Effects of unstable angina when resting

[Quovadisuk]

Hi all , I am new here, but thought I do a quick posting on Unstable angina , I am looking to compare notes with other sufferers of this issue ... especially the effects this has when at rest. My issue is that I have all the problems of the pains in the chest and heart when resting or indeed asleep and can often be woken early morning with a range of issues affecting the arm, chest and breathing . but not so bad or at all when I am physically doing something ....anyone else experience this ?? kind regards

[MichaelJH Heart Star]

This sounds like a condition called Prinz-metal angina that affects the small blood vessels. When angina that affects the larger vessels becomes unstable and occurs at rest the condition has become very serious with intervention required sooner that later. As you can do hard physical work I am dubious that you have large vessel disease. Prior to my bypass I got pain and breathlessness after 20 yards!

[Quovadisuk in reply to MichaelJH]

Hi Michael thank you for the reply .... The recent angiogram I had last week suggested a narrowing of the arteries just after both the fitted stents, so I am wondering ( and this is only a guess ) that if I am working the heart pumps harder so the pressure allows blood to pass through these narrowing s better than at rest , when I am at rest the pressure is not so great so the blood doesn't reach the extremities so well causing me the problems ??

I know they did say when I first had the stents fitted that there was other damage to the smaller vessels , but couldn't do anything about these as they were to small and could do more damage if they tried !! so what you mention seems to make sense Do to see the specialist this Friday ...fingers crossed ...kind regards

[Milkfairy Heart Star in reply to MichaelJH]

Michael

Printzmetal / variant/ vasospastic angina / Coronary artery spasms effects the epicardial or Coronary arteries.

When spasms occur in the coronary arteries the symptoms are same as unstable angina.

A severe prolonged Coronary artery spasm can lead to a heart attack.

This temporary narrowing of the Coronary artery cannot not be fixed by a stent or surgery.

Microvascular angina affects the small vessels and can be due to the blood vessels being unable to dilate or again going into spasm.

Both are equally painful and debilitating and are known as none obstructive coronary artery disease usually treated by medication.

Obstructive coronary artery disease is due to the pernament narrowing of the Coronary arteries and can be treated by medication, stents and sometimes surgery.

The BHF has the following information about Microvascular angina and Coronary artery spasms which you may helpful.

bhf.org.uk/informationsuppo...

bhf.org.uk/informationsuppo...

[Quovadisuk in reply to MichaelJH]

Thank you for your valued posting : I did write to my surgeon with a diary of events times and symptoms which happened to full in line with your posting . I did write that although its sometimes dangerous to self diagnose , could it be linked with Prinz metal angina . He has responded to me today to say they have had a MTD meeting ( Multi disciplinary team meeting ) just after having the angiogram the later part of the previous week and stated that this may well be a variant of angina as suggested . and spur from the coronary heart disease I have .

He is now stating that he has put me on the waiting list for "pressure wired guided stent placement" ? I did do a search on this and it would suggest blood pressure is measured after the two stents that are in place already to see if there is a pressure drop using a probe ... but I dont see anything on it as stent placement as well ?

Does this mean they are considering putting further stents AFTER the existing stents OR putting new stents inside the old ones?

With any heart issues there are always a risk, and I was aware of these when I had the previous stents fitted , but with this procedure is the risk greater and will I need to be hospitalised to do it ?

[Kristin1812 Heart Star]

Yes, very similar. I have been told I have both stable and unstable angina. I have learned that if I start slowly, and steadily, I can do quite vigorous exercise. I find it’s wise to warm down slowly, too.But, like you, I can also get unstable angina when I wake up, and at rest.

These are both now better controlled (after lots of stents) with meds, that have been juggled for years. The stents can deal with the larger vessel blockages, but I’m also left with microvessel blockages.

It’s been a puzzle to me why I can exercise hard, getting little or no angina (if I do, i just slowdown and it reduces), but still get some while resting. The explanation given by qupvadisuk rather appeals to me!

[2stents]

Hi quovadisuk, we all have different symptoms and I’m not medically trained. I did have unstable angina many years ago, but was different to yours I couldn’t talk laugh without having attack. Stents did sort it out.

Although I have blocked stents now and waiting for new ones.

I would definitely discuss this with your GP & Cardiolgist he maybe able to sort this out for you with meds x

[Hidden]

I'm the same. Getting woken up, daily. I feel that this is fairly common among women. When I saw a Cardiologist Consultant, recently, he didn't seem to be too concerned by it and in fact, quite the opposite. When I looked, active angina episodes occurring regularly should be taken, seriously. In reality, it's not. No wonder how many of us would end up in A & E as a result. Something I much preferred to avoid doing. Nobody would bother seeing a Cardio for nothing, but knowing they see 1000 patients through the door, they would probably become desensitised and develop some male cavalier attitude, not meaning to be insensitive to "men", though.

[Blue_Fisherman]

Today, I attended an education class for those who are post-procedure for Coronary heart disease. It was about how the heart is affected by Angina. They were quite clear that there’s 4 states of this condition.

1 Stable Angina

2 Heart attack (STEMI)

3Heart attack. (NSTEMI)

4 Unstable Angina.

Stable Angina can usually be easily and successfully treated by medication.

The others are treated as emergency conditions and should be dealt with immediately. Unstable Angina requires hospital observation and may require an urgent Angiogram/Angioplasty.

[Milkfairy Heart Star in reply to Blue_Fisherman]

They missed non obstructive coronary artery disease which can lead to the following:

MINOCA

Myocardial infarction non obstructive coronary arteries thought to be responsible for 10 % of heart attacks.

Spontaneous coronary artery dissection SCAD and Takostubo syndrome

All poorly understood and recognised conditions that tend to effect younger women.

All listed as possible causes of a heart attack and Acute Coronary syndrome aka unstable angina by the 4th Universal definition of a Myocardial infarction published in August.

academic.oup.com/eurheartj/...