I hope you don’t think this is a really silly question but for my chest pain I use the GTN spray on top of all the meds, here comes the silly bit..... I know you need to go to hospital after a few sprays of GTN but I thought I saw a post on here that a hot water bottle can help with the pain, so would I use the spray and some heat if possible at the time ?
Also just increased the amlodipine and think my chest feels heavy today could this be a side effect that can go or something that shouldn’t happen.
There..... said it now, but sort of want to know 🥺
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Fluffybee
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There are silly questions but yours is not one of them
I was on that discussion where the use of a hot water bottle for chest pain was suggested and was specific only - ONLY - to the chest pain pericarditis causes.
If you have not been diagnosed with pericarditis you MUST NOT try easing your chest pain with a hot water bottle - you must-must-must consult a medical professional to report chest pain the GTN is not having a long lasting effect against (for example if you need two five minute apart pumps in the morning then a few hours later you need it again as two pumps five minutes apart to gain some temporary relief).
It is vitally important you understand the hot water bottle tip was only for recurrent pericarditis acute flares (I have recurrent pericarditis) - NOT for angina (I also have 'angina with normal coronaries. And a couple other well controlled heart conditions).
Please reply back so I know you've seen this reply and understand what the hot water bottle thing was about I will be worrying about you until I hear back.
Thank-you for letting me know you've seen my reply - I really was worried about you. It's scary to have angina pain that the GTN isn't giving long-lasting relief from, I completely understand hoping something as lovely as a hot water bottle might give a good fix. Sadly not, though, and I hope whatever is causing your angina pain is sorted very soon.
Please report the way the GTN isn't reliable for an all-day fix to your medic, it's important they know as soon as possible. These days everything is by phone or email but you need to report your continued symptoms so 'they' can decide if you need to be physically seen or if a phone/email consult would be helpful.
And again, update us. I've been following your posts and I seem to recall you're not having an easy time of the chest pain and getting some relief.
Yes I do on some days have pain quite a lot then other days nothing.
It’s just the bad days are difficult, I thought the GTN spray could be used 4-5 times per day with 2 sprays each time as long as a third spray was needed at the same time ?
I’ve so much to learn and getting into a right muddle, having a bad memory due to another medical condition and all the meds that go with that makes it so much worse.
My Dr has now increased the amlodipine so hope that will help more or even help the pain go 😃
I'm a little embarrassed to say this as I know so many here aren't - but I'm great, actually. I've never had an acute flare of my recurrent pericarditis be so severe and last so long (all in about ten months - insert jaw-dropping emoji here - it usually clears in a couple of months) but it's cleared now and I really haven't felt this well in years. The angina, well, that was a bit of a surprise but the GTN works for me when I need it - two 'hits' and I'm good for another few weeks.
Everyone is different but it seems concerning to me at least your GTN isn't giving you the same sort of relief most people get from it (usually once a day from what I've read). What does your doctor say about you needing it so many times over a 24 hour period - he/she will be best able to let you know if your use is ok/not ok.
Look its great to walk and breath without pain and the fear of the consequences. I couldn't walk before my operation more than 50 metres without chest pains. This morning in 10 mins I will take our 3 dogs for a 2 hour pain free experience. Great to be alive to do it.
Sunnie2day I have lived with coronary vasospastic angina and microvascular angina for 8 years.
Fluffybee I believe also has been recently diagnosed with microvascular and vasospastic angina.
The advice for those of us with non obstructive coronary arteries is different. The mechanism of our angina is due to a temporary narrowing of the coronary blood supply. It is a chronic coronary angina and pain condition.
I have a confirmed diagnosis of MVA and vasospastic angin.
My Cardiologist knows and encourages me to use alternative methods of pain relief including hot water bottles, TENS machine and breathing and relaxation techniques.
I have with experience learned when it is necessary to go into hospital for treatment with IV GTN to stop my vasospasms.
To anyone who has not had a definitive diagnosis of Microvascular and or Vasospastic angina I suggest they do go into hospital for an ECG and their bloods to be checked if they have chest pain not relieved by GTN.
I experience very severe episodes of chest pain at least twice a week and I am frequently woken at night. I would live in CCU if I followed the usual advice for obstructive coronary heart disease.
Fluffybee if in doubt you should always seek medical advice.
I suggest you seek out a Cardiologist who is knowledgeable about microvascular and vasospastic angina and put a plan together with them to say when you need to go into hospital and which self help measures are appropriate for you.
I have a written protocol for the staff to manage my admissions.
Just caught up with this post. I’m similar to you with the chest pain and have had 3 admissions this year alone. Although my cardiac enzymes are elevated they do slowly normalise. This time I tried to push for a care plan as I feel I’m becoming a problem! FAT chance. Even at my discharge interview!! I was asked to repeat why I made the decision to go to A&E this time. No real explanation as to what might be happening to me and when I asked advice, it was a shoulder shrug and when pushed, a half hearted reply about not ignoring chest pain!
Have you got a confirmed diagnosis and a Cardiologist?
My Admission protocol was hard won. It was in response to the acknowledgement that I have a complex heart condition and the concerns I had raised about my care.
I usually end up in hospital for about a week to stabilise my vasospasms.
Perhaps contact the Patient Advisory Liaison service PALS and bring the issue up with them.
