Should I ask for a Stress test or an event monitor? Any suggestion would be most welcome.
回答
你好休,
首先，我要再次联系你的医生，谈谈你在夜间的感受。可能值得再戴一段时间的Holter监视器。
您可能还会对Sinatra博士关于电磁场暴露对心脏的影响的内容感兴趣。减少接触可能会缓解你的症状。
如果你想进一步研究这种可能性，你可以在他的博客上找到信息。下面是一些例子:
愿一切都好！
丽莎·纳尔逊RD