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Meg Mangin R.N.
Research Team
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Posted: Sat Nov 27th, 2004 03:17 |
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When should I be concerned about cardiac symptoms?
Anyone with a Th1 inflammatory disease may have cardiac (heart muscle) inflammation.
"The first sign many males have of extensive Th1 infection is a stroke or a heart attack. Th1-induced Cardiovascular Disease frequently afflicts men, women tend to suffer from other th1 ailments. Women get cardiovascular disease too, but it is the most common presentation of Th1 in men." ..Trevor..
The presence of inflammation may be known due to previous symptoms of heart irregularity (arrhythmia) and/or congestive heart failure (CHF) or it may be undetected (subclinical).
Cardiac Th1 inflammation is extremely difficult (and unnecessary) to diagnose definitively. Heart biopsies are not recommended because they are very dangerous and often do not target the affected tissue anyway.
Development of (or an increase in) cardiac symptoms is fairly common in folks on the Marshall Protocol. This is because the recovery process provokes an immune system reaction. This immunopathology is unavoidable and results in a temporary exacerbation of current symptoms and/or the provocation of previously undetected symptoms.
The presence of cardiac symptoms in someone with a Th1 inflammatory disease is a strong indicator there is cardiac inflammation which must be carefully treated with the MP in order to resolve the symptoms permanently.
The MP was developed with the knowledge that anyone could have cardiac involvement, even if asymptomatic. This is why we are adamant about following the MP guidelines exactly so the immunopathology can be controlled. Read all precautions and instructions in the Phase One Guideline. Print it out so that you can check it regularly.
Before you begin the Marshall Protocol, ask your doctor if you should have any special tests to assess your cardiac status. A cardiac workup will provide valuable information to your doctor about the presence or absence of cardiovascular disease. This knowledge will help assess any cardiac symptoms that may develop while on the Marshall Protocol.
Chest pain
Chest pain is a fairly common symptom endured by patients with Th1 inflammatory disease, substantiated by reports such as this one, which found that about 30% of sarcoidosis patients suffer from chest pain. Chest pain has many possible causes.
Chest pain is one of the most challenging symptoms for a clinician to unravel. While it is true that chest pain can be due to cardiac involvement, it may also be due to other problems brought on by sarcoidosis such as enlarged lymph nodes which can cause pressure, crowding and pain in the chest. Chest pain and pressure can be caused by other structures within the chest wall besides the heart.
Rule out coronary artery disease
Because chest pain and pressure may be due to coronary insufficiency (lack of blood to the heart) which is what causes a heart attack, we advise everyone with even the slightest chance of coronary artery disease to have a cardiac evaluation to rule out myocardial ischemia before they assume that their symptoms are due to immunopathology and are therefore benign.
Angina is often provoked by an increase in activity or exercise but it may also occur at rest or awaken you from sleep.
Symptoms typical of a heart attack include:
- pain (crushing) or pressure in chest or either arm (often, but not alwasys, radiating down the left arm)
- jaw pain
- increased shortness of breath
- sweating
- nausea
- rhythm disturbance
- sense of impending doom
Women have atypical cardiac symptoms
"When women have angina, they are more likely than men to experience "atypical" symptoms. Many women report a hot or burning sensation, or even tenderness to touch, in the back, shoulders, arms or jaw; often they have no chest discomfort at all. They may experience a heart attack as nausea, heartburn, profuse sweating or profound fatigue.
Furthermore, women are more likely than men to experience true angina (chest pain due to a coronary artery disorder) but with "normal" coronary arteries seen on cardiac catheterization."
See this article for when women should seek medical help.
Immunopathology
If you have these symptoms and think it may be due an immune system response:
- DO NOT take your next dose of antibiotic/s
- take 40mg of Benicar, crushed, immediately
If symptoms improve, take 40mg of Benicar every four hours around the clock (set an alarm and use a dosette) until symptoms are gone or minimized unless your doctor advises immediate medical attention. You may also take 20mg sublingual with each oral dose.
Specific instructions can be found in My immune response / symptoms are too strong. What should I do?
If these measures result in a decrease of symptoms, an immune response was the likely cause.
Symptoms suggestive of heart attack that are not relieved by altering the MP medications should always be considered an emergency due to possible heart attack unless you KNOW coronary artery disease has been ruled out recently with tests done by your doctor.
When in doubt, seek medical attention immediately.
