I have had heart disease for 20 years. I have 2 stents. I have had numerous angiograms during that time. 2 years ago my angina symptoms returned worse than ever. I have seen a couple of cardiologists and am waiting a heart MRI to confirm suspected microvascular angina and or cardiac spasms.
My question is does anyone else find that taking GTN spray when having chest pain, the pain becomes worse for a couple minutes before it eases off?
This happens to me everytime I use the spray after the chest pain has started and the doctors have never heard of this?!!
Am I the only one??
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Shelbey2
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I live with coronary vasospastic angina. I have spasms in my small vessels and coronary arteries. Microvascular angina and coronary artery spasms. .
It is good to hear that your Cardiologist is aware of Microvascular and vasospastic angina.
A Cardiac perfusion MRI may pick up microvascular angina due to the inability of the small blood vessels to dilate, microvascular dysfunction but not vasospasms. I had a specialised angiogram to diagnose my vasospastic angina.
I don't use short acting GTN anymore . The spray works briefly however then I experience worse pain afterwards.
I have been prescribed isosorbide mononitrate extended release tablets and patches instead.
Perhaps discuss this option with your Cardiologist.
It is an usual response but those of us with Microvascular and vasospastic angina just do things differently.
The awareness of MVA and vasospastic angina is not widespread and very few Cardiologists have much experience of looking after us.
The BHF have some up to date information on their website about Microvascular and vasospastic angina.
If the GTN doesn't help with your chest pain and/ or you get chest pain at rest then you will need to get checked over which means a trip to A&E.
There are quite a few of us around and I am sure they will be along to share their experiences too.
I to have chest ache, I say this because it is not painful. I mentioned this to my GP and he disregarded these symptoms as imaginery and says most people have ache I will go in two weeks for pre op assessment. Should I mention this? I am in forCABGx3.
Thank you for your response. I have attended A&E a couple of times lately because if the unstable MVA and Printzmental angina. Normally the ECG's are normal but one was carried out whileI was having an episode and it showed ischaemia which was no surprise but I was so glad I had evidence of a problem! I saw my cardiologist on Monday who is arranging the cardiac MRI for a confirmed diagnosis. So hopefully things will go ok. Although even having a confirmed diagnosis doesn't stop the attacks or affects of the GTN!
Hi. I have taken lots and lots of GTN sprays and never had that! Sometimes it doesn’t get rid of the pain, or the angina returns v quickly, but it never gets worse.
Let’s see. Someone may come along with exactly what you are describing.
I am sorry and most sympathetic to your plight, but I am SO GLAD that you posted it, and here's why - I am in the exact same predicament, right to the point that my Cardiologist says she has never had a patient, or has ever heard of anyone who reports the same set of circumstances with regard to the use of the GTN spray.
I thought I was going crazy and despite posting here on this forum, I felt very alone as no other members were able to actually relate as to what I was experiencing. Although we are not to take Dr.Google's advice - I couldn't resist going on line to see if there was anything relating to my experiences.
There wasn't a single thing I could find, despite searching literally for hours.
I have 3 stents, I was supposed to be having a quadruple bypass but I swerved the knife as my surgeon refused to do the surgery as he didn't think I would make it, due to a host of other medical conditions. So we settled on the stents.
There was supposed to be 4 arteries that needed doing but one was very small and narrow, apparently in a location that was difficult to access, hence ending up with just the 3.
I had this done back in July of this year, through the groin and under a full general anesetic as I'm pain intolerant.
Apart from staying in hospital overnight for monitoring, due to my other conditions, plus some extensive bruising and a sense of overwhelming tiredness, my recovery was good and without incident, and for the first time in quite a few years, I could actually breathe without discomfort.
I thought I was pretty much "fixed". I was put on all the standard post-stenting medication, the nitrates and the clopydogrel and didn't even give a thought to the remaining un-stented 4th artery.
