Janis 58 Angina

[20041961]

Hi, today I was diagnosed with Angina. I'm a 58 year old female.

I'm obviously a little scared.

I want to ask if anyone can give me any advice to help with the anxiety I am experiencing.

Thanks

[Milkfairy Heart Star]

Hello Janice

Welcome to the forum.

I have lived with angina for 8 years.

I found learning as much as possible about what causes my type of angina helpful.

bhf.org.uk/informationsuppo...

I use various strategies to manage my symptoms. Learning your triggers and how to use the various medication such as a GTN spray or sub lingual tablets ( tablets that you put under your tongue) is key.

Lifestyle changes are really important and again there is a great deal of useful information on the BHF website.

Stopping smoking, exercise, adopting a diet such as the Mediterranean diet, managing your weight, cholesterol levels and stress as well as taking your medication are all important.

The BHF has lots of information on their website.

Also perhaps give the BHF helpline a call too and talk to one of the Cardiac nurses.

bhf.org.uk/informationsuppo...

I manage my stress and anxiety through mindfulness meditation, Tai Chi and yoga.

I am sure with time you will find what works best for you.

It is very early days for you and it can feel very bewildering at the beginning. Give yourself time and be kind to yourself.

Good luck!

[20041961 in reply to Milkfairy]

Hi MilkyFairy

Thanks so much for your reply.

Yes, it is really daunting, especially with the virus stopping me from getting a good diagnosis as to which type I have.

I have a spray which I used for the first time on Saturday. It helped.

My gp said if I require 2 sprays and I still don't feel right I must ring for an ambulance.

Obviously I guess we're all feeling overwhelmed with the virus and it does take its toll on us in one way or another.

I am trying to do breathing exercises to calm myself.

Because all this is new I've tried to gather information from the internet.

I've read from different sources and I am confused with when to use the spray. Is it only during an attack or to prevent one?

You can imagine my dilemma.

Thanks again

Janis

[20041961 in reply to 20041961]

Ps sorry I spelled your name wrong

Milkfairy

[Milkfairy Heart Star in reply to 20041961]

You can use your GTN before exercise to prevent angina as well as afterwards or to manage your angina

I suggest you sit down when first start using it as it can make you feel dizzy, light headed and give you a headache as well making you feel sick. These side effects wear off with time.

It's really important to still call an ambulance if the GTN does not relieve your angina. It is especially important to call for help if you get chest pain at rest.

Cardiologists are worried that people are staying at home when they should be seeking medical help.

We are all in limbo at the moment. Has your GP referred you to the rapid chest pain clinic?

The NHS is still in business for heart patients.

bhf.org.uk/what-we-do/news-...

The internet can be helpful but perhaps Dr Google's Consultanting room should come with a health warning.

I suggest you start with the BHF and other recognised evidence based sources of information.

[20041961 in reply to Milkfairy]

Hi, yes my gp is referring me. I hope to hear soon. However if because of the virus there are no clinics then I shall have to wait.

Thanks again, it is so nice to reach out and receive help.

Take care.

Janis

[Hidden in reply to Milkfairy]

you can also get nitro patches if you are having persistent on off angina. I wear 1 or 2 a day at the moment. Its longer lasting than the spray .

[20041961 in reply to Hidden]

Thanks Moonflower1

I'll have a chat with my gp about this.

I didn't realise there were patches.

Thanks

[Milkfairy Heart Star in reply to Hidden]

Patches are useful along with isosorbide mononitrate extended release tablets to prevent angina occurring .

The maximum dose of GTN is 120 mgs in 24 hours

However short acting nitrates such as sprays or sublingual nitrate are most effective for acute episodes of chest pain.

There is the issue of developing a tolerance to nitrates which is why as patients it is important to have a period of at least 8 hours without any nitrates in your system.

medicines.org.uk/emc/produc...

Saying that I end up in very high doses of IV GTN for days when I am admitted to hospital.

[20041961 in reply to Milkfairy]

Thanks.

Have you ever had beta blockers?

Do you know if they can be prescribed to use daily and the spray only used in case of an attack?

[Milkfairy Heart Star in reply to 20041961]

Has your GP prescribed beta blockers for you?

