British Heart Foundation

Change in Angina Presentation

I have suffered with both stable and unstable angina for the past 7 years but over past 6 months or so there has been a change in it`s presentation. Previously it was typical angina symptoms central chest pain a feeling that your chest was being squashed, pain in left arm e.t.c. now it feel like someone has put my chest in a G clamp with the general tightness as before but now debilitating pain and pressure centered above my left nipple area and more acute in my back about half way on my left side. Anybody having similar episodes or any ideas?

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You should go to see your Gp with these latest symptoms.

It could be anxiety due to something totally unrelated.

But you just can't take chances when it comes to symptoms like that.

I'm sure it's all ok, but keep us updated never the less.

Take care now, Jo 😊

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Hi stow101,

As you have a history of angina,it may mean that your medication isn't as effective now. You may need to be referred to a cardiologist for review. If the pain is severe, it would be a good idea to go to your local A&E to be checked out ,but do make an appointment with your GP too if he isn't aware of these new symptoms. I hope you feel better soon.

Take care,

Philippa

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Hi Philippa,

My GP is aware of the change in presentation and I am on the maximum dose of nitrates and other cardiac meds hence the pain control by opiates including Oramorph I`m at a stage when there is little or no interventions left, hence my choice of the DNR directive which is in place (with agreement from my GP and Cardiologist).

Thank you for taking the time to respond

Stowl01

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Hi Stowl01,

I live with vasospastic angina, Microvascular angina and coronary artery spasms so like you also have a lot of pain in my life too. It has become my constant companion it is like an uninvited guest outstaying their welcome.

I acknowledge your comment about how living with pain can lead you to make your decision about your DNR request.

I take 8 different drugs to try and control the spasms in my blood vessels. I have chest pain mainly at rest so sleep poorly. I am rarely pain free. I have found oxygen helpful especially at night to help me sleep. I also use a TENS machine, meditation and hypnosis. These help me to control my breathing and stay calm. These techniques don't stop the pain but they turn the ' volume down' as it were.

I end up in hospital from time to time for some IV GTN and a PCA of morphine. It usually takes about a week for my spasms to settle.

Have you been seen by a pain specialist? I attended an 8 week Pain Management course run by psychologists 3 years ago which has really helped me. I also met other people living with chronic pain and I am still in touch with these people. Nobody other than someone living with chronic pain quite gets it!

I also have access to a Cardiac Psychologist who supports me through the unfortunately too frequent episodes when my acute pain eposodes have been mismanaged by the hospital staff.

Yes it is challenging to live with pain in your life. I too try to keep the positive attitude and hope. It is very much about how you emotionally respond to your pain that is important.

I take everyday as it comes and count my blessings.

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Hi Milkfairy

Thank you for your views which I appreciate and understand. I worked for 21 years in a mental health maximum security establishment and am fully are of all the cognitive behaviour therapies you have mentioned.

The DNR decision was not taken on a whim and is part of a much more detailed Advanced Decision Directive which also covers any form of advanced life support and was made with the support of my family.

For me its about quality of life and relieving the trauma and stress of my family having to make decisions about my life.

Some people find my views difficult to understand and this is not the place to discuss them all I will say is I have no fear of dying and am certain that the decisions I have made are right for me.

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Hi stowl01,

I totally respect your decision. It is perhaps something more of us should openly discuss with our families.

It is absolutely about quality of life and living with purpose.

Pain is poorly acknowledged and treated at present it goes unseen and not well understood.

Let's hope in due course better diagnostic tests and treatments come along to help all of us to live as well as possible with our angina.

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Thank you

Stay well

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