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British Heart Foundation
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Avoiding using GTN spray

Hi there. I'm here to try to help my 82yo Mum, who has had angina for a few years. Because she has suffered disabling migraine headache throughout her life, she has been too scared to ever use her GTN spray. When she gets breathless walking, or on steps, she just waits for the feeling too pass. My question is, does her approach put her at extra risk, say, of a heart attack, or is it ok to continue this way? Thanks for any advice.

Derek

12 Replies
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This was exactly how I managed my angina before I knew it was angina (sometimes ignorance is bliss). I played golf regularly in that state. I can’t say if this is more or less risky than using GTN spray, but the choice is always hers. GTN will almost certainly result in a banging headache. You might want a chat with her GP.

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Hi Derek. I have a spray and take isosorbide tablets, and have had awful migraines since I was a child. Although the isosorbide gave me really bad migraines for 2-3 weeks when I started taking them, the spray doesn’t at all and it does help with the breathlessness. Everyone is different but maybe if she would try it, she might be the same. I hope she gets on ok.

Helen

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I have a great spray and also scared I’ll hurt myself so my bloke advises me. He says if u don’t use it it puts u st extra risk.

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Like Raynads, Migraines are vascular in origin. It is when the arteries close/tighten. Angina can be due to this same vascular tightening or more commonly an artery blockage. Over time arteries get stuck in their ways and become stiffer. Nitrates relax arteries and thats why you get that 'banging head ach. So that banging head ach is actually saying the GTN is working. so who ever said keep taking it was correct, just keep an eye on her blood pressure

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Many thanks to all those who replied.

Derek

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I have found that different makes of GTN sprays vary in side effects. Some don't give me a head ache. Just a matter of trial and error.

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Am alternative to GTN spray are isosorbide mononitrate tablets which are designed to prevent angina attacks. I was on these prior to my bypass. These might be an alternative for your mother. The one time I used a GTN spray I got a disabling headache - never an issue with the tablets.

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Many thanks again. She is on isosorbide mononitrate tablets, so it is to be hoped this will keep her on an even keel. All the same, she accepts her age, and doesn't want to go on forever, and many of her friends are already gone. So I won't give her too much of a hard time!

Derek

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Hi, I'm a bit younger than your Mom but also have had migraines all my life. Strangely as soon as I started my angina medication they stopped and I haven't had one since. I have statins, beta blockers & aspirin, my migraine nurse thinks it's the beta blocker, personally I think it's the aspirin, but really I don't care, to be migraine free after so long is just amazing. As for the GTN spray I felt the same, bit scared of it and I don't use it very often, and yes it does give me a headache but only for a few minutes, and it really does work for the chest pain. So in my opinion I would go for it.

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Thank you for sharing your experience. I'll let her know.

Derek

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Does it help if she takes painkillers before using the gtn spray in anticipation. This is what I do and it certainly brings down the pain level in comparison to if I don't use the painkillers. Without using the spray I fear BP would get too high and be risky. If Dr says use gtn spray then I think she should the benefits outweigh the side effects. The side effects can be treated. What's any medical advice she's been given? I was told it helps to sit down when taking the spray and stay still for five minutes plus be well hydrated, plenty of water. I don't suffer the headaches for long now and BP goes down and then I carry on after a little rest. Of course I'm only 50, I know with advanced age or with children the side effects can be worse. Hope your mum is ok and there is some solution. Maybe the slow release tablet form as preventative could be added so she doesn't have the need to use the spray as often.

Best healthy wishes

Laurie

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Thanks for your thoughtful reply,

Derek

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