?new weird flu?

Lynn Casey RN · May 6, 2001

Hi!My husband had flu like symptoms for the last 2 weeks.Last Sunday,he almost passed out,had sweaty palms only,left sided chest palpitations and numbness both arms.(In the reverse order actually!)Anyways,he is a very healthy 41 y.o male,athletic,no medical history,no remarkable family history.We went to ER and after some negative cardiac work up,normal blood work,ECG,etc...he was given Ativan and sent home.(I was irate because he is not an anxious fellow)For the next week he had several small episodes.Then,he had a very bad day...frequent ,increasing severity of symptoms.We went to ER again and after another intensive thorough exam....negative.We have heard some other people around town have had exactly the same symptoms.While I am waiting for the appointment with the specialist(ID),I was hoping someone could contribute?Thanks in advance! :confused:

stiritup · May 7, 2001

Just having negative cardiac enzymes and a negative EKG doesn't exclude a Dx of Acute Coronary Syndrome which includes a variety of sx, including Angina. If he had came to my hospital, he would have most certainly received a cardiac catherization to rule out CAD (especially after the second episode). Also, there was no mention of a CT scan of the head being done??? In additon to the cardiac issue, it may also be TIA's!!! By now, you should know that anything that the Docs can't immediatley dx is labeled as a viral syndrome. Also, with the neurological sx, I would hope they would have consulted a neurologist.

[ May 06, 2001: Message edited by: stiritup ]

stiritup · May 7, 2001

Just having negative cardiac enzymes and a negative EKG doesn't exclude a Dx of Acute Coronary Syndrome which includes a variety of sx, including Angina. If he had came to my hospital, he would have most certainly received a cardiac catherization to rule out CAD (especially after the second episode). Also, there was no mention of a CT scan of the head being done??? In additon to the cardiac issue, it may also be TIA's!!! By now, you should know that anything that the Docs can't immediatley dx is labeled as a viral syndrome. Also, with the neurological sx, I would hope they would have consulted a neurologist.

[ May 06, 2001: Message edited by: stiritup ]

oramar · May 7, 2001

My friend was just discussing her 29 year old daughters ailments with me. She had mono several months ago and now is having symptoms just like your husband. She has had every neuro and cardiac test you can think of and everything is negative. They are now blaming it on the mono. I doubt there is any relationship between your husbands problems and my friend's daughter's problems but I thought I would mention it.

oramar · May 7, 2001

My friend was just discussing her 29 year old daughters ailments with me. She had mono several months ago and now is having symptoms just like your husband. She has had every neuro and cardiac test you can think of and everything is negative. They are now blaming it on the mono. I doubt there is any relationship between your husbands problems and my friend's daughter's problems but I thought I would mention it.

**canoehead, BSN, RN** · May 7, 2001

Sounds like with his symptoms he should have at least a stress test, and hopefully a cath. However with waiting lists as they are in NB you may have better luck pushing for a stress test. Also I wonder, is his pain relieved with nitro? That would go a long way towards convincing me that the pain is heart related.

Good luck to you.

**canoehead, BSN, RN** · May 7, 2001

Sounds like with his symptoms he should have at least a stress test, and hopefully a cath. However with waiting lists as they are in NB you may have better luck pushing for a stress test. Also I wonder, is his pain relieved with nitro? That would go a long way towards convincing me that the pain is heart related.

Good luck to you.

Lynn Casey RN · May 7, 2001

Thanks for the replies!Last night was the worst episode.He and I were watching TV,relaxing....then....BOOM!He turned sheet white,pupils like pancakes,sweaty palms,chest palpitations,and passed out very briefly.We rushed to the ER(1 minute away).There we were placed in "acute",no monitor,ECG was normal,and(you guessed it....ativan!)I was so irate!My husband is not an anxious man.However,a half hour later all of his physical symptoms were gone.So...diagnosis for now is panic attack.They said his ER presentation was "classic"panic attack.So,today we are going to the GP and I am packing a lunch because I am not leaving without a CT scan of his head(his Dad died at 50 y.o with cerebral aneurysm...and no one is listening!)So,I am demanding some tests first before the Ativan 'script is passed over the desk.Thanks....you guys.I'll keep you posted.