There is an initiative by the NHS to improve the experience we have as patients.
Never thought about PALS will contact them thanks. I rarely see a cardiologist now as I have been in Permanent A fib since 1986. Luckily there has been no worsening around the leaky valve! Am allowed to keep my GTN spray as it often helps, but my last stress test indicated that I haven’t got angina? Obviously glad that tests are good there but have had 2 strokes with good recovery, then spent last 9 months with very high bp and nothing being done until very recent. During this last incident my bp at triage was 180 but dropped in about an hour to 99. Discharge 3 days was 101/70! Just feeling vulnerable somewhat now! Regards
Hi there, I have just read your post and am confused I have been living with pericarditis since I was young now in my early 30’s and I have chronic pericarditis for the last year and have now been put forward for a pericardectomy, the other day I was taking into hospital and they used the gtn spray on me for the 1st Time it seemed to work and help drop the pain from a 7 to a 4. I asked the doctor and she said it was for angina or a heart attack and said it was no good for me even though I said it helped….. my questions are really as I regularly use a hot water bottle is that ok to do and can you use the gtn for your pericarditis. I no it’s been along time since you posted so hope you get this. Thanks
I do use the GTN when the pericarditis pain is bad and the aspirin hasn't kicked in yet - the GTN works so quickly to relieve the pain long enough for the aspirin to take effect and keep the chest pain off for hours.
My cardiologist finds the GTN success with acute pericarditis flares 'a head scratcher' as it's not supposed to work for pericarditis pain...but for me it does so he's ok with it. I should note here I also have presumed microvascular angina (MVA) - when I'm in an acute pericarditis flare the MVA seems to me to be aggravated. I report that to him and he's not sure if the GTN is dealing with the MVA pain the pericarditis brings on or if the acute flare makes the MVA worse. Unfortunately so far there is no diagnostic to determine if it's a matter of the MVA versus OR in conjunction with, I hope that makes sense.
Bit more about using aspirin to relieve pericardial pain - I do take 600mg aspirin but I have a tested and monitored high tolerance for aspirin - most people take paracetamol (which for some reason I don't tolerate well at all). Only your medic can advise regarding what pain relief to use that will be appropriate to your specifics.
Yes absolutely the correct advice if you live with obstructive coronary artery disease.
Those of us with a lived experience of microvascular and vasospastic angina often manage our angina pain differently and this is supported by our Cardiologists.
Any change in the frequency, severity or pattern of my angina pain. I will go into hospital.
Microvascular and vasospastic angina are poorly recognised and understood.
Often as a group our symptoms are dismissed as not being heart related as we have clear coronary arteries, have subtle ECG changes and slightly raised Troponin levels.
I haven't been 100% diagnosed but have had several tests (scans etc) which have shown no blockage in my main arteries. The supicion is that its microvascular angina. However I'm relatively free of symptoms, only getting pain on exertion, and it does disappear quite quickly when I stop. I count myself quite lucky for now.
Milkfairy (I think it was) sent me a paper which stated that something like 38% of all angina sufferers have no obvious blockages in the main arteries!
No, I don't believe I have seen any of those three before. I just remember a percentage of 38% ; one of the papers you have just posted mentions "about 40%".
At least I can more or less understand the third paper you linked to, unlike the other two!
It does look like progress is being made towards finding relief for MVA; hopefully the results will come in before too long!
That's very interesting. Thanks very much for posting. I don't think I'm under a cardiologist at the moment, but I'll certainly bear it in mind when i next see someone.
With your vasospastic angina, what symptoms do you personally have.
One of the symptoms is that during the night I’ve woken up gasping for breath and a dull ache in my chest, do you have the being woken up at night and need to basically gasp for breath in, very odd ?
We all have slightly different symptoms. Many of the symptoms of Vasospastic angina are the same as a heart attack or acute coronary syndrome so you need to be seen in A&E if necessary.
I suggest you keep a diary with your symptoms and show this to the doctors you see.
If you are still having symptoms I suggest you need a review of your medication.
It is also important to discuss with your Cardiologist your individual plan of care and when you need to go into hospital.
Microvascular and vasospastic angina are complex conditions and it takes trial and error to find the best combination of medication that works best for you.
Just a quick question, it seems since my amlodipine has now been increased to 10mg that I have an in the background sort of an ache in my chest, nothing horrific in anyway at all, it could be a coincidence it’s been happening since the increase but thought I’d ask if you have this or know this can happen.
I have been prescribed another calcium channel blocker Diltiaziem as well as a small dose of Amlodipine.
I do experience as someone else described a ' foot print' of pain over my chest area around my heart especially if I have had alot of chest pain. It feels bruised.
Keep a diary of your symptoms to show your Cardiologist.
There are various different medication options to try.
So if Amlodipine doesn't work for you there are other options to try.
Certainly not a silly question as I’ve just asked my cardiologist a similar question. I have RCA >90% blockage and they tried to fit a stent 2 weeks ago but were unable. I now take amlodopine and aspirin daily in addition to all the other drugs I’ve been on for 3 years. I have the same problem as you describe in that I have chest pain and breathless daily and whilst GTN works well, the symptoms return in the same day if I exercise. Exercise = emptying dishwasher, walking in the garden.
I think contacting your GP/Cardiologist is the best thing to do.
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