Angina Question

[Smileyian]

When chatting with a lady yesterday, she advised she sometimes gets Angina almost every day when walking or even doing light housework. Is this possible and has anyone experienced chest pain to some degree or another most days. If so, how would you deal with such a problem.

[Milkfairy Heart Star]

Yes, at night too.I live with refractory vasospastic angina, vasospasms in my small and large blood vessels.

Many other people living with Microvascular dysfunction also live with frequent debilitating angina, breathlessness and fatigue too.

[Smileyian in reply to Milkfairy]

Well I did not want to question the lady who is only in her late 50's. My goodness as it must be horrific having Angina everyday, no matter what the type. It must be so scary for you. Once or twice a week is bad enough - you must have a lot to endure if you have most days and some nights as well. Than you for answering Milkfairy.

[Sunnie2day in reply to Smileyian]

Mine was every day (also the breathlessness, etc) until I went on Bisoprolol 1.25mg once a day. The beta blocker very nearly stopped my angina in its tracks, I only get it now when it's very hot and/or humid, or when I've accidentally been exposed to mould.

I've been tentatively diagnosed with microvascular angina, in part after my angiogram and right heart study showed 'crystal clear' coronaries and owing to my near-immediate excellent response to the beta blocker.

The only anomaly for my case of presumed MVA, I'm told, is my having problems in heat and humidity - it's my understanding most people with MVA suffer more during cold weather. I'm the opposite - summer is not my friend. Perhaps that's down to recurrent pericarditis on top of the presumed MVA, my cardiologist says he can't say for sure.

[Smileyian in reply to Sunnie2day]

Thank you Sunny. The lady I was chatting to was absolutely correct then. I did not realise some folk had Angina every day hence my education on these matters continue. I am also on Bisoprolol 1.25mg daily but as advised in earlier posts, my pain only lasts a matter of 10 to 20 seconds then subsides hence no time to pull out the GTN. Tks for taking the time to answer and educate me further.

[Sunnie2day in reply to Smileyian]

We've talked about that 'flash angina' before - I get it when hot/humid/mouldy/walking too fast without a warm-up, and like you, it's usually here and gone so quickly I don't have time to spritz (NitroLingual 400). Not always, there have been a couple of times the angina pain hits and stays around long enough for me to get the GTN out, uncapped, aimed and spritz. But most often it's too fast to react to with the spritz.

I try to shrug it all off telling myself we're all different with some similarities to make it all that much more interesting 😜

OH HEY - totally off topic, apparently now we can add photos to posts in a discussion, not just the header discussion starter!

[Milkfairy Heart Star in reply to Sunnie2day]

Oh how exciting. Totally off topic here's one of my strategies of managing my pain.

Millie sitting nicely not chasing the ducks in the pond behind her😂

[Sunnie2day in reply to Milkfairy]

As she is part of your strategy for heart pain management, I don't think that photo is off topic in any way Blimey, she's grown and nice use of the new feature (photo adds), too!

[lettingoffsteam in reply to Milkfairy]

She's gorgeous!Definitely good therapy having her.

[Smileyian in reply to Milkfairy]

Marco ..... after Marco Polo

My Cardiac Therapy Dog x 3 walks per day. Hahaha

[Handel in reply to Smileyian]

Marco is brilliant. Good to have a furry friend xxx

[Handel in reply to Milkfairy]

Millie's gorgeous!!! xxx

[Sunnie2day in reply to Milkfairy]

Every time I look at her I see the 'I'm being so good but it's definitely a struggle with those tempting ducks just behind!' look in her eye

[Smileyian in reply to Sunnie2day]

Tks Sunny. Good Title "flash angina". Fell asleep last night so read again this morning.

[Sunnie2day in reply to Smileyian]

'Flash' just describes it so well, doesn't it - it is a flash of pain and is gone within a nano-second.

Your cardiac therapy dog is a proper stunner, he looks so healthy and am I seeing hints of chocolate colour in his coat? It's hard to tell from the photo, is he toy or standard? Either way, he's gorgeous

[Smileyian in reply to Sunnie2day]

Large toy 8 years on Christmas Day. Wow good spot - yes a tony chocolate.

[Smileyian in reply to Sunnie2day]

I have always read in heart literature and even told by a cardiologist that chest pain lasting 1 or 2 seconds is highly unlikely to heart related. In spite of that, both of us seem to encounter the very short pain you have called "flash Angina".

[Sunnie2day in reply to Smileyian]

I wonder about that as well but my cardiologist is quite sure what I have is MVA and definitely heart related, possibly owing to what he calls an exceptionally strong heartbeat and is why I've responded so well to the beta blocker - it calms my heartbeat (except when I move too quickly or it's hot-humid-mouldy) which in turn means much less angina pain.

