Angina. : Having had a nstemi on 13th... - British Heart Fou...

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Angina.

Smerblue profile image
15 Replies

Having had a nstemi on 13th May yesterday I had what felt like another to be told by the hospital that it was angina, being treated with meds. It was identical symptoms and my gtn spray didn't work and my TropT levels did not rise. If Angina is narrowing of the arteries is this a Heart attack in the waiting?

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Smerblue profile image
Smerblue
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15 Replies

The bad news is all narrowing of your heart arteries could cause a HA, as can other conditions. But by far the better good news is your heart condition has been identified and under the care of health professionals and mostly yourself the risk can be managed through medication, diet, exercise, and other things such as body weight management, and alcohol reduction and smoking cessation if those apply. I can't comment on your angina, you will have to rely on the diagnosis and recommendations of the health professionals whose care you are under.

Smerblue profile image
Smerblue in reply to

Thanks. I have a chemical stress test on 31st so I'm hoping they will have a better idea of what is going on.

MONIREN profile image
MONIREN

Angina is scary, but medication goes a long way to help your heart. It's frustrating when you don't feel right, you want a solution, don't want that pain or anxiety. They are doing their best. Try to keep calm, troponin level is their best way to diagnose you. Don't hesitate to ask for help. Ask for a cardiac nurse contact number, I still have contact with mine from 2011. She checks in with me, has all my records, she is very reassuring, and gives me advice. I can phone her, usually if she isn't there, she will contact me as soon as possible. Take care. Moni

Smerblue profile image
Smerblue in reply to MONIREN

It's nice to hear you have been going since 2011. I had my first stemi in 2019. 2 stents then two more fitted in 2020 then the latest just this month. It feels like a fight all of the time. It's difficult to know what to do as both heart attacks have occurred after either gym session and boot camp and I don't drink or smoke. Although I do have the occasional choc hit and not the good dark stuff. Thanks 👍

Chappychap profile image
Chappychap

It's a great question but it's more complex than that.

Don't forget something like half of heart attacks occur in people with less than 50% arterial blockage. That's actually quite tricky to even detect!

Conversely there are plenty of people on this forum who have been diagnosed with 90%, 95%, or even higher levels of arterial blockage, but have never had a heart attack.

The reality is that some people are prone to have arterial lesions/plaque which are prone to bursting therefore causing heart attacks. And other people seem to tend toward arterial lesions/plaque that are stable and resistant to bursting.

Just to go back to your point about being treated with medication. Yes, medication is critically important. But you actually have two weapons in your armoury, medication and life style changes. To really improve your odds you need to use both these weapons to their absolute maximum effect.

Good luck!

Smerblue profile image
Smerblue

Thanks Chappychap. You have set the gray matter turning. I have been watching videos on vitamin D and very low carb diets, mainly American doctors. They seem very passionate about the benefits of this but I'm gonna have a chat with my cardiologist on 31st. Thanks again.

Mountwood profile image
Mountwood

Good morning Smerblue. I had what sounds like a similar incident to yours 3 weeks ago. My GTN spray didn't work so I pressed my alarm but was told there would be a 45 minute delay for the ambulance, by which time my symptoms had faded (angina in my jaw and facial bones, pressure in my throat, and a lump of lead in my chest) so I foolishly cancelled the ambulance. I won't do that if it happens again. For the next 2 days I had no more angina etc but just felt ill and very tired so I spoke to a doctor, not my own GP who was unavailable, and he thought I could have had a mild HA 3 days before, and packed me off to the Medical Assessment Unit where I had an ECG (normal apart from my usual LBB) blood tests (Troponin negative) CXR (normal) and was told by a doctor who listened to my heart through my clothes that it was "just" angina. It was nothing like my normal angina and I will see my GP this week. An angiogram years ago showed that 2 small branches of my L coronary artery were blocked but not badly enough to warrant any invasive treatment and I've been taking Bisoprolol and Monomil ever since.I'd be very interested to know what symptoms you had during your incident. Good luck with your investigations.

Nettekin profile image
Nettekin in reply to Mountwood

Hi mountwood. Apologies for jumping in but your mention of pressure in your throat struck a chord with me. This was pretty much the only symptom I had prior to my ha nearly 3 years ago. A consultant in hospital agreed it can be a symptom but I have struggled to find any mention of it anywhere else since. When I had the same feeling last year I had a telephone consult with my GP who said it was just a virus and could I look in the mirror and see if my throat was red?!II still have the feeling on and off, but haven't really tried my gtn for it. There are no other symptoms and after 2 stents I am ok.

Best wishes x

Mountwood profile image
Mountwood in reply to Nettekin

Thanks for your reply Nettekin. It's interesting that you had the throat pressure. I'm going to reply to Smerblue so can I include you in that?

