"Clinton Syndrome"

[Brown]

In 1998, the term "Clinton Syndrome" referred to sexual addicition. In recent days, however, "Clinton Syndrome" refers to the fact that men having chest pain are getting themselves checked out. Former president Clinton suffered from chest pains and shortness of breath, and upon medical examination discovered that he needed quadruple bypass surgery. In the past few days, medical providers have reported a dramatic increase in the number of men in the USA who have had themselves checked because of chest pain.

I am one of them.

Last Thursday, I visited my doctor, reporting that I had shortness of breath and pain in my chest.

Both chest pain and shortness of breath were were known side effects of medications that had recently been prescribed for me. In addition, my visit to my doctor was a scheduled visit intended to check how I was reacting to my meds, not an emergency visit. To be on the safe side, however, my doctor admitted me to the hospital to check me out for heart problems. I was taken by ambulance to a downtown St. Paul hospital.

I underwent lots of electrocardiograms. I gave dozens of blood samples. I was monitored overnight. On Friday afternoon, I was discharged, but I returned to the hospital for more tests on Monday.

I am pleased to report that I did NOT have a heart attack, and that current indications are that I do not have acute blockage of my coronary arteries. Chances are that the symptoms are caused by the medications.

So for me, anyway, my case of "Clinton syndrome" was not serious.

 

[Deetee]

So for me, anyway, my case of "Clinton syndrome" was not serious.

Glad to hear it.
Did they suggest a treadmill (exercise EC(K)G)?

I keep hoping someone will diagnose me with Clinton syndrome (circa 1998)

 

[Dr. Imago]

I am pleased to report that I did NOT have a heart attack, and that current indications are that I do not have acute blockage of my coronary arteries. Chances are that the symptoms are caused by the medications.

What medications are you on now/new one did they give you/regimen change that you think caused this, if I may be so forward as to ask? If you have atherosclerosis, there are clearly certain ones you SHOULD be on right now, despite the fact that you haven't had an acute blockage. What was your discharge diagnosis?

Also, did they only do blood tests and EKG monitoring while you were in the hospital? If so, exercise EKG, as Deetee most appropriately suggested, is precisely the next step to follow up with your GP or your cardiologist (whomever's treating you), if you haven't had one yet. This is protocol to really ensure everything is okay with 'ye ole ticker'. If that's abnormal, then they'll probably send you (at least they should) for a stress test.

-TT

 

[Brown]

Did they suggest a treadmill (exercise EC(K)G)?

Yes, I did the treadmill test yesterday. The technician deployed electrodes on my chest and I walked on a treadmill until I couldn't walk anymore. I walk pretty briskly ordinarily, so the first three levels weren't too tough. But as the treadmill got steeper and faster, it started to get hard to keep up. I finally had to quit when the speed and angle were too tough for me.

I was told later that it was permissible to run if I felt like doing so. Before the test, however, I was told that I had to walk. At the level where I tired out, there was no way that anyone--other than a speed-walker--could walk that fast.

Anyway, the results of the treadmill test (aka stress test) were pretty good.

 

[Brown]

Re: Re: "Clinton Syndrome"

What medications are you on now/new one did they give you/regimen change that you think caused this, if I may be so forward as to ask? If you have atherosclerosis, there are clearly certain ones you SHOULD be on right now, despite the fact that you haven't had an acute blockage. What was your discharge diagnosis?

Also, did they only do blood tests and EKG monitoring while you were in the hospital? If so, exercise EKG, as Deetee most appropriately suggested, is precisely the next step to follow up with your GP or your cardiologist (whomever's treating you), if you haven't had one yet. This is protocol to really ensure everything is okay with 'ye ole ticker'. If that's abnormal, then they'll probably send you (at least they should) for a stress test.

I would rather not mention the specific medications, as I would not want to unfairly cast any particular drug in a bad light. My pharmacy always hands out an extensive description of each prescription, including its potential side effects, and I always read the descriptions. (Years ago, I used to have access to the Physicians Desk Reference, and I would read the PDR entry on every drug prescribed for me.) The side effects of chest pain (or heartburn) and shortness of breath were said to be rare.

Incidentally, I do not have a history of heartburn. So when I started having pain in my chest, I wasn't able to say, "This feels like heartburn," because I didn't know what heartburn felt like. The good news was that the pain did not radiate out, and it did not extend into my arms, as it might do in the case of serious heart trouble.