He says he can't be certain until I can get in there for the definitive diagnostic (angiogram with acetylcholine provocation) but he thinks my heartbeat causes and cures the clenching action at the same time (except under heat and humidity conditions, when the pain is long lasting and resolved by the GTN and removing to a cooler drier environment), if that makes any sense reading it rather than hearing and seeing it in person - he used a clenched fist to illustrate. At first the clenching is caused by the heartbeat 'surging' then the surging almost immediately 'pushes through' and causes the unclenching. (wow, that is almost exactly what I understood him to say but I'm still not sure that makes much sense just reading it rather than hearing it).

[Smileyian in reply to Sunnie2day]

Hahaha..... the A test will hopefully confirm or otherwise.

[Milkfairy Heart Star in reply to Smileyian]

Ian there is also a group of patients who have ongoing angina following stent insertion and open heart surgery.

Here's a patient's story from the BHF website.

bhf.org.uk/informationsuppo...

[Smileyian in reply to Milkfairy]

Will read with interest when hp charged

[Smileyian in reply to Milkfairy]

Thank you so much for sending me the link to Jenifer Waller's story and her MVA diagnosis. Extremely interesting and fantastic to read she now has a very acceptable lifestyle. My wife and I were wondering at what stage in our conversations we should start paying you "Consultancy Fees". 😂

[Debtyd in reply to Smileyian]

Hiya..im only just turned 50 and verbally diagosed with angina a year ago.i nrly got the all clear in Sept til I had standby angiogram.i had been struggling breathing on even the slightest exercise I constantly have a kind of winded feeling and feels like my throat has pressure being applied to it kinda like the top button of a shirt that's getting too small lol.ive never had chest pain as such..angiogram diagosis was mild narrowing of 1 artery and 1 completely blocked artery close to the valve..after almost 3hrs in theatre i had 2stents in but I still feel that strangling feeling almost all the time.sometimes it lets up but not for long.ive recently had chat with surgeon who's quite happy to put a stent into the slightly narrowed artery and see if it helps at all...but it's horrible being youngish and active to such restrictions of movement.so here's hoping it helps a little...oh and my gtn pump hardly does anything for me.i think I hope it will lol also the cold actually makes My symptoms worse...and I hate the heat 😁x

[Smileyian in reply to Debtyd]

Interesting post Debtyd. I am a little surprised a heart surgeon would suggest stenting mild stenosis in your artery. Generally the guidelines would be to stent a 65 -70 percent blockage and above, unless there were individual specific circumstances. The breathing discomfort is indeed a horrible feeling so I hope all goes well in your follow ups.

[Debtyd in reply to Smileyian]

they were going to originally take me in for a bypass if they couldn't get past the blockage..im not exactly sure if I'm honest why..but I can tell you it's been a horrible journey from January til Oct...they missed the blockage completely from echocardiogram and ct angiogram...as well as rewarding me with a "contrast extravasation "they said that mild narrowing could be seen but to what extent they were unsure and gave me a list of meds to put me on and said I should hopefully get better.those meds I was already on and double the dose.so I asked if there was anything else they could do for me...and surgeon called me and said they would perform standing angiogram and I'm so thankful they did.the blockage took as I said,almost 3hours to unblock and put 2 stents in they were going to stent the other one but I have a feeling that they didn't want to put my body under too much more stress at once.the blockage was quite solid so I was told and something that had occurred slowly over many years..again I had a murmur detected at age of 15 but local ECG wasn't a cause for concern. I gave up all the good things I liked a long time ago smoking caffeine greasy foods etc..im so glad I did.I also sometimes sleep well propped up which does help by the way...hope that helps if you don't already.tc x

[Smileyian in reply to Debtyd]

Indeed a very comprehensive posting which I now fully understand. Rather alarming that the could miss so much but thankfully you persevered and hopefully a positive outcome is just down the road. Quite a shock for someone just turned 50 and so glad you are making progress, albeit slowly. I am 77 and extremely disappointed that I have 2 stenosis, but they are apx 48 and 50 pct hence no stent as blood flow more than adequate. FFR 93 and 87 and LVEF 61. However I have symptoms of short pain, problem with hills and unexplained breathlessness from time to time. They suspect MVA or other Variants. Take care and get well as much can be done these days for even the worst case patients.

[Hidden]

I'm the same. Simple answer is I just live with it. I use my Gtn spray when it's bad. That can sometimes wipe me out for a day or more. I've just had an mri scan that lasted over an hour and I'm waiting for the results so hopefully I'll know what's causing it all soon.