They can be useful for most types of angina.

The GTN spray is useful as it is short acting and you don't develop a tolerance to it.

Many people manage their angina successfully with medication and the spray .

You know your body best and hopefully once the Cardioligist understand what is causing your angina you will be treated appropriately.

I cannot take beta blockers as they worsen my type of less common angina.

[20041961 in reply to Milkfairy]

Thanks again. I'll consult with the gp.

[MichaelJH Heart Star]

Another drug that is used as an anti-angina is the CCI (Calcium Channel Inhibitor) Diltiazem. I found it very effective.

[20041961 in reply to MichaelJH]

Thanks for your comment Michael. I'll see what my gp thinks.

[fikhatri2]

Don't take Anxiety for Angina as it is very common nowdays, anxiety can trigger more chest pains, so you will be in viscous cycle. Keep anti anginal drug handy which doctor has advised to you.. try to be more relax and eat fruits with nitrates like Pomogranate, etc.,

[Bellipan]

Hi,

Similar to yourself I am 59 and was diagnosed at the turn of the year and now recovering from an Angioplasty and stent fitting.

I had always maintained a good degree of fitness, ate the right things, and a life long non smoker, so it came as an un welcome surprise to find out I had Angina.

However, my cardiologist helped with the anxiety aspect by explaining that my Angina isn't due to something that happpened last week or x months ago but began developing from teens and early twenties, just that it has now reached a stage where I had become symptomatic.

So his advice for anxiety was simple. Whilst waiting for further investigation, be vigilant but not paranoid. You are aware of the current feeling of discomfort with your Angina, and how you manage that, so if it feels different and won't go away then time for 999. Other posts have rightly pointed out that heart intervention procedures are still continuing during the Covid outbreak, so if you need earlier treatment you will get it, it's just a balance of risk.

So, you are now a member of an exclusive club that non of us wanted to join. However, benefits are Angina is treatable, relatively low risk and with a good prognosis for the majority.

All other threads have been worth a read up to this point as they are offering sound advice.

So try to find an activity or so to engage in during lockdown, whilst you wait for your referral and take time out to catch up with any pals you may have, to have a natter about nonsense ( my normal conversations ) Always helps.

Take Care

[Sunshinebrew]

I have angina initially treated with stents and beta blockers, and because of continuing symptoms further medication has been added and tried over time. I am happy to say my symptoms are now controlled with medications and I am able to have a normal life. I take isosorbide mononitrate slow release tablets every day as well as ranolazine and have the GTN spray if needed. It can take a while to get the right medication but it is very treatable, I have found this forum helpful and reading others experience has been helpful to me. I wish you well.

[DaveGL]

Hi, I’m in the same boat but ahead of you by 3 or 4 weeks. All my tests have failed to materialise. Living with the uncertainty is difficult but I’ve rationalised it to assume the initial diagnosis is correct (aided by the fact that the GTN spray works for me). Called the paramedics just once when GTN had no effect but false alarm. Had a bad do at weekend but held off calling and it did settle......I don’t want to waste their time.

I’ve lived with anxiety for years and I’m having to work very hard to control it currently. Deep breathing really helps (feels more effective after a GTN spray). Learning to understand my condition is helping...read plenty....BHF site very good.

[Milkfairy Heart Star in reply to DaveGL]

Hi Dave

Have you seen this free app? It has loads of meditations, breathing and relaxation exercises.

insighttimer.com/

[DaveGL in reply to Milkfairy]

Thank you, much appreciated

Dave.

[Pajebynight]

I’m not really bringing anything new here, except to say that you’re not alone - in fact, reading your case and the replies above I’m struck by the similarity to my own situation. I’m 59 yo, female, never smoked, diagnosed in late 2018 and had an angioplasty and stent in March 2019. Diagnosis was a complete shock as, like Bellipan above, I thought I was fit (I had jogged my way slowly around 5 marathons since 2014) and ate what I thought was pretty well. I’ve always been prone to anxiety, and the diagnosis, plus the sudden transition to lots of meds, really made me spiral into a vicious cycle of panic that increased my symptoms.