Smerblue profile image
Smerblue in reply to Mountwood

Hi Mountwood. I started with indigestion type pains, I took some gaviscon which didn't help. I then started to get cold sweaty hands and chest pressure. Two lots of GTN and no change so called ambulance. The symptoms settled down about an hour later whilst in hospital, at this point I'm sat on the bed feeling as if I've wasted the medics time, but what can you do? I too have two blockages in lower branches which are not able to be stented. I have been feeling very tired, sleeping a lot, and just not right since my nstemi 2 weeks ago. Hope you get sorted with your GP.

Mountwood profile image
Mountwood in reply to Smerblue

Thanks for replying Smerblue. I felt cold, but not sweaty, I just didn't feel well, and for the first time ever the angina started while I was sitting down doing nothing. The pain extended from my jaw up to my facial bones followed by the surge of pressure into my throat and the feeling that someone had dumped some lead on my chest. Two sprays of my GTN did nothing so I pressed my alarm. All the symptoms gradually faded and the whole thing lasted about 30 minutes and I am still feeling very tired and not quite right.The hospital doctor was prepared to just say it wasn't a HA and leave until I stopped him and asked if not a HA, what was it? His answer was "just angina". Plainly, I was wasting his time. I hope you get sorted too.

This bit is probably of more interest to Nettekin. When I was 12 it was discovered that I had a congenital diaphragmatic hernia which began to bother me during my teens. During a meal I would get a tight pain around my lower ribs with pressure rising through my chest into my throat, the same pressure I felt during my recent "angina" but without the chest pain. However, I had not felt this for 20 years, after the hernia was repaired. Investigations of breathlessness revealed that my stomach, part of my intestine and a kidney were in my chest, compressing my left lung, and my heart was displaced to the right. Surgery put things back where they should be and a Dacron patch repaired the hernia, but one complication was atrial fibrillation. An MIBI scan showed that I had a fixed perfusion defect in septum, anterior wall, and apex and apparently I had had a heart attack at some time. For 20 years I have not felt that pressure in my throat. When it happened with angina recently it took me right back to my pre-op days and I wondered if that pressure all those years ago was the HA I didn't know I'd had.

If I ever get to see a cardiologist I'll ask about throat pressure and HAs. I hope you keep well.

David-75 profile image
David-75

Hey Smerblue, sorry to hear about your continuing issues. My understanding (which might be wrong?) is that Trop T levels are the main indicator of a HA; so hopefully that is a good sign. Sorry to hear you are having continued issues. I am replying because I am looking into the low carb thing too- not sure how far I can go with it, but I can reduce them. As it seems you have been doing plenty of reading just thought I would mention Dominic Cummings - the fat emperor. He is very much aligned with the lob carbs ,low sugar ; Keto style of diet- and that heart events are inflammation caused by spikes in insulin rather than to do with cholesterol. There are some very interesting podcasts which highlight how Pharma and governing bodies of food sectors have shaped the current approach to treatment. However I still think this points to the Med diet overall ( which I think is pretty low carb anyway) - but trying to avoid too much sugar. Another factor is including things like Vit D that you mention and also CoQ10 ; the latter apparently was to be added in the original statin patent but was removed!….apparently statins lower your coq10. Just a few things to look into- you will have the same issue as me and others though - how far do you go down the rabbit hole with these studies? ; there is living to be done but no harm in slightly adjusting your approach. Exercise wise, I don’t do HiT or boot camp kind of things anymore - I don’t go for the burn!… I would probably be ok, but perhaps my body is not at 47 supposed to be pushing it that hard for short intervals (even with warm up and warm down). I miss the competition of sport, but i am lucky in I generally seem to be not having many issues ( and as you know I have 5 stents). Lots of walking for me, reasonably fast occasional 5k running, body weight and dumbbell exercises. Perhaps more lower state cardio was missing for me?… just a few rambling thoughts. Hope you have a more settled summer mate and can get out and enjoy some natural D 😉

Smerblue profile image
Smerblue in reply to David-75

Hi, I've seen some of Domini Cumming's stuff. He is very easy to understand and talks sense backed up with facts. I know it's a minefield and you can finds information to back up any argument, there is just something that hits a chord with me about carbs and their link to heart disease. I have just signed up for a two year medical test on a drug called Dapagliflozin which is used to treat diabetes and has reduced the reoccurrence of heart attacks so they want to try it on people without diabetes. Should be interesting. Keep well.

David-75 profile image
David-75 in reply to Smerblue

Yes- I feel the same about the carbs. As much as I was/am fit - I did love my carbs and it is the only thing I can really point to in my pre-HA nutrition that stands out. However, like you say- there is evidence pointing in most directions if you look ; and I am not sure keto has been shown as a beneficial longterm diet option - which leads me back to the Med diet. A source of frustration for us all - but I am yet to see a simple table tallying the research and evidence for the various approaches ; as cynical as it is- people are still making money from this (including Cummings and all other authors etc) - so it is a minefield for us to navigate.

David-75 profile image
David-75

I should add and I know you will of course- but check all that vitamin stuff with your cardiologist.

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