I'm on loads of medication, 10m amlodopine, 10m ramipril, 7.5 bisoprolol to name but 3 of them...

You live with it is the simple answer. I don't let my heart issues define me. I respect my illness but I'm more than it 👍😊.

[Smileyian in reply to Hidden]

My very best for good results.

[Mallowme in reply to Hidden]

Interesting to learn that gtn wipes you out. I feel the same and avoid using it unless really struggling. I love the comment that you don’t let your heart issues define you. That’s what I hope to achieve in time. Xx

[4Stents4me]

Hi,

I also had angina from walking or light exercise, it was the trigger for me go the GP and start the investigations. I didn’t know at the time it was angina, it turns out in needed 4 stents. Like many on this forum I take regular medication but apart from that everything is back to normal with the exception that I now regularly train to maintain my new found cardio fitness. Hope those chest pains are investigated soon

[MichaelJH Heart Star]

I am sure I would have suffered angina from narrowed arteries daily if I had not been on anti-anginals. Typical ones are Isosorbide Mononitrate and Diltazem (a CCI - calcium channel inhibitor).

[Subo21 in reply to MichaelJH]

Hi Michael sorry for the long post in advance. I have just read through this chain in Angina as I also suffer but wanted to reply to you as you have been the only person to mention the isosorbide mononitrate. As mentioned I also have coronary artery disease, heart failure after an MI in 2017 with 4 stents in RCA had 6 segment damage with right longitudinal problem and LSVD which was severe but now improved to moderate. Had plenty of the normal symptoms from HF breathless, fatigue, dizziness etc. but I didn’t really suffer angina as such for couple of years but then started experiencing problems on exertion at different levels sometimes walking going up the stairs etc. I was sent for a Pet CT scan which showed lack of oxygen reaching part of heart on exertion and turns out my RCA needs another stent and my Lcx is partially blocked (which knew before but not bad enough to stent) so when do angiogram/angioplasty are going to check that again. I was supposed to have Angiogram done early January at Barts but was cancelled due to Covid so waiting for new date when things are better. I am on Aspirins 75mg

Ramipril to 10mg Rosuvastatin 40mg

Furosemide 40mg Spironolactone 25mg (half tablet)isosorbide mononitrate 25mg

GTN spray Lansoprazole 30mg

Asthma and other meds for different medical problems.

My question to you is did you find the isosorbide mononitrate made a big difference to you and your capabilities of exercise and general energy levels ?

[MichaelJH Heart Star in reply to Subo21]

Hello.. No worries about the long post. It's the ones with minimal detail and a throwaway "usual drugs" that become difficult to answer. My pre-bypass situation was obviously rather different to your current one. I found Isosorbide Mononitrate quite effective at preventing angina unless you pushed it! It can also be taken twice daily seven hours apart (to prevent nitrate resistance developing) or in an Extended Release format. I found Diltazem slightly more effective as an anti-anginal but at the cost of feeling washed out at times!

[Subo21 in reply to MichaelJH]

Hi Michael thank you very much for your reply., I am on the extended release format of isosorbide mononitrate and have found it has certainly helped with my angina. I have still needed the GTN spray on occasions but have felt the benefits of these medications. I also wondered if these are a long term medication or only until stent treatment if you happen to know ? Also appreciate your comments on Diltazem too. Thanks again

[MichaelJH Heart Star in reply to Subo21]

Hi... There is no simple answer. If stents are applied to the most affected arteries there is a chance of sufficient atherosclerosis for angina to remain but after harder exertion. I never had stents as an angiogram showed I had four arteries between 70% and 85% (the LAD) blocked. It was felt that with calcification and some awkward locations a bypass was more appropriate. After surgery the Isosorbide Mononitrate was stopped, Lisinopril reduced, Atorvastatin increased and Bisoprolol introduced. The Atorvastatin was reduced within weeks as my liver didn't like it and my Lisinopril further reduced last year because of hypotension last year.

[Subo21 in reply to MichaelJH]

Thanks Michael, appreciate our situations a bit different and pleased you had your bypass successfully and meds adjusted accordingly. I suspect that my meds will be adjusted after the further stents procedure too then. Thank you again for your help and wishing you future good health.

[Pete-Benje]

I get chest pain on exertion still waiting for tests,

[Smileyian in reply to Pete-Benje]

Good luck with the tests.

[MichaelJH Heart Star in reply to Pete-Benje]

Have you been referred to an Urgent Chest Pain Centre? And how long have you been waiting?

[Pete-Benje in reply to MichaelJH]

yes,I have been there waiting for heart stress tests