Diagnosed with coronary artery disease and unstable angina feel anxious

[Arty56]

Hi all, I have cad and unstable angina, I was diagnosed 18 months ago. I'm on the usual meds statins, calcium channel blockers, beta blockers, aspirin and, my gtn spray which I can't do without... I feel I was diagnosed, which was a shock and then left to fend for myself, I feel alone in all this, I have other symptoms and take other med for my stomach, osteoarthritis and anxiety and depression. I cannot walk much now and get out of breath easily and suffer from heart palpitations, the angina attacks come on with no warnings, I'm not exerting myself I can be quite still and they come on, iv been to hospital a few, times when my spray didn't work, where I thought I was going to die, the pain was very bad. Every day I worry about the attacks, but, try to carry on. For instance last night I woke up shouting with pain I couldn't move the osteoarthritis in my foot was so painful, i have pain meds and water by my bed, so took them and just kept crying out and moaning until the meds made me sleep. Then I have the angina waking me up, which is horrible and frightening, I don't want to wake my children up, so I sit up take my spray and just hope it works, if I av to take the second lot, I'm already thinking about what to do next, recently I my spray worked on the third lot of sprays, did I feel scared. Iv been waiting to see my cardiologist for ages now must be a year.... The doc chased 3 times now covid they cancelled appointments. I don't like the docs or going to hosp and I know I should chase them. I know I am worse, I can't walk I shuffle after abit. Is it me or are we left alone? Or have I had bad luck with my cardiologists I'm in Shropshire. I don't sleep much and I fight depression every single day, if I let up it does overcome me, it does wear you out fighting the depression, I do succumb....... Iv only been fighting it for two days now, its constant my mind is full of everything, my chest is tight as usual, does anyone else feel like this?? I'm a 57 year old woman with older teenagers. My life and my plans which I have studied for a long time are ruined now because I know I haven't the energy or health to do the job I wanted to do, it's very disheartening and I'm wasting my life in my bedroom but still trying to care for others.

I know it's a long post. Thank you for reading it, if you stayed with me, lol take care xxx

[Kristin1812 Heart Star]

I’m sorry you are having such a tough time. I am afraid it’s true, we are rather more alone with our Heart issues now, than we were before Covid.

Even then, i found it was a rather lonely experience. But do persist, and still try and get your GP to work for you, getting Cardiology advice.I notice you have both unstable and stable angina. Mine always says it’s the unstable that she’d like to get under V good control.

I guess this may sound obvious, but I found it much easier to get a grip of the stable bit! More predictable ...so pacing myself better, helped a lot.

EG Exercising with a slower start and working longer not harder.

I’m afraid unstable angina can be really unnerving, mine has taken lots of drug juggling (they’re still doing it!) But it’s lots better.

I’m replying at some length, (please dont read if it’s off beam) But I wanted you to know you are not alone, and it’s not at all easy.

For me, what helped most was adopting a kind of persistent problem-solving approach , so eventually I felt I had a little bit more control.

Do tell us how you get on.

[CarlGreen]

Hi Arty56

Hang on in there, it will get better, Time is the greatest healer of all.

I know its easy to write words and that its not easy to allay your fears, but speak to your doctor, they are the most qualified to help you.

My Aunty used to say A Squeeky Wheel Gets Oiled......so if you don't feel your getting any where with your GP or Cardiologist, make some noise!

Good Luck

[Milkfairy Heart Star]

Hi Arty56

I am so sorry to read your post.

How has your coronary artery disease been diagnosed?

I live with unstable angina too. Mine is due to the blood vessels in my heart going into spasm,

Vasospastic angina.

I get woken up at night too.

It is important to tell your GP, Cardiologist and A&E doctor you are having pain at rest.

I love CarlGreen's Aunty's advice

' A squeaky Wheel Gets Oiled......so if you don't feel your getting any where with your GP or Cardiologist, make some noise!'

Go and make some noise you are absolutely worth it!

[Imin]

It’s awful to read you are struggling so much. And just as awful for you to be feeling alone.

I love CarlGreen’s Aunty’s saying that a squeaky wheel gets the oil!

I had a HA with two stents fitted last September and I’m now on the usual meds...Statin, Asprin, Losartan, Ticagrelor, Bisoprolol and Omeprazol. The Ticagrelor is well known for indigestion and acid reflux therefore given Omeprazol. Will stop the ticagrelor in September so really hoping that will relieve the chest pain I have for a good proportion of the day - if that is the cause I may be able to stop or reduce the Omeprazole.

Since I exercise daily and run 5k regularly with no pain on exertion the cardiologist said it was not angina or cardiac related pain. I had a stress test and echo last week which I paid for privately. The private consultant asked for symptoms, one of which was that I fight through extreme tiredness every day which I had been putting down to daily chest pain. He suggested stopping the Bisoprol since my blood pressure is quite low at around 95-105/58-65 and my heart rate was around 48-55 throughout the day, lower at night. For days 2 & 3 after stopping Bisoprol I actually thought he had cured the chest pain but on day 4 it came back but I do have lots more energy with BP staying where it was and heart rate only increasing to around 56-65 through the day, again lower at night. I have everything crossed that stopping the Ticagrelor will relieve the chest pain in 44 days time. If no better though, my GP has suggested the pains could be caused by the atorvastatin so she will play around with that once we have ruled out the Ticagrelor being the cause.

