Using GTN before and during cycle ride

[Damian78]

Hi All,

I'm hoping to get a bit of advice please?

6 months ago today I had a heart attack whilst riding my bike. I didn't realise this at the time, I thought I just had really bad stitch, though was confused about why I was so out of breath as well as it was unusual (I'd usually recover quickly after a hill climb but that day I wasn't doing). I completed 42 miles, went home, had some gaviscon, felt better, and thought not much about it. However I was due to ride a sportive in the Lake District a couple of weeks later so went for a check up at the doctors after work on the Monday. One look at my blood pressure and I was sent straight to hospital where I stayed for a week, and had a stent fitted.

Fast forward to 6 months later and I've been back on the bike for a few months, gradually increasing speed and distance. I occasionally get a bit of discomfort so stop for a minute or 2 for it to wear off then carry on - its nothing like the attack, and always goes off, so I'm not convinced it's anything to do with my heart but I'm always a bit paranoid now.

Tomorrow I'm taking part in my first event since that day, an 83 mile ride around Staffordshire. I've told myself that if at any point I don't feel up to it I'll drop to one of the shorter routes, or call for a pickup.

However, I do have a question over the GTN spray. I was told by a nurse and read on the NHS website that it can be taken before exercise to help reduce the risk of another attack, so I've been doing this. Just the 2 sprays before I set out.

My question is, how many times should i take it maximum in a day. If for example I take it before setting out, then feel discomfort after a couple of hours can I take it again, wait for a minute and carry on? And how many times should I do this maximum (obviously spaced apart - if I took it and it didn't work, so took it 5 minutes later and it still didn't work, I'd call for assistance). Is it likely to wear off after a couple of hours so just take it again?

I would really appreciate any advice

Thanks in advance.

Damian

[Andyman]

I would not rely on an answer from here. Sounds decidedly dodgy to me but I am not a doctor. I would go ask my GP. Or that nurse.

[MichaelJH Heart Star]

Hello and welcome to the forum! I am basically off line for a few days. However, I noticed your post and felt I should reply. I am not medically qualified but feel that you need to speak to your GP or cardiologist before undertaking this as only they know your precise history. Somebody else's experience may not be totally relevant. I remember when I was suffering angina before my bypass my cardiologist told me to keep as fit as I could but not to push it! As the event is today I think you need to tread (pedal) carefully and pull out at any sign of discomfort unless medically advised otherwise.

[Alison_L]

Having ended up in hospital after "overdosing" on GTN (2 puffs, 5 mins apart), I would be extremely wary of using it as a pre-exercise preventative measure.

[Damian78 in reply to Alison_L]

That's concerning considering it's the dosage recommended. I actually read up on the NHS website itself that it's ok to take it before, my consultant said the same, but I'll check again with my GP next week. It turns out my GP is actually a cardiac specialist at the hospital I was in (Glenfield in Leicester) so a good person to speak to about it.

[Alison_L in reply to Damian78]

The paramedics who scooped me up off the floor told me that it should only ever be used if you actually have chest pain. I took it as I was feeling dizzy! Not a good idea, but the hospital hadn't really explained it to me...

Well done on the 64 xx

[Damian78 in reply to Alison_L]

I'll definitely have to ask about that then, thanks. When the nurse told me that they often recommend it before all exercise it was actually in response to my question about whether its dangerous to take if pains aren't actually to do with the heart.

Oddly most people I know who take it say they get severe headache afterwards, which is a common side effect. However I never get a headache, but do sometimes feel like my throat is tightening straight after, which goes off after a minute or 2.

Thanks It was a tough ride, and being nagged by my heart monitor on all the hills was frustrating but necessary, but just happy to have finished it.

[Damian78]

Thanks for your replies, and the advice.

The event was actually today so unfortunately I didn't see the responses until now. I actually dropped onto the 64 mile route after 30 miles, rather than the full 83 miles - just seemed sensible which is something I'm not used to. I do have a heart monitor strap that I wear around my chest when riding, I have my current and average heart rate shown all the time on my cycle computer and have it setup to alert me when my heart rate exceeds 148bpm (as advised by my consultant last week - unfortunately forgot to ask him the question in this post at the time). It went off a few times when riding up hill (hit 162bpm at one point on a particularly difficult hill) so I just dropped off the pace a bit - felt fine but had to be careful not to overdo it.

Feeling fine now too. I did take the GTN before I set off, and once more during the ride (just a bit out of breath and small amount of discomfort), was fine afterwards.

But I'm going to see my doctor next week anyway just to get his professional advice, and maybe see if he can do a couple of tests to see if it's had any adverse impact.

Thanks again.