- Call 911
- Chew one 325mg uncoated aspirin
- Lie down so your heart doesn't have to work so hard
- If you think you might pass out, try forcing yourself to cough deeply. It changes the pressure in your chest and can have the same effect as the thump given in CPR.
Follow your instincts. If you think you need to see a doctor, call an ambulance. A cardiac emergency should not go to the hospital in a car.
Emergency room personnel should know that a patient is on the Marshall Protocol. Please see Information for Emergency Room personnel.
It is recommended you print it out and add your personal medical information such as diagnosis and medications with the contact information for the person to notify in case of emergency.
Put it in a clear protective folder and keep a copy in a handy place in your home (ER personnel often look on the refrigerator for info) and in the glove compartment of your car.
If you go to the ER, you should be prepared with the following information: CAUTIONARY WARNING FOR SARCOIDOSIS PATIENTS WHO MAY BE HOSPITALIZED
Resuscitation
If someone goes into cardiac arrest, note that the American Heart Association recommends CPR without the mouth-to-mouth breathing; Call 911, then push hard and fast on the person's chest until help comes.
Cardiac arrhythmia (extra beats, rapid or slow heart rate)
Heart rhythm disturbances are not uncommon with Th1 inflammation. Although palpitations can be frightening, if there are no symptoms suggestive of heart attack, the situation is not as urgent. Our experience has shown that the best treatment for cardiac arrhythmia while on the MP, is an extra dose of Benicar.
If the rhythm disturbance is mild but worrisome:
- DO NOT take your next dose of antibiotic/s
- take 20mg of Benicar, crushed, immediately
If symptoms improve, take 40mg of Benicar every four hours until symptoms are gone or minimized unless your doctor advises immediate medical attention.
When in crisis, you can increase the Benicar frequency to 3 hours, with a little incremental benefit over 4 hours, and even supplement that with 20mg sublingual, if need be. FDA assured us that there was no dose of Benicar, within the range that we use, which FDA regards as unsafe. However, we know a little more about how it works than they do, and I would always advise to try and use just enough. This drug hits a lot of receptors, not only the VDR and the Angiotensin II receptors.
Specific instructions can be found in My immune system response/symptoms are too strong. What should I do?
Palpitations may feel like a skipped beat but they are caused by a premature heart beat. It's not possible to diagnose the nature of palpitations without an electrocardiogram.
Substances to avoid
Caffeine (chocolate contains caffeine) is a stimulant which can increase premature ventricular contractions. Alcohol can precipitate PVCs and Nyquil contains some alcohol.
A rapid heart rate (see tachycardia) is usually not a cause for alarm. There are no absolute numbers to use as a guide because other clinical signs need to also be taken into account. Dehydration may cause low blood volume which could result in an increase in heart rate. Maintaining an adequate salt and fluid intake can prevent dehydration.
A slow heart rate (bradycardia) can be due to an abnormality in the heart's conduction system. If an EKG establishes that the heart rhythm (no heart block or premature beats) is normal (normal sinus rhythm), a slow heart rate is not a cause for concern.
Your doctor may decide that your unusual heartbeat needs investigation or s/he may decide it is benign based on the presence or absence of other symptoms.
Report the following rhythm changes to your doctor:
- very slow (below 50 beats per minute)
- very rapid (above 160 beats per minute)
- extra beats that are very frequent (more than 10 per minute)
- unusually long intervals between beats (more than 3 seconds)
These abnormal rhythms are more serious (especially if they are accompanied by lightheadedness) and your doctor will want to assess them by electrocardiogram as soon as possible. Call your doctor for instructions.
In the meantime, you should not be alone. Have someone else drive you to the clinic. It is preferable to see the doctor in the less stressful atmosphere of his office rather than wait until you need the attentions of a busy ER.
Syncope
Syncope (fainting) is defined as a transient loss of consciousness with an inability to maintain postural tone that is followed by spontaneous recovery. The term syncope excludes seizures, coma, shock, or other states of altered consciousness. Cardiac syncope is associated with increased mortality, whereas vasovagal syncope is not.
Cardiac causes should be ruled out when a syncopal episode occurs.
Congestive Heart Failure
Congestive heart failure symptoms develop more slowly and most folks know if they have this problem. Ask your doctor what symptoms you should report. For example, when does s/he want to know if you gain weight, experience swelling or increased shortness of breath.
If you experience significantly increased or sudden:
- exercise intolerance
- severe shortness of breath
- fluid retention or swelling
- weight gain (3 lbs overnight or 5 lbs in 3 days)
Do not take your next dose of antibiotic/s and increase Benicar to 40mg every four hours until symptoms are gone or minimized.
