Confused

[IanAG]

I’m new here, 58 and had a double bypass eight years ago, followed by a serious carbon monoxide poisoning two years ago which caused damage to my heart.

I’m a bit confused because I am getting angina symptoms at rest which I assume is unstable angina. I’ve read that unstable angina is a medical emergency and I should go to a&e. But then I’ve read about refractory angina which is something different. And my cardiologist told me that I ‘probably’ have small vessel damage.

He has also told me that they consider me now to be at too high a risk to perform an angiogram or more surgery, so he wants to treat my pain ‘conservatively’. He’s prescribed another medication called ranolazine on top of my Elantan and GTN spray in an attempt to manage the pain.

I’m conflicted because if I went to the a&e every time I had chest pain i’d Be living there, and in any case if operating isn’t an option what can they do? And if it is refractory angina then going to a&e seems pointless.

Even when I have been all they’ve done is checked my troponin levels and told me I haven’t had a heart attack and discharged me. So what’s the point of going?

How do you respond to persistent angina symptoms?

Ian

[shopman]

Hi

Sorry to hear of the problems you are having and can thoroughly sympathise with you. I was always told if getting chest pain (angina) then 2 squirts of my GTN Spray and if the pain had not gone within 5 minutes then to repeat it again. If after another 5 minutes it had not worked then to dial 999 and ask for help as it should then be treated as an emergency.

[Shoshov in reply to shopman]

Me too. But as many will agree we go to a&e and you get the funny looks as if “oh not her again”. We can’t win. Hope you get some relief and answers soon❤️

[Chappychap]

"if operating isn’t an option what can they do?"

There's a difference between electing to have a risky operation when you're still getting by okay, and having that same operation in an emergency when it's your only chance of survival. Consequently, if you presented at A&E in a critical condition the cardiologist may well rethink his or her advice! Certainly in the early days, while you're still coming to terms with the symptoms, I'd err on the side of safety and get checked by A&E. Later on, when you're very familiar with your own symptoms, then it might be different.

[Keep-it-ticking]

Sorry to hear this Ian and I can fully empathise as I'm in a similar position. Been on Ranolazine for a few years and just had Ivabradine dosage upped. Also they've been doing anything but an angio and don't want to go in. I could easily go into A&E most days despite being able to go out running and training.Please do still err on the side of caution and don't risk it if you feel unwell. As my cardiologist said " Always listen to your body as you know best" . Good luck and stay safe.

[Ianc2]

Your heart is complaining because the arteries are getting clogged up again . try ruthlessly getting your weight down, changing your diet to drop your sugar levels, briskly walk a mile a day and lose complex carbs (cakes, biscuits, processed foods, sugary drinks). Unfortunately a lot of people get this advice, don't act on it and fairly quickly find themselves back at square 1.