One night around three years ago, I was up late reading in the living room when I felt a sudden stabbing pain right behind my sternum. I flopped onto the rug, stretched my legs, pulled my knees to my chest, and rolled back and forth, trying to find a position that would ease the torment. My husband was already in bed, and I wondered if I should wake him, but I was in too much pain to even make a decision.
Then in less than an hour, as suddenly as the pain had appeared, it was gone. I felt completely fine, so I went to bed, amazed that something that had been so severe could have disappeared so completely.
I found some answers—just not the right ones
I was 62 years old, and up until that moment in my living room, I’d felt great! I exercised a lot, taking yoga classes and going on long walks. The next morning, I Googled “chest pain” and diagnosed myself with a gallbladder attack, which I read could cause sharp pain lasting minutes or hours. Since the pain had gone away on its own, I hoped the problem had resolved itself.
I felt fine until a couple of months later, when I experienced the same stabbing pain. This time I made an appointment with my primary care provider. She listened to me describe the symptoms, examined my belly, and ruled out a gallbladder attack. She wasn’t sure what it was, but because I was otherwise healthy, she suspected I might have gastroesophageal reflux disease (GERD). She prescribed a special diet and a proton pump inhibitor. I took the medicine and was very careful about my diet. But since I didn’t have any symptoms other than the pain, which had only happened twice, it was hard to tell whether it was working. While I was on this regimen, I told my son, a resident in emergency medicine, what had happened and he said, “Mom, if you ever have that kind of pain again, promise me you’ll go straight to the ER!”
It wasn’t a heart attack, but it was my heart
A few weeks later, I felt it again. This time it wasn’t as severe, but it lasted much longer. Following my son’s advice, I woke my husband and asked him to take me to the hospital. When we arrived, I had an electrocardiogram and a chest X-ray. I also had blood tests, which showed elevated troponin, a marker of heart injury. I was admitted to the hospital with a possible heart attack. After several more tests, including an ultrasound of my heart and a cardiac catheterization, the cardiologist told me it was not a heart attack. I had a condition called myopericarditis, a disease marked by inflammation of the membranes around the heart as well as the heart muscles. He told me that myopericarditis is usually caused by a viral infection. I had just retired from working as a speech-language pathologist in an elementary school, and there were always lots of colds going around. I remember that about a year before my first attack of pain, I was really sick with a virus and had to take antibiotics for a bad cough. That might have caused it, but I’ll never know for sure.
My recovery and best advice for you
My cardiologist put me on a heart monitor for a month and told me to avoid strenuous exercise. I was also prescribed a beta-blocker and anti-inflammatories, which I took until a follow-up appointment showed I was well on the way to recovery. Then last fall I had my one-year follow-up; my heart is completely recovered!
I would tell everyone that if you have terrible chest pain, don’t try to diagnose yourself: Take it seriously and go to the doctor or the ER. I’m so grateful that I’ve recovered and can go back to enjoying my retirement.
What is myopericarditis?
The myopericarditis Karlow experienced is a combination of two related conditions: “Myocarditis is an inflammation of the heart muscles, and pericarditis is an inflammation of the membrane that covers the heart,” explains Sandra Chaparro, M.D., a cardiologist at Baptist Health’s Miami Cardiac & Vascular Institute.
The inflammation is most often caused by a virus that has traveled through the bloodstream to the heart, Dr. Chaparro says. The virus can be a simple cold, flu, or stomach bug, or it can be something more serious: According to the CDC, among patients seen in a hospital setting, those with COVID-19 had nearly 16 times the risk of myocarditis of those who didn’t have COVID. “In the majority of cases, myocarditis and pericarditis will resolve on their own without any treatment other than rest and Tylenol,” Dr. Chaparro says. “But in some cases there can be more significant damage and the patient may need to be treated with medication such as steroids to decrease inflammation. In very rare cases, if there has been severe damage, it might require surgery or even a transplant.”
Symptoms may include:
- Sharp chest pain
- Shortness of breath
- Heart palpitations
- General weakness
- Pain in the back, neck, or left shoulder
Read more medical mystery and misdiagnosis stories like this one in our column, My Diagnosis, which focuses on stories of real-life medical struggles and journeys to wellness. Have one you’d like to share? Write us at firstname.lastname@example.org.