Specific instructions can be found in My immune system response / symptoms are too strong. What should I do?
If these measures are not effective, consult your doctor.
Your doctor may contact Dr. Marshall
Dr Marshall wrote: "Make sure you keep communicating everything with Doc, and make sure Doc knows s/he can call me if s/he wants to discuss anything."
805-492-3693 or 805-300-1679
Natural light exposure symptoms
Be mindful that natural light exposure can increase the level of 1,25-D and might raise it high enough to cause a flare in cardiac inflammation and cardiac symptoms. Diligent avoidance of sunlight is particularly important for the Th1 patient with cardiac symptoms to avoid a sudden severe cardiac event. See Why does exposure to natural light increase symptoms?
Anxiety may compound cardiac symptoms
If anxiety is one of your problems and your doctor has prescribed an anti-anxiety medication, taking it as ordered may also relieve some of your cardiac symptoms. See How can I control my anxiety and depression?
Stroke identification
Early intervention is critical to prevent residual effects from a stroke. But sometimes symptoms of a stroke are difficult to identify. Remember the 1st three letters... STR OKE
S Ask the individual to SMILE. (Another 'sign' of a stroke is this: Ask the person to 'stick' out their tongue... if the tongue is 'crooked', if it goes to one side or the other that is also an indication of a stroke}
T Ask the person to TALK . to SPEAK A SIMPLE SENTENCE (Coherently) (i.e. . . It is sunny out today)
R Ask him or her to RAISE BOTH ARMS .
See also:
Atrial fibrillation
Congestive heart failureLast edited on Sun Oct 5th, 2008 02:24 by Meg Mangin R.N.
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Meg Mangin R.N.
Research Team
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Posted: Thu Mar 9th, 2006 03:01 |
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Members who have successfully coped with cardiac immunopathology
-I have taken Tenormin 50 mg for years, but I don't think it is doing much for me right now but will keep it onboard until doc changes. The benicar is helping me much more and now I know I am having cardiac herxes because they are relieved so quickly with the benicar.
I really do believe now that I have had sarcoid for a long, long time. For you MPers that are starting behind me and have concerns about your heart, know that the moderators are the! re 24/7 to help you and the protocol is very thorough. You just have to try. This is our 1 chance to get our health back and we finally have some control! ~Debbie
-See CelticLadee' experience.
These Members have also experienced cardiac immunopathology symptoms and would be happy to write to you about their experience via private message
Hopeful
Hrts4me
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Meg Mangin R.N.
Research Team
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Posted: Sat Aug 12th, 2006 17:30 |
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(filelink)
Tachycardia
The sudden, rapid racing of the heart is a condition called paroxysmal (per-ok-siz-mahl) tachycardia (tack-eh-kar-dee-ah).
Most tachycardia is benign
There are several types of tachycardias or tachyarrhythmias (rapid heart rate). Most types are relatively benign in nature though they can produce significant symptoms.
What are the symptoms of tachycardia?
Depending on how fast the heart is beating, symptoms may include:
breathlessness
upset stomach
chest pain
weakness
fainting spells
The attack may be over in minutes or may last for several days, with a heart rate that may range between 140 and 250 beats per minute. In most cases, tachycardia is not life threatening, but it can cause you to feel anxious or frightened.
What causes tachycardia?
Tachycardia may be triggered by conditions such as heart disease, an overactive thyroid gland, too much thyroid supplement, fever, or by drinking alcohol or caffeinated beverages.
If you are taking a thyroid supplement, be sure to have your thyroid function checked regularly.
What can I do to control tachycardia?
The few patients on the Marshall Protocol who experienced a disturbance in their cardiac rhythm, got relief with an increase of Benicar to 40mg every four hours or by modifying other MP meds.
Other self-help measures that may help slow down the heart rate include:
-splashing your face with cold water
-taking a slow drink of water
-holding your breath for a moment
If these techniques are not effective, your physician may need to prescribe medication, apply pressure to the arteries in your neck, or use an electrical stimulus to restore your heart rate to normal.
For more information about paroxysmal tachycardia, contact your doctor.
In patients with underlying heart disease, the dangerous (malignant) forms of tachycardia - ventricular tachycardia and ventricular fibrillation - can occur.
However, a rapid heart rate is usually not a cause for alarm. There are no absolute numbers to use as a guide because other clinical signs also need to be taken into account.
