I managing Angina with justb medicines ever succesful?

[mrpetethomas]

I have just been told that I have Angina and following a CT Scan that my small artery is 75-90 percentile for blockage. My father had heart disease and went through the whole process of medication, angioplasty and bypass over a period of 20 years and had problems all the way through until the bypass. I have been prescribed the usual Statins, Aspirin, Beta Blocker GTN and this has reduced the attacks to around 1 a day. So my question after that rather long preamble is should I be pushing for a stent or even a bypass asap? Are there people on here who have successfully managed ANGINA with medicines?

To add to the above my Angina comes on at rest between 10pm and 6am.

[Milkfairy Heart Star]

Hi mrpetethomas

Welcome to the forum

You maybe interested in the results of the Ischemic trial which showed that treating angina by medication can be as effective as by interventions such as stents or bypass

nejm.org/doi/full/10.1056/N...

Has anybody considered vasospastic angina as a cause of your angina?

With this type of angina the person experiences chest pain at rest usually in the evenings and at night.

The BHF has this information about vasospastic angina and Microvascular angina which effects the small vessels

bhf.org.uk/informationsuppo...

bhf.org.uk/informationsuppo...

[mrpetethomas in reply to Milkfairy]

I'll give the study a read, My Angina has been described as UNSTABLE which I think is the general term for vasospastic/Prizmetal etc... what I haven't been able to find out is whether there all the same/

[Milkfairy Heart Star in reply to mrpetethomas]

The BHF has this information about angina.

bhf.org.uk/informationsuppo...

Unstable angina is a referred to as Acute coronary syndrome. It can be due to obstructive coronary heart disease or vasospastic angina.

Vasospastic angina is the term nowbeing used to describe Prinzmetal / variant angina/ Coronary artery spasms.

It is a type of non obstructive coronary heart disease also called Ischaemia non obstructive coronary artery ( INOCA)

You can have vasospasms in your small vessels microvascular angina.

The symptoms of unstable angina and vasospastic angina are very similar.

It is important to go to hospital to be assessed if you have ongoing chest pain at rest or chest pain which is not relieved by several sprays of GTN.

[Milkfairy Heart Star in reply to Milkfairy]

My links keep being missed off

Here's the BHF info on Angina again

bhf.org.uk/informationsuppo...

[Milkfairy Heart Star in reply to Milkfairy]

Here are the Ischemia trial links again

medscape.com/viewarticle/92...

nejm.org/doi/full/10.1056/N...

[mrpetethomas in reply to Milkfairy]

Thank you for all the info I am hoping to talk to a consultant this week after having the CT scan. With the COVID situation it is a nightmare getting things going. Apart from the disease itself I am interested in the restrictions I am a traveller with expeditions planned in The Artic and Gobi Desert which may involve flights tho it us possible to do them overland.

[Milkfairy Heart Star in reply to mrpetethomas]

One thing to consider is perhaps the triggers for your angina?

The cold, emotional and mental stress as well as physical exertion can cause problems.

I suggest you keep a diary of your activities and symptoms to see if you can find a pattern.

In particular the time of your chest pain and if it is at rest.

Discuss this with your Cardiologist when you speak to them.

I hope you get the answers you need. It can take time and a process of trial and error to find the best treatment that will work best for you.

This is especially so if your chest pain is caused by microvascular dysfunction or vasospastic angina.

Good luck

[mrpetethomas in reply to Milkfairy]

yes I have considered this, I have led a very fit and active life and have always been given a good heart health at healthchecks so I am wondering whether it is a reflection of stress and anxiety brought on by the lockdown and additionally my son having a mental health crisis.

[Milkfairy Heart Star in reply to mrpetethomas]

I am so sorry to hear about your son. I hope he is getting the help he needs.

I was very fit too before I was diagnosed with vasospastic angina 8 years ago.

The trigger was the stress of my job and bereavement.

I hope you can find some time for yourself something that can be difficult when you are caring for someone else.

[mrpetethomas in reply to Milkfairy]

Are you managing it with medication or gave you had Angioplasty

[Milkfairy Heart Star in reply to mrpetethomas]

Vasospastic angina cannot be treated with a stent as it is due to a transient temporary narrowing of the coronary blood vessels.

The only treatment option is medication.

I suggest you discuss your CT angiogram results with your Cardiologist.

Do make sure you mention your chest pain at rest between 10pm and 6am, this is a significant symptom which you need to tell your Cardiologist

[mrpetethomas in reply to Milkfairy]

thank you MilkFairy I have now got an appoinment with my consultant who wants to do various tests to establish whether the Angina is brought on by spasm or the blockage. I'll keep you posted.