My first point to this lengthy post is that you are not alone. There are plenty of us on here, each with our own journey that will have had to have been navigated! Some routes are easier than others. - I was getting nowhere asking for someone to help with the chest pain I was experiencing so ended up writing to my GP and the cardiologist detailing my symptoms and pressing that they were impacting on my quality of life, therefore impacting on my children’s quality of life. The cardiologist telephoned me emphasising that he would be amazed if the chest pain was due to angina since I don’t experience it during exercise - he did not offer any suggestions as what could be the cause but advised me to go and live a happy life with my family and try not to worry. The GP also telephoned and explained that she will play around with my meds if symptoms persist after I stop the Ticagrelor.

My second point is that I was that squeaky wheel - I made a noise in the form of a very detailed letter asking how I go about asking for a second opinion (after already setting the wheels in motion with my husband’s private health care providers he has through work which includes his spouse and children so I am lucky in that respect as my work does not afford such luxuries!)

My letter and request prompted two phone calls and the cardiologist now agreeing to do a stress echo which I will be having next week! So now I am awaiting the written report from the private cardiologist, the GP to play with my meds if symptoms continue after stopping ticagrelor and the NHS cardiologist has agreed to investigate further to at least rule out angina.

I certainly am not going through what you are but I really hope you take CarlGreen’s advice and make some noise!! Our NHS is a wonderful thing and it went against every grain in my body to go privately but I was at my wits end and it was upsetting me seeing my children so worried about me. As wonderful as the NHS are we all need to take some ownership of our own health and help the medics out by expressing as clearly and as loudly that is needed to help them to help us. I know this is easier said than done when you feel you’ve said it all before and no one is listening but they are - they are under a huge pressure right now!

Good luck! I wish you well with your journey and hope to read soon that you are feeling better and that you have got somewhere with your doctors 😊

PS Sorry if I have waffled...you may have given up reading by now!! 😂

[Milkfairy Heart Star in reply to Imin]

Hi 1min

I have the answer to the Cardiologist below

'The cardiologist telephoned me emphasising that he would be amazed if the chest pain was due to angina since I don’t experience it during exercise - he did not offer any suggestions as what could be the cause but advised me to go and live a happy life with my family and try not to worry. '

I can exercise, I have chest pain at rest.

I was repeatedly told I couldn't have angina. I do, Vasospastic angina as my coronary blood vessels go into spasms. It is often overlooked along with microvascular dysfunction both are more common in women too.

[Imin in reply to Milkfairy]

Thank you Milkfairy. I’m amazed anyone read my full post!!

Can I ask how those conditions are diagnosed and what the treatment is?

I have read your posts and wondered! Do you ever get chest pain during exercise?

I didn’t have any usual angina symptoms before my HA, certainly no chest pain so am very disappointed that I didn’t come out of the Cath lab feeling like a new woman as promised...rather a more poorly woman! The private cardiologist did say that sometimes, very rarely, a body just doesn’t take well to the stents inserted and the affected artery cannot dial ate and construct as it once did! Does that mean I just have to live with chest pain for a considerable amount of every day? He did ask if I can function normally throughout the day, ie can you cook, clean, wash and dress, go to work which I do and more but I have to do it with pain!

Thanks for taking time to read. I eagerly await your reply as I have read a lot of your posts and you seem very knowledgable on the subject.

[Milkfairy Heart Star in reply to Imin]

Hi Imin

Tucked away in the European society of Cardiology's guidelines for the management of chronic coronary syndromes is this information section 6.2

'Vasospastic angina should be suspected in patients with anginal symptoms occurring predominantly at rest, with maintained effort tolerance. The likelihood of vasospastic angina increases when attacks follow a circadian pattern, with more episodes at night and in the early morning hours. Patients are frequently younger and have fewer cardiovascular risk factors than patients with effort angina, except for cigarette smoking.

Coronary vasospasm should be also suspected in patients with patent coronary stents and persistent angina.'

academic.oup.com/eurheartj/...

I feel that Cardiologist underestimate how pain can impact on the quality of their patients' lives.

I suggest you ask your Cardiologist to read the ESC guidelines for Chronic coronary syndromes.

The latest ESC guidelines about the diagnosis and treatment of Microvascular dysfunction and vasospastic also known as Ischemic non obstructive coronary arteries (INOCA) is in this link.

academic.oup.com/eurheartj/...

These are complex conditions that until very recently have been over looked.

There have been some recent developments and Microvascular dysfunction and vasospastic angina can now be diagnosed during a specialised angiogram.

[Imin in reply to Milkfairy]

Thank you. It’s very kind of you to take time out to send me all this info. It makes for very interesting reading! x