The thing is, a year on, I’m feeling much better. The NHS cardiac rehab course was wonderful and, when my health anxiety continued, I was referred to a psychologist at the hospital who got me into a much better place. I vividly remember one moment on the rehab course when we were asked if we could think of anything positive that had come out of our diagnoses, and at the time I was like ‘No, of course not, how could it?’ But now I do feel that there is good among the bad. I eat healthily (bought The Doctor’s Kitchen cookbook and learnt how to cook things I’d never tried before) and practise mindfulness. I’m not saying I’m glad it happened - I’m not - but there is light at the other side, and there’s a sense of safety in being part of the medical machinery.

Sorry this is all about me! Welcome to the forum and all my best to you.

[jerry12953]

I'm no expert (apart from having had angina on/off for several years now!) but this was my experience.

The first few episodes of chest pain appeared to one offs but after the second one which scared me quite a lot I started going down the NHS route. I was prescribed GTN spray and began a series of tests to try and pinpoint the cause. Unfortunately the GTN didn't seem to work; as time went by the chest pain became more predictable and was obviously related to exercise - it was walking uphill that caused it. I have had several tests (whose names i can't remember) to try to locate a blocked artery and all have come back negative. So it appears that there is no obvious cause of my chest pain, and no chance that a inserting stent to open up a blockage will stop the pain from occurring. This finding is a mixed blessing, in my opinion!

By a process of elimination something called microvascular angina has been diagnosed which means that the tiny arteries inside the heart are not opening up as they should to allow blood to flow through them under exertion. Apparently a very large percentage of angina sufferers have no obvious cause for the pain - something like 39% if I remember correctly. Milkfairy , who has replied to you above, is very well versed in this condition.

Medication-wise I'm on low-dose aspirin which thins the blood, a statin to reduce my cholesterol levels and bisoprolol which does seem to help to reduce the symptoms - although they are very variable. Sometimes I easily get pain on walking uphill, sometimes I can walk up the same hill (or a steeper one) and get no or little pain. It is all a bit unpredictable.

In the last few days I have started to get an intermittent pain to the left side of my chest which is a bit worrying. It comes and goes and doesn't seem to be related to breathing, movement or exercise. It is easy to get paranoid about any new symptom like this which may or may not be related to the heart.

Hope this helps a little!

[Sunnie2day]

I have multiple heart conditions (mild-ish and well controlled by meds and lifestyle), one being angina with normal coronaries (determined by angiography and right heart study).

I take one Bisoprolol 1.25mg+300mg aspirin every morning and since starting it April 2019 my angina is well controlled. I have a GTN spray (Nitrolingual 400) and on the now rare occasion the angina hits, the GTN sorts it quickly.

Since the angiogram revealed clear arteries my anxiety level has dropped to near zero - until then I was having considerable anxiety. I didn't know if I was a walking heart attack about to happen even though the medications had an immediate effect and I felt better than I had in years.

The tests, especially the angiography, ended my anxious moments - I wish you the same result. Once the pandemic is over you'll be sent for tests - the waiting for the appointments to be booked is the worst part but eventually the tests do happen and you have answers.

[MydogBrandy]

Hi, my Colin had it really bad after he had three heart attacks , he was in and out of hospital so much with angina when the spray didn’t seem to work THEN they got the tablets just right and touch wood he is symptom free at the moment, in fact he is washing the windowsill as we speak bless him , he reckons it not leaving the house as long as you keep one hand on it!!! X

[MydogBrandy]

Sorry forgot to say, keep well and think nice things, do try and keep anxiety down x

[20041961]

Thanks again to all of you. You're really kind.

I have an appointment tomorrow with rapid access chest pain service at my local hospital.

Luckily it is in a separate dept to the rest of the hospital which has set my mind at ease.

I hope to get some answers and advice after my check up.

I hope to be in touch after the appointment.

Take care.

[IMAGES]

Hi Janice, I came on here to reply, but having read the other comments notably from Milkfairy, I have no need. But I would reiterate the remark about Dr. Google. This site is vey good for advice and putting your mind at ease, but always seek professional help if you know something isn't right with your body. Good luck and try not to stress.