cardiac complications in Als

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WendyWooG

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Jan 10, 2016
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519
Reason
PALS
Diagnosis
07/2016
Country
Uk
State
Hertfordshire
City
Stevenage
Hi
has anyone had cardiac muscle in ALS?!

I was rushed into hospital last week with classic heart attack symptoms. I was lucky enough to get a doctor familiar with ALS.

My ecg came back fine with tachycardia the only thing shown.. So both the doctor and myself felt it must have been just chest muscle spasm.

However when my blood tests came back they indicated high levels that indicated cardiac muscle damage consistent with a heart attack.
she went off to check and came back to say that it's a rare complication of ALS and they have upped my painkillers to assist.
I have searched but can't find much. Has anyone else heard of this?
Wx
 
I would sooner think the incident was separate from ALS. You can have heart issues with or without ALS. Just my opinion. Did you have a cardiac consult?
 
I haven’t heard of cardiac muscle being involved as a result of ALS. Cardiac muscle is somewhat different from skeletal muscle and is of course involuntary.

When cardiac muscle is damaged as a result of a heart attack or orher injury, it releases a different form of CPK known as CPK MB. Damaged skeletal muscle releases CPK MM. There are other muscle enzymes more specific to cardiac muscle that are also released with heart damage.

Chest wall or rib muscle pain can mimic a heart attack, and may trigger the release of skeletal, but not cardiac, muscle enzymes.
 
If you go to PubMed at pubmed.gov and type in 29021775[uid] in the search box, you can access a free article from Frontiers in Neurology that discusses some cardiac findings in ALS (click on the PMC Full Text icon). It sounds as if this article is describing a more severe scenario than yours, but it might explain some of the underlying causes for cardiac involvement in ALS. There are very few articles on the correlation in PubMed, but when I checked the references for this article they include articles that discuss how sympathetic disturbances that occur in ALS increase risk of MI in some patients, how ALS can impair autonomic control in some patients, and the association of cardiomyopathy with some motor neuron diseases. If you would like copies of any of those articles, I would be glad to send them to you.
 
Not everything that happens post dx is ALS. And ALS decidedly does not give you a free pass on other diseases. Since dx I have been diagnosed with Type 2 diabetes and Hypretrophic cardio myopathy. The increased cardiac enzymes would make me think HEART ATTACK, based on the theory of when you hear hooves think horses not zebra. Cardio ALS is a multi coloured zebra. I would get in to see a cardiologist ASAP, even if it means going to emergency. Chest pain and elevated cardiac enzymes= HEART ATTACK! Drs are sooooo quick to write off everything as ALS it becomes dangerous.
Vincent
 
We know ALS is associated with higher energy consumption/metabolic rate than the level of activity would warrant. Tachycardia/cardiac enzyme elevation could signal you were/are tapping into reserves you don't have, regardless of the heart activity returning to normal as shown on the EKG. Were you under any kind of physical or mental overload/stress?

Agreed, would follow up w/ a cardiologist if only to have one if needed in future.
 
An other thought, are you anemic ? My husband was anemic ( cause unknown) throughout his time with ALS and had on a few occasions( usually in the hospital with an illness) heart symptoms and elevated heart enzymes , cardiology would be called in and each time would say it wasn't a "heart attack" ( don't know how they determined this). Our very expierenced RT would suggest his anemia could be a factor. He would say even if one's O2 is normal ( it only measures the amount of O2 in one red blood cell) if one is anemic there aren't enough red blood cells to carry the total needed oxygen to all parts of the body, including the heart ( especially under stress). Have no idea if this is right but it is the only theory that was presented to us.
 
thanks for your answers. I have had a heart CT about a year ago. Everything excellent. I have had high creatinine levels throughout but the one that worried her was Troponin?? I did find limited info in the link below. Iam also going to talk to GP about another cardiac check.!

I will also get iron levels checked and follow up the other search areas.

https://www.ncbi.nlm.nih.gov/pubmed/26801485

Thanks everyone Wendy.
 
Check yout potassium levels as well. Mine was low for several months. It is now on the low side of normal. Perhaps it is used by the disease as other PALS have reported low potassium.
 
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