GTN? What to expect.

[Classicfan49]

I’ve been getting a chest pain since 1998, when I was blue-lighted to hospital, spent 5 days there having tests and then sent home after an angiogram gave me the all clear. I’ve described the pain to doctors who say it’s just like a heart attack and if it ever lasts for longer than usual I should call an ambulance.

So, for all these years I’ve been experiencing this maybe every few months, or sometimes 3 times in one week. It’s put down to some oesophageal spasm . It’s most likely to happen when I’m resting and usually it wakes me during the night.

Now that I have been diagnosed with 2 heart issues I’m wondering about this pain again! Is it angina? So, my doctor has given me a GTN spray to test it out. Used it once and I think the pain was less severe but still stuck around for its usual 20 mins or so.

Can someone who uses GTN tell me, is its effect fast and does it get rid of angina pain completely?

[Milkfairy Heart Star]

Hello Classicfan49

Has anybody considered non obstructive coronary artery disease NOCAD?

It is possible to have angina without obstructed coronary arteries.

Angina non obstructive coronary arteries ANOCA.

The causes are microvascular dysfunction or coronary vasospasms.

I have lived with vasospastic angina for 10 years. My coronary arteries are unblocked, however my coronary arteries go into transient contrictions causing a lack of blood supply to my heart. The pain of a coronary vasospasm feels like being in labour for me.

Vasospastic angina typically causes chest pain at rest, often between midnight and 6am.

GTN is helpful to help prevent vasospasms or oesophageal spasms.

The short acting spray usually works within seconds. If you need to use the spray again within 5 minutes 3 times in a row, you need to ring 111 or 999.

The BHF has this information about microvascular and vasospastic angina.

bhf.org.uk/informationsuppo...

bhf.org.uk/informationsuppo....

I suggest you ask your GP to refer you back to see a Cardiologist so all the possible causes of your angina can be assessed.

[Classicfan49 in reply to Milkfairy]

How interesting! Thank you. I hadn’t heard of that

[Milkfairy Heart Star in reply to Classicfan49]

Microvascular and vasospastic angina are often overlooked, under diagnosed and under treated.

I had a very specialised angiogram to diagnose my vasospastic angina.

Good luck!

[Classicfan49 in reply to Milkfairy]

Hmm. Interesting. Whatever it is, I've had it for 24 years and I’m still here so I try not to worry about it too much. Thank you. I’ll suggest these possibilities to my cardiologist next time I see him.

[Hidden]

Have any of the medics ever suggested that your chest pain might be gastro and not heart related? I was told I had angina some months back after A&E visits after chest discomfort but even then the cardio man wasn't sure and subsequently I have not had any symptoms, and am now pretty certain is it is related to a hiatus hernia.

And as far as a GTN spray is concerned I only used it once in hospital and it did nothing for me.

[Milkfairy Heart Star in reply to Hidden]

Interestingly it's a common occurrence for women to have their heart attacks and angina misdiagnosed as either anxiety or gastro problems.

[Classicfan49 in reply to Hidden]

Yes, exactly. They do think it’s gastro. From the oesophagus

[JonathanH]

Listen to Milkfairy! I too suffer from waking at night with ANOCA. In reply to your question, GTN doesn't work for me and my cardiologist has said that is quite common with microvascular angina.

[Milkfairy Heart Star in reply to JonathanH]

Hello JonathanH

How are you?

I hope you are managing in the heat?