Chest pain made my life a nightmare

[Trinton1]

Hey everyone,

My name is Tarek and i am 36. I live in Romania, i am married and i have my own business. I am sure i am happy with my life, my wife and my work.

But 4 years ago i started to have strange feeling in my chest, like heart is jumping out of my chest, for sure i went to make a cardio checkup and they said they are pvcs and it s benign, just i need to ignore them.

3 years ago they started to be more frequent, especially at night, sometimes i was not able to sleep.

So they gave me beta blockers( metoprolol 50mg) it was ok for me, they helped me to not feel those pvcs.

But i started to feel some kind of chest pressure. In time it started to be so annoying and unpleasant.

One time i ended up in the emergency room because of a crushing pain in my chest, ecg and heart enzymes were ok.

They said i have to make further investigations.

I did heart eco and was fine, heart MRI and it was ok, Coronary angio CT revealed a small stenosis in LAD. We did an angiograph and it was 30-40% LAD stenosis, so they said i am crazy and it s not possible to have pain because of that stenosis.

After insisting, i found DC who was able to understand me, she said that it might be a prinzmetal or a microvascular angina, so i am taking Norvasc 5mg, nitrate twice, Atorvastatine, meteoprolol, plavix, Trimetazidine twice, and nitrate spray for attacks). The treatment is ok, but from time to time i get some pain which is relieved by Nitroglycerin spray.

I would like to hear also your experience with chest pain, it is a nightmare for me, i am disparate and i dont know what to do.

[Milkfairy Heart Star]

Hello Trinton1

Welcome to the forum.

The BHF has this information about Microvascular angina.

bhf.org.uk/informationsuppo...

This information about Vasospastic angina term now being more commonly used to describe Prinzmetal/ variant angina and Coronary artery Spasms.

bhf.org.uk/informationsuppo...

bhf.org.uk/informationsuppo...

Perhaps ask your Cardiologist to carry out further tests to find out what's causing your chest pain.

Beta blockers can be helpful in treating microvascular angina however they can make coronary vasospasms much worse.

I have lived with vasospastic angina for 9 years.

It can take time to find the best combination of medication to help manage your symptoms and I suggest you discuss the options with your Cardiologist.

This article may help your Cardiologist. Microvascular and vasospastic angina are known as Ischaemia non obstructive arteries INOCA.

academic.oup.com/eurheartj/...

[Trinton1 in reply to Milkfairy]

Thank you so much Milkfairy for the articles and for the support, i will try to talk to cardiologist to see what we can do, i dont think that i can do more tests because either they dont give these kind of angina any importance or even they dont believe you. My old cardiologist told me to talk xanax and to stop the other heart medicines.

[MONIREN]

It is hard living with that condition, I started my journey 10yrs ago, no family history, just diabetes. I've had all the tests, a couple of years ago, pressure tests on all arteries during angiogram , that when microvascular disease diagnosed. I have under 3 cholesterol levels, low blood pressure, but I clot. I have other health problems, but constant angina is difficult. All you can do is face every day as a new day, find something to laugh about. It must be so much harder at your age. I have a sick husband, so I have no choice but to keep going, make every day count. Take care.

[Trinton1 in reply to MONIREN]

Thank you so much Moniren, you are right i have to fight, life can be so hard and so unfair but it worth to fight to live with the family and people that we love.

[MountainGoat52]

Hi Tarek,

As soon as I read that you had your own business I thought stress might be a factor. It certainly was part of my problem which resulted in a heart attack. I was self employed for 28 years until I retired last year. I had a narrowed RCA which blocked with a clot. I was told that I would probably have been fine, but stress was overriding the effects of the medication that I was on.

Kindest regards,

Gerald

[Trinton1 in reply to MountainGoat52]

Thank you Gerald.

You are right, stress destroys our bodies and we keep ignoring this fact.

[Page12]

Hi, it's most likely that makes it worse, I my self suffer from stress due to personal issues. I say always stay in top of your health and keep being checked put when you feel its getting worse.

[Papou1]

Hello Trinton1 welcome aboard, sorry to hear of your problem with your heart. I notice that you never said if you had any stents inserted or not. during October last I had heaviness in my neck and upper chest ,not real pain just tightness and discomfort. I have suffered from HBP and LBP for a few years so I thought it was that which was giving me the neck and chest discomfort. Saw GP who sent me for an angiogram which determined that I had 80% stenosis in two LAD and aberrant artery below the top two. Surgeon gave me a choice of treatments, A. open heart surg. B. A confab with his colleague's as to what can be done alternatively. The outcome was two stents inserted via my right wrist. it was done there and then ,kept in hospital overnight and discharge next afternoon. Medication is Plavix 75mgs Bisoprolol Fumarate 2,5mg and GTN spray plus Metoprolol 50mgs 1/2 daily as required. No problems with medication, twinges now and then and BP up and down . Have never used GTN spray yet. I am 72 years young and try to lead an active life without lifting much . Please try to keep yourself active ,don*t worry unduly and you will find that life will look rosier if you try and lead as normal a life as possible . Take care ,Ischaemia is lack of O2 to the blood due to stenosis and is very common in cases like ours , you might find yourself getting out of breath sometimes take this as a sign to slow down and moderate your lifestyle.😷👍

[Milkfairy Heart Star in reply to Papou1]

Hello Papou1

There are two causes of a lack of blood supply to the heart, ischaemia.

The most common type due to a permanent blockage if the coronary arteries.

Coronary artery disease CAD

Another type of angina is caused by temporary transient constrictions of the coronary arteries due to coronary vasospasms, vasospastic angina.

The other microvascular dysfunction which is when the small blood vessels fail to dilate as they should in response to extra demands like exercise, microvascular angina.

These are known as Non obstructive coronary artery disease NOCAD or Ischaemia non obstructive coronary arteries INOCA.

Neither can be treated by stents or surgery. These are often overlooked and under recognised conditions.

The only option is treatment by medication.

I live with debilitating episodes of angina due to vasospasms in both my small and large blood vessels, vasospastic and microvascular angina.

I have just come home from a 9 day hospital stay to manage my unruly and debilitating angina.

[Trinton1 in reply to Papou1]

Hello Papou, Thank you for your reply.

Well me situation is totally different, i went thru angiography and it revealed a 30-40% LAD proximal stenosis, which can be treated by life style changes and with medicine.

[Papou1]

Hello Trinton1, This is good news about not requiring surgery. Please do try to keep to the lifestyle changes, I know it can be hard to do but persevere with doing it and remember to take your meds. Good luck and take care of yourself.