I had my ECG monitored (12 lead) more times than I can remember. Love those adhesive electrodes. I went through quite a few of them. Results of the ECG were uniformly good, although I have a surprisingly slow heart rate.

Had blood tests, too. Both arms and both hands contributed to the cause over the next several hours, so I am symmetrically bruised today. My enzymes were okay which to me was GREAT news. (As I'm sure you know, but as others may not, when heart tissue dies as a result of a blockage, certain enzymes, such as cardiac troponin T, are naturally produced.) My results did not show elevated or changing enzyme levels, which indicated I did not have dead heart tissue. Yay!

I was placed on a telemetery monitor for about fifteen hours. No problems there.

Yesterday, I had an echogram (which was very interesting, watching my own heart beating and seeing inside the chambers of my heart) and a stress test. Preliminary results were good, and I was released. I was prepared, however, to undergo an angiogram if the stress test indicated a problem. There was no such indication, so my groin was spared from surgical invasion.

I am following up with my physician later this week (by which time she should have all of the results of my tests).

 

[Dr. Imago]

Re: Re: Re: "Clinton Syndrome"

I would rather not mention the specific medications, as I would not want to unfairly cast any particular drug in a bad light.

First, generally I'd advise most people not to read the PDR or the package insert for most drugs, unless they can have the proper perspective on what they're reading. For most drugs, things like "nausea", "vomiting", "headache" (etc.) are meaningless because you can give 100 people anything and they're going to report one of those things during a clinical trial.

Secondly (and nonetheless), I think other people may be curious to know what drug it was because they may have had a similar side effect, and have not been able to pinpoint as to why. Also, I'm sure that no matter what you think you might say "bad" about a drug, it's already been reported.

But, if you prefer not. I respect that. Not everyone wants to post publicly what meds they're on, like the name of that cream I'm currently applying six times a day to my fiery butt rash.

My enzymes were okay which to me was GREAT news. (As I'm sure you know, but as others may not, when heart tissue dies as a result of a blockage, certain enzymes, such as cardiac troponin T, are naturally produced.) My results did not show elevated or changing enzyme levels, which indicated I did not have dead heart tissue. Yay!

Most institutions prefer Troponin I (cTnI) over T, I can't remember exactly why without looking it up... all I remember is that the mnemonic is Troponin T is "T"errible and Troponin I is "I"nvincible. Anyway, you're right. These enzymes are specific only to cardiac muscle cells. So, no cardiac enzymes in the blood stream, no break-down of cardiac muscle (as in from an acute infarction and death of tissue), hence no permanent damage to the heart muscle. They also look at CK-MB, LDH, AST as well as a few others that used to be used that get even less and less specific than those. Troponin is now the gold standard.

I am following up with my physician later this week (by which time she should have all of the results of my tests). [/B]

That's great, and it sounds like you got great care. The Million Dollar work-up. Keep us posted on what the final findings are. And, be sure to thank Clinton for scaring the crap out of everyone next time you see him.

By the way, if you're on a beta-blocker, that's probably why your heart rate is slow. This is a "good" side effect of the medication. If your not sure, the generic name of the drug, without exception, ineluctably ends with -lol.

-TT

 

[Brown]

Re: Re: Re: Re: "Clinton Syndrome"

They also look at CK-MB, LDH, AST as well as a few others that used to be used that get even less and less specific than those. Troponin is now the gold standard.

My results were for troponin and CK. Both were okay.

By the way, if you're on a beta-blocker, that's probably why your heart rate is slow. This is a "good" side effect of the medication. If your not sure, the generic name of the drug, without exception, ineluctably ends with -lol.

Exactly right. The drug is atenolol. I mention this medicine because I've got a history of using it and I have had no trouble tolerating it. But it does bring my heart rate down into the 50s and sometimes the 40s. As a result, I've had some experience with the nurses worshiping me. They would take my blood pressure and pulse rate and say, "My God!"

 

[Luke T.]

So your heart is okay, right?

































BOO!









How 'bout now?

 

[Brown]

(Clutches chest)
Eeeeegggggh!

(Redd Foxx voice)
I'm comin' Elizabeth! It's the big one!






Just kiddin'.

 

[Soapy Sam]

I want to hear more about TT's fiery butt rash.

 

[Dr. Imago]

I bet you would.

-TT