Defining nutcracker esophagul spasm from coronary artery spasm.

[Goldenheart]

Hi all. I have coronary artery spasm, ,,,diagnosis of exclusion a while ago. I also get the occasional nutcracker spasm, and the name certainly describes the pain. Can anyone tell me ,if they suffer these conditions, what defining symptom seperates the two? As both cause chest and left arm pain.And both can leave a shadow of the pain hours after. I have nitro, but im aware relief from this isnt an indicator, as nitro can work for both conditions.

[Milkfairy Heart Star]

The two conditions can be difficult to tell apart.

Have you seen a gastroenterologist and any tests to confirm whether you have oesophageal spasms?

patient.info/doctor/oesopha...

Have you ever had any ECG changes or a rise in Troponin blood levels when you have had chest pain as these are associated with coronary spasms.

You can also have both conditions at the same time. The treatment is similar uCalcium channel blockers and nitrates.

[Goldenheart in reply to Milkfairy]

Hi Milkfairy, thankyou for replying, weve spoke a few times on here...yes i had an endoscopy over ten year ago,following esophagus pain. Admitted to hospital with suspected heart attack after another very painful episode, leading to diagnosis of esoohagul spasms,after exclusion of heart involvement. I do have both conditions,, coronary ,and esophagul spasms. Im on 300mg tildiem daily, nitro when needed. I hate taking the nitro, recently its triggered episodes of sustained tachycardiamover 130 bpm. If i take an ecg with my alive cor,during any of the spasms, will it show ? X

[Milkfairy Heart Star in reply to Goldenheart]

How unlucky for you to have 2 painful conditions at the same time. You have my sympathy.

A 12 lead ECG is the best way to pick up any vasospasms though it can be like chasing a will 'n the mist to catch one.

I suggest you contact your GP and ask for a review from a Cardiologist there are other medications that could be tried.

Perhaps ask for a review from a different Cardiologist a second pair of eyes can be useful incase something is being overlooked.

If you have chest pain that is not resolved with GTN spray it's a call to 111 or 999 if necessary

Good luck

[Goldenheart in reply to Milkfairy]

Hi, my dctr always gives the same response,i have to wait for the cardios appt, which are usually a year apart.And now ,of course, im told it will be more like an 18 month wait. Is there an alternative to the ventolin, i know its needed,but the tachycardia it triggers is nt good?

[Goldenheart in reply to Milkfairy]

Sorry, not ventolin, i meant nitro...you can tell ive had no sleep, lol .

[Milkfairy Heart Star in reply to Goldenheart]

If you are in pain with new or worsening symptoms then I suggest you ring 111 especially if you can't use GTN

Have you thought of seeing a different GP?

Perhaps asked to be referred to a different Cardiologist too for a second opinion.

Where in the UK are you based?

[Goldenheart in reply to Milkfairy]

York area.

[Milkfairy Heart Star in reply to Goldenheart]

I have sent you a message

[TuckBox2]

I occasionally have spasms over the last 12 years since I had a Nissan Fundoplication which has resolved most of my reflux problems. I went to A&E the first time it happened and was always told to get checked out at A&E as the pains can be confused with a heart heart attack.

After a few visits to A&E and being told it was a spasm, I found that about 20 quick sips of ice cold water did help settle things down.

Last August I had started getting pains that I thought was a spasm, I tried sipping iced water and the pain did not go off. When I did take myself to A&E after 2 hours being triaged, ECG, bloods, x-rays, I was back in the waiting area when the Dr came over to me and said I better come with her. She took me into majors and I was put straight into a room and some other Dr's came in gave me some asprin and other drugs and told me I had had a heart attack. I was taken straight to the Cardiac Care Unit connected up to monitors ECG etc. and later had a stent fitted. I was in hospital for 4 days, off work for 10 weeks, on new meds, had cardio rehab, but I am here to talk about it.

I did later realise that with the usual pains this time I also had pain in the back of my jaw, that should have told me as there was something different I should go straight to A&E.

[Goldenheart in reply to TuckBox2]

So sorry to hear that, glad your ok now. It is stressful to say the least, living with conditions that have the same symptoms as a heart attack.