I was fortunate enough not to be working so I rested- up and followed the recovery advice for the next few months, whilst trying to take on board, the changes I had to make to my lifestyle. I've never smoked and rarely take a drink, for me it was mainly an issue of diet, Grrr
Anyway about 6 weeks in, I was pottering about, very low exertion levels and wham, from nowhere, I was right back to experiencing the exact same symptoms prior to the stenting.
Long story short, I was blue-lighted to A&E, where some hours later, it was determined that I hadn't had a HA but an Angina attack, most likey brought on by that pesky, un-treated 4th artery. Upon discharge the following day, I was prescribed the GTN spray.
Angina attacks followed, I held out for as long as I dared - then I sucumed to using the spray. Pretty quickly I realised that my symptoms were not abating, in fact it was like the spray was causing the symptoms to intensify.
Confused, I rang my Cardiologist, who told me to come in and see her the following day. We met and discussed my issue - this is when she told me she had never heard of such a thing regarding the spray. I could tell from her face that she seemed totally puzzled by it.
She booked me in for a repeat angiogram and stress echo within days, saying that she didn't think that the 4th artery alone was responsible for angina and thought something else may be going on, what, she didn't say . . 🤔
Two days later, just before my appointment - I was having an angina attack, brought on by nothing more than my bending down to pick up the dog's water bowl. I became very dizzy and took a fall, and a hard one at that - resulting in a broken shoulder in 2 places and fractured ribs !!
Ambulance called and by the time we arrived to A&E, I don't know what was worse, the chest pain and the angina or the pain from my shoulder - they were both level-pegging and crying out for pain relief stat. lol. Funny now, but certainly wasn't at the time.
Obviously the arranged appointment was put on hold and here I sit, 2 weeks later, still in abject pain from the shoulder injury (Morphine doesn't even touch the sides) and still experiencing these frequent angina attacks. If I followed the angina / spray protocol, I'd be in the hospital 24/7.
I now don't even bother with the spray anymore, I just sit down for a while and try and control my breathing. Up till now, I'm still in the land of the living, just . . .
I called my Cardiologist today and have the re-arranged appointment next week. So the mysterious saga continues, you couldn't make it up could you 😉
Apologies for the late reply. I am sorry to hear that you have had such an awful time. I hope you are feeling better now. As you said I also tried to control my angina with breathing rather than using the GTN spray.
The MRI was the worst experience of my life! But I did it! However it found that a had problems with my arteries and stents and that I was born with bicuspid aorta disorder! News to me!! I was then told to have an angiogram on 13th January and the consultant wanted me to be admitted immediately afterwards for a coronary bypass operation! One of my arteries was 99% blocked and he said I was on the verge of a heart attack!
A week later following further investigations, CT scan, ultrasound, bloods etc. I had my double bypass operation. My angina has completely gone. I am still a bit breathless but had a chest infection post surgery which didnt help. I am 5 weeks post op and still have aches and pains but heart wise it's all good. I should return to work in about a month. I have nothing but praise for the Basildon Cardiothoracic Centre who sorted me out so quickly from a condition that I had suffered with for the past 5 years!!
Hi Shelbey2. So glad to hear that it has all been sorted for you. You must feel so much better. I'm still praying for that day. Since we last communicated my condition remains ongoing - worsening angina day by day not helped my a monumental move back home to the UK from Malta bringing home the household chattels, the car and the dog, who incidently also has a had a heart condition for the last 5 years! It was not a move for the, and I joke, faint hearted, it was horrific and since I am still battling with my fractured shoulder which is refusing to heal (orthopaedic consultants, in both countries agree that a shoulder replacement is needed but won't operate as the consider me too high risk, which leaves me . . . well nowhere and with an arm that is pretty useless.
Trying to stay positive, I've re-registered with my GP and as I'm fortunate to live in a surrounding county, I've been referred and I'm waiting waiting to see a new consultant at the John Radcliffe Hospital in Oxford who deals in Micro Vascular Angina and praying that he or she can fathom out what's going on with me before it's too late.
Take care and enjoy every day of your "new life" 💖
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