H/A Then Angina

[tazcat123]

Hi guys, newbie here

I'm just coming up to the first anniversary of my ha and stent (I'm 55). A few months ago I started to experience chest pain upon exertion, so my doctor has put it down to angina and given me a gtn spray (which I have to use occasionally), and also isosorbide mononitrate to go with my ever growing cocktail of drugs. the isosorbide does a wonderful job of keeping the pain away but I do get really breathless if I do too much too quickly, even a flight of stairs can be a challenge ! Has anyone else experienced angina after a ha where there was none before. I'm currently speaking with my doctor in the hope of a nuclear scan and stress test. I've read quite a few times online that after their ha and stent, they feel like a new person, but quite honestly, I don't. In fact, along with the fact that I cannot go as fast as I used too, I feel like I've aged somewhat in the last 6 months or so.

[heartsonfire]

Hello tazcat123,

One of the cocktail of meds that you’re now on is likely to be a Beta Blocker, most commonly prescribed one appears to be Bisoprolol in different amounts from 1.5mg upwards. This keeps your heart beating at a steady pace, really no matter what you want it to do, so any more exertion that would normally raise your heart rate so you get more oxygen into your blood, then into your lungs, doesn’t really happen that way anymore. However having said that I wouldn’t have thought a single flight of stairs would be too taxing.

Definitely time to contact your Cardiologist, if possible, as you must also be due an annual review, and hopefully they’ll get to the root of the fairly recent changes you’re experiencing.

Good luck and I’m sure you’ll get more replies/info from other members of the Hearties.

[tazcat123 in reply to heartsonfire]

Thanks for that heartsonfire, I'm on 10mg Bisoprolol, 80mg Atorvastatin, 7.5mg Ramipril, 75mg Aspirin, 15mg lanzoprazol, 60mg Isosorbide and 75mg Clopidogrel (which I'm due to finish next month). My resting heart rate averages out at around 60 at rest. I had blood test last week but got called back in again for a repeat as my potassium level was low. Not sure why that is because I have quite good diet. If they say that its just a consequence of the ha, I can live with that. I'm just worried that something else might be brewing without anyone realising.

[heartsonfire in reply to tazcat123]

Some of the meds you’re taking will deplete your potassium levels, bananas,mushrooms, broccoli and kale, not necessarily together may be enough to help. I take a diuretic every day with Irbesartan for my BP and my potassium levels drop too.

The Bisoprolol will definitely be keeping your heart rate down, the isosorbide keeps the arteries open wider, the clopidogrel helps your blood not be too sticky after stent are inserted.

Your cardio nurse or specialist should be made aware of your breathlessness though and it’s probably time, as you said, for another echo or ECG to see what’s going on.

[Chappychap]

Are you overweight? Do you smoke? How active are you/were you before your HA? What's your diet like? Do you drink much? Do you sleep well? Would you say you're stressed, either at work or at home? Any family history of heart disease?

[tazcat123 in reply to Chappychap]

Hi Chappychap. I'd say that I was slightly overweight but not too much. Don't smoke, diets good, activity levels....well my job sorts that for me as I work in a very busy factory doing 12 hour shifts. I sleep like a baby and the only stress I have like many, is work. As I recall I do believe I have lost a couple of relatives years back to ha's but with advancements made since then I'm sure if they were still around, they might have stood a better chance.

[Chappychap in reply to tazcat123]

I"m not a doctor so I can only share my experience. But here's my totally unqualified thoughts!

Your angina isn't going away. If you were obese or smoked 60 a day then tackling those issues might materially reduce your angina symptoms. But you're not way out of shape, and you're already on the full cocktail of medication. So right now there's not too much more that the doctors can do.

Are you at a sky high risk of a heart attack? Actually the correlation between stable angina and heart attacks isn't as close as you might think, so as long as you take some sensible precautions (ie, actually take your meds-about 30% of people don't, eat a decent diet, don't get consumed with road rage ten times a day, etc) then as long as your angina doesn't change into the unstable version then your odds aren't all that bad.

But as you say, it's like waking up to find you're turning into an old man.

I was slightly older than you when I was diagnosed with angina. Even though I'd previously been fairly fit and active, I'd just assumed that feeling tired on walks was an inevitable part of approaching 60. However my angina was a bit more advanced than yours, so I ended up having a heart bypass operation.

But here's the thing. It was absolutely transformational. Sure, the first few weeks afterwards weren't a load of laughs. But overall it was like Clark Kent going into a phone box and emerging as Superman! Okay, maybe that's going a bit far, but I now feel twenty years younger with loads of energy.

The problem you face is that it's unlikely the doctors will be in any rush to go to surgery. And indeed you may well feel the same way (I know I would have done if I'd have had the choice)!

In the short term I'd say you should focus on trying to push back the restrictions of angina just as far as you possibly can through a combination of life style changes and tweaking your meds. But if your angina doesn't respond then at some point there'll probably have to be a surgical intervention, maybe stents, maybe a bypass. All I'd say is that knowing what I know now, I wouldn't be too alarmed if your consultant's recommendation was for a bypass.

Good luck!