A tachycardia is said to be 'reactive' if it is caused by other disorders such as severe anemia, fever, thyroid disease, or other medical conditions.
The most common reason for the heart to beat too rapidly is excess stimulation, such as a thyroid problem. Please see THYROID DISEASE and Th1 Inflammation
Significance: The benign forms of tachycardia can produce significant symptoms and functional disability if it occurs often enough.
The malignant forms of tachycardia - again, seen almost exclusively in patients with underlying heart disease - are a common cause of sudden death. Symptoms of significant palpitations, and especially symptoms of sudden lightheadedness or syncope (fainting), need to be carefully evaluated by a physician.
The Marshall Protocol has been designed to reduce the chance of tachycardia. Taking a cardiac medication (like a beta blocker which slows the heart), as a preventative, isn't usually necessary. Following the MP guidelines carefully should prevent any serious cardiac rhythm disturbances.
A resting heart rate mildly elevated is not a cause for worry. It is another symptom of your inflammation and it will come down as your inflammation resolves. It's tempting to blame Benicar but it is really the disease that's responsible and you are on the way to defeating it with MP.
Heartbeat heard in ears
The 'heartbeat' you hear in your ear is called pulsitile tinnitus. This article states, "Pulsatile tinnitus is usually due to a small blood vessel that is coupled by fluid to your ear drum. It is usually nothing serious and also untreatable." Of course, we believe that tinnitus is due to Th1 inflammation and will resolve with the MP.
Members' experiences
-Update – 2 years on MP (27/12/07)
I can’t remember the last time I had the racing heart beat. If I have had a busy day, I will still get the ‘blood zinging in my ears’ when I lay down. The heart still seems to be playing catch up at times. ~Vicki SA
Last edited on Wed Feb 20th, 2008 17:01 by Meg Mangin R.N.
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Meg Mangin R.N.
Research Team
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Posted: Sun Apr 15th, 2007 23:44 |
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[filelink]
Congestive heart failure
When we are ill with unusual diseases, our case can be challenging for medical professionals. Sometimes we just have to decide whether we think they are evaluating us correctly or they have been thrown off by how confusing the disease is.
Here is a simple overview of congestive heart failure. Many of the symptoms of CHF are non-specific. The presenting clinical symptoms of CHF and sarcoidosis overlap (SOB, fatigue, weakness, cold extremities, cyanosis of lips and nail beds, mental confusion). Notice that the first consideration in treating CHF is "removing the precipitating cause."
It is possible for sarcoidosis to result in congestive heart failure, either due to uncontrolled arrhythmia or due to sarcoid thickening of the myocardium, which results in restrictive cardiomyopathy, a very rare condition. We caution all patients on the MP to assume they may have hidden cardiac involvement. Anyway, diagnosing heart failure can be fairly complicated.
Angiotensin II causes some real problems for people who do have congestive heart failure.
- It causes blood vessels to constrict, which raises blood pressure.
- It causes the kidneys to retain sodium and fluid, which can lead to edema.
- It increases our thirst and desire for salt, which can cause more edema.
You can see then why angiotensin receptor blockers, which block Angiotensin II, are used in treating congestive heart failure. It makes little sense, in my opinion, that ARBs would in any way cause this problem. Olmesartan is known to have cardio-protective effects.
BelindaLast edited on Thu May 8th, 2008 00:31 by Meg Mangin R.N.
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Meg Mangin R.N.
Research Team
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Posted: Sat Sep 8th, 2007 01:51 |
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[filelink]
Atrial fibrillation
Atrial fibrillation is caused by a disturbance in the electrical system which runs throughout the heart muscle. When the heart suffers damage due to a heart attack, infection or inflammation, the normal rhythm of the heart may be disrupted as the electrical conduction is diverted by the damaged tissue.
Immunopathology could cause a temporary increase in inflammation that results in atrial fibrillation if you have subclinical cardiac inflammation. Increasing the frequency of Benicar is the best way to calm the inflammation. Normal rhythym sometimes returns spontaneously. Occasionally other measures are tried to restore normal rhythm.
If you notice an irregular heart rhythm, consult your doctor as soon as possible. S/he will determine the urgency of the situation and what, if any, treatment might be needed.
To prevent recurrent spells of atrial fibrillation avoid caffeinated products, alcohol and OTC meds that contain stimulents such as psuedoephedrine.
Last edited on Sat Sep 8th, 2007 02:26 by Meg Mangin R.N.
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