Lynn Casey RN · May 7, 2001

Thanks for the replies!Last night was the worst episode.He and I were watching TV,relaxing....then....BOOM!He turned sheet white,pupils like pancakes,sweaty palms,chest palpitations,and passed out very briefly.We rushed to the ER(1 minute away).There we were placed in "acute",no monitor,ECG was normal,and(you guessed it....ativan!)I was so irate!My husband is not an anxious man.However,a half hour later all of his physical symptoms were gone.So...diagnosis for now is panic attack.They said his ER presentation was "classic"panic attack.So,today we are going to the GP and I am packing a lunch because I am not leaving without a CT scan of his head(his Dad died at 50 y.o with cerebral aneurysm...and no one is listening!)So,I am demanding some tests first before the Ativan 'script is passed over the desk.Thanks....you guys.I'll keep you posted.

CEN35 · May 7, 2001

OK here we go:

1st there are only 111 different types of flu strains. They constantly change, bit remain inside the 111.....so new? not likely.

Now the other thing to consider is the sped in which this starts. You said it started suddenly, which pretty much r/o a viral syndrome. People suffering from some type of viral syndrome, usually are not feeling well for a while prior to the event. Viral events are not instant.

I will say that we have seen some anxious type people come in to the ER, and have had their spouses/significant others say "they are not an anxious person". However, it does happen...and sometimes the significant other is the last to realize this new problem.

I will tell you (as someone else said), he would have bought a ticket for inpatient admisson after the second visit. However, prior to admission, he should have had an EKG, CBCcdiff, CMP,myoglobin/troponin? and m/b CPK/mb/index, and head CT prior to admission. The CT is needed to r/o a Hemmorhagic CVA, as identifying a CVA caused by a clot, that would not show up anywhers from 24-48hrs to 3 weeks after the incident (if it was a cva of some type). This is because it takes time for any tissue to necrose and show up on the film. Even more importantly it is a big factor in how things are handled prior to admission. if it is a clot, they would heperanize him, or use Lovenox. If it was a bleed, they would do neither and call neurosurgery.

As one person stated, was the pain releived by nitroglycerin? Even if it is, it does not r/o a number of other possibilities. Unfortunatly, Nitro also releives pain caused by a Hiatel hernia and some other GI problems, which can cause all the same symptoms as your husband was having.

After the CT (assuming no bleeding in the head), they would Heparanize him, and hopefully consult a neurologist and cardiologist. Then the next day they could cath him to r/o any coronary problems. Although, people do have "coronary spasms" that are not disease related.

Hopefully it will all work out. You also have to rememeber, that not only is missing a potential life threatening problem and/or permanent injury (if that is what it is), is not the only issue. delay in Dx and/or TX is an issue also. I would make sure everything gets done first, if you are really worried, prior to taking anymore ativan to cover up a potential problem.

Rick

CEN35 · May 7, 2001

OK here we go:

1st there are only 111 different types of flu strains. They constantly change, bit remain inside the 111.....so new? not likely.

Now the other thing to consider is the sped in which this starts. You said it started suddenly, which pretty much r/o a viral syndrome. People suffering from some type of viral syndrome, usually are not feeling well for a while prior to the event. Viral events are not instant.

I will say that we have seen some anxious type people come in to the ER, and have had their spouses/significant others say "they are not an anxious person". However, it does happen...and sometimes the significant other is the last to realize this new problem.

I will tell you (as someone else said), he would have bought a ticket for inpatient admisson after the second visit. However, prior to admission, he should have had an EKG, CBCcdiff, CMP,myoglobin/troponin? and m/b CPK/mb/index, and head CT prior to admission. The CT is needed to r/o a Hemmorhagic CVA, as identifying a CVA caused by a clot, that would not show up anywhers from 24-48hrs to 3 weeks after the incident (if it was a cva of some type). This is because it takes time for any tissue to necrose and show up on the film. Even more importantly it is a big factor in how things are handled prior to admission. if it is a clot, they would heperanize him, or use Lovenox. If it was a bleed, they would do neither and call neurosurgery.

As one person stated, was the pain releived by nitroglycerin? Even if it is, it does not r/o a number of other possibilities. Unfortunatly, Nitro also releives pain caused by a Hiatel hernia and some other GI problems, which can cause all the same symptoms as your husband was having.

After the CT (assuming no bleeding in the head), they would Heparanize him, and hopefully consult a neurologist and cardiologist. Then the next day they could cath him to r/o any coronary problems. Although, people do have "coronary spasms" that are not disease related.

Hopefully it will all work out. You also have to rememeber, that not only is missing a potential life threatening problem and/or permanent injury (if that is what it is), is not the only issue. delay in Dx and/or TX is an issue also. I would make sure everything gets done first, if you are really worried, prior to taking anymore ativan to cover up a potential problem.

Rick