Angina spasms

[Finn-]

I had been on Isosorbide Mono-nitrate ER 30mg taking half pill in the morning and the other half in the evening. This kept my angina spasms in check for about a month. Then, I started having minor spasmodic feeling close to the evening dose. We have since upped the dosage to full 30 mg in the am and 15mg in the pm, but the feelings persist. Anybody with similar situations?

[Hidden]

Hello

I just packed in the isosorbide mononitrate after two and half weeks as gave me horrific headaches and didn’t do much for my chest pain, but I did had some strange sensations and I was exhausted. I was on 30mg in the morning.

I also felt my blood pressure was all over the place. I’m relieved to be off it.

Although the chest pain is back😔 back to square one.

Hope you find out what’s causing them.

[Finn- in reply to Hidden]

Thank you. I dealt with the headaches which went away after a few weeks. What may I ask are you taking now?

[Finn- in reply to Hidden]

Sorry about the pains. Hope you find a solution and relief from the pains soon.

[Hidden in reply to Finn-]

Thanks nothing at present waiting for cardiologist, he just said to stop. I found the headaches weren’t easing, but I’d have carried on though if he’d told me I had to persevere but it wasn’t doing anything for chest. He’d implied it was going to be a trial and error approach regards meds 🤪 I’ve also read nitrates are a contraindicated in myocardial bridges in that they exasperate the effect of the MB on blood flow. It’s hard to know what’s right.

[ba69]

Hi FinnI managed through the headaches, still stomach upset as I have Colitis but am having similar experience, nearing end of first month and having flutter, sob and shaky, will have to go back to GP , don't want to up dose and not looking forward to trying another new med. Hope your symptoms settle.

[Ghost-233 in reply to ba69]

Hi ba69. I have also been taking Isosorbide but after a few months have reduced the dose to 15mg a day. Like you I have Ulcerative Colitis and have been having lots of issues regarding that since starting Isosorbide. At the same time I was also started on Clopidogrel and Metoprolol so really not sure what’s causing me to feel shaky anxious headache and stomach problems. I have an appt with my GP next week to discuss it all.

Hope you find a solution please let me know.Sorry Finn for hijacking your post and I hope you find the right dose to help you.

[ba69 in reply to Ghost-233]

Hi Ghost-233Sounds silly but it's good to know someone else has same problems and I'm not going mad. I hope you get some help at your GP appt, if I find any solutions will let you know 🙂

Finn, I hope you find a balance that helps.

Thanks ba69

[Finn- in reply to Ghost-233]

No need for an apology. we are all learning from each others experiences.

[Clerkenweller]

Yes. Even when I got 60 mg (30 and30) I was getting minor angina attacks both day and night. Consultant added amlodopine at night and I take the IM breakfast and lunch. Haven’t had any attacks for over two years. Back in gym and very well (for now!).

[Finn- in reply to Clerkenweller]

Glad to see you have found a balance for your angina. I was on Amlodopine and Toprol XL. They caused severe dizziness that I had to stop.

[Milkfairy Heart Star]

Hello Finn,

When you say angina spasms do you mean coronary vasospams, vasospastic angina?

I live vasospastic angina which is resistant to treatment.

I take 60mgs of isosorbide mononitrate extended release tablets at 6pm and 11pm

20mgs of GTN patches at 6pm.

I am also on other medications to try and manage my vasospasms. Calcium channel blockers and nicorandil.

You can develop a tolerance to nitrates perhaps discuss with your doctor about an alternative timing of when you take your tablets.

[Finn- in reply to Milkfairy]

Yes it is the same thing as you call it. On this side of the pond, my cardiologist are calling it Micro Vascular Dysfunction/Angina. I could not tolerate Calcium Channel Blockers (Amlodopine) at all. Developed extreme dizziness.

[Milkfairy Heart Star in reply to Finn-]

Microvascular dysfunction causes Microvascular angina while coronary vasospasms cause vasospastic angina.

They are related but distinct types of angina/ ischaemia non obstructive coronary arteries ANOCA/INOCA.

I live with vasospastic angina, my coronary arteries go into transient contrictions rather than Microvascular dysfunction when the small vessels fail to dilate in response to exercise etc.

Have you had any testing to determine what type of ANOCA you have?

It's important as the treatment options are different.

I was assumed to have microvascular dysfunction at first and prescribed beta blockers which are contraindicated if you live with vasospastic angina.

I ended up in hospital.

I had an angiogram with acetylcholine which confirmed my vasospastic angina.

There is some developing research that suggests that nitrates are not always affective in treating microvascular angina while they are the mainstay for vasospastic angina.

The BHF has this information about microvascular and vasospastic angina.

bhf.org.uk/informationsuppo...

bhf.org.uk/informationsuppo....

You might find this website helpful. It was written by 4 patients with over 50 years combined experience of living with microvascular and vasospastic angina. They are supported by 30 world expert Cardiologists.

One of whom is Prof Roxana Mehran the lead author of the Lancet Women and Cardiovascular Disease Commission Report published last year.

internationalheartspasmsall...

Where in the US are you based?

[Finn- in reply to Milkfairy]

Thank you for the extensive education. I will be sure to consult the resources you have so kindly provided. I have a appointment on the 15th with my cardiologists and will be sure to discuss these with him. I am in eastern Pennsylvania.

[Milkfairy Heart Star in reply to Finn-]

I will send you a message

[LSCE]

Hello,

I'm on ISMN too I take slow release 60mg once a day. Worked well for a few months then angina attacks started again. I was started on a calcium channel blocker and this has helped.

[Finn- in reply to LSCE]

Thank you. I keep hearing about the Calcium Channel Blockers. May be I have to go back on them and hope to get over the dizzy spells as I did with the headaches caused by the Isosorbide.