I’m a 50 year old female with CAD, only diagnosed 18 months ago (no symptoms but my older sister discovered she has severe carotid artery calcification and was advised to tell siblings to get tested) I’m on ramipril and 40mg atorvastatin as my cholesterol was high.
last night I had an awful dream and woke up feeling very odd, tight/heavy chest and a feeling something wasn’t right. Husband called 999 and an ambulance arrived, lovely paramedics did an ECG which scared me when they spent quite a while looking at it. Upshot was a trip to A&E where my initial blood test showed a troponin level of 12 which they were a bit concerned about. So kept me to do another blood test 3 hours later which came back negative. It has really scared me as by the time we got to A&E I felt ok and had convinced myself it was just the bad dream that made me feel out of sorts. I was shocked when they said my initial reading was 12. They sent me home after blood test 2 so obviously are not really concerned but suggested I ask for a calcium scan and a repeat of the CT coronary angiogram I had 18 months ago. The thing is, since my diagnosis I changed my diet, lost 3 stone, gave up drinking pretty much, did couch to 5k and now run 6k 3 times a week. So I feel I’m doing all I can, and if this was a cardiac episode should I just give up?! I’m only 50, my kids are 14 and 11 and I’m terrified of leaving them. My dad died of a HA (his 4th) at 57 suddenly which was incredibly traumatic and I don’t want my kids to go through something like that. I guess I’m looking for reassurance/advice please. Thankyou, Vicky
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But no, you should not give up, not one jot. If you had not eliminated excess booze and not lost excess weight, then your incident would have been a lot lot worse. So well done Vicky.
Keep a sensible diet.
Take exercise.
Get good sleep.
I had horror dreams for a long time after a stroke and then again after heart surgery. But the bad dreams have eased away.
Maybe you would benefit from relaxation classes. Certainly won’t do any harm.
thankyou! I’ve had weird dreams since I started on statins and sertraline but last nights was particularly unpleasant! Luckily I’ve just started a course called ‘live better worry less’ which is good timing! Thankyou for being so encouraging, I’m not going to give up
Hello
We all need reassurance I need it 24/7 if I could get it but by posting on here I hope it helps
It is awful when we have a scare it really shakes us up
You said your blood test level came back at 12 but then your second test was negative sorry if I am been a bit thick but what do you mean when you say the second one was negative that it was lower or the same ?
I would book in for those tests they advised
You have done really well losing weight , hardly drinking exercise you are doing everything you should and should feel very proud of yourself
Heart attacks and Bypasses run in my family and I have followed suite been the one to have the heart attacks and Bypasses I admit my Dad had the same years ago and he went on to live to a good age but I understand where your concerns will be coming from but remember what happened to your Dad was a few years ago I imagine now and they are now so much more advanced in how they treat things and what they do keep focused on those thoughts
You should not give up at all you have a long life ahead of you with the best professionals we have now if ever needed so you keep going you have so much to look forward to
If you need to talk or that reassurance just come on as there will be members who have so much knowledge been through similar as you that will reassure you everything is going to be ok x
thankyou bekind! So the second blood test came back negative which they told me means ‘no troponin detected’ or very minimal amounts so all clear and a good result. The earlier one of 12 really threw me as I was feeling ok and thinking I was a time waster as it was probably anxiety related triggered by the awful dream. Thankyou for being so kind and encouraging, I am lucky to have bupa cover at work so should be able to get the tests done quite quickly.
Troponin in the blood is an indication of heart damage - I believe it's supposee to be less than 5. But for comparison, my first Troponin test was 314... and the Dr said he'd seen levels between 5000 and 30,000.
So it sounds like you were definitely right to get yourself checked out, but the results coming down so quickly is a good sign too 😊
You sound like you've made really good progress so please don't give up. A lot of us come to this forum for reassurance and advice... myself included!! Everyone is really lovely and helpful!
It certainly sounds like you are doing all the right things in your life. Well done on an amazing achievement! Keep going and certainly don't throw it away now. It is important to remain positive and put this experience behind you.
I would have thought the small release of Troponin into your blood stream was down to the awful dream that you had. Stress can cause the heart muscles to release it. For most nightmare experiences I would expect that it is not discovered as people do not call the emergency services.
With regard to Troponin, you would need to see a level much, much higher than that to indicate a heart attack. But it's not abnormal with an anxiety attack (having had a few that sent me to the hospital...). Yes, definitely get as many tests as you can. CAD nearly took me down for good last year, even though I already had a few stents...yes it's stressful and worrisome knowing that you kind of have a ticking time bomb. Wondering if you should also go on aspirin and extra-high statin doses (80 mg statin + 10 mg ezemitibe)?
thankyou. Yes I wondered the same, they asked in a&e if I’m on aspirin but the cardiologist I saw last year said on balance he wouldn’t put me on it. My sister is on statins, aspirin and ezemitibe as statins alone didn’t bring her cholesterol down enough. I will ask about that too when I ask for a Review with him.
I am sorry to hear you have had such a scary experience.
I wouldn’t be too worried about theECG, it is a skill to read them and it takes time. There may have been a paramedic in training.
Most labs in the U.K. use highly sensitive troponinT (TNT) to diagnose myocardial infarction/heart attack.
I think what most people don’t understand is that for all these tests, it is normal to have some level of TNT in their blood due to normal cell turn-over, and these levels can be different from individual to individual because of genetics or current health.
As a result of 12 is borderline (14 is usually the cut off for a repeat). <14 is a very normal result in some labs.
The range of the test is less than 3 to 10, 000.
The diagnosis of a heart attack requires an increase of 20% in 6 hours. There are a few other reasons TNT could increase besides a heart attack, this is the curse of having a highly sensitive test, there are false positives.
I would still have this further investigated and see what the GP advises, hopefully you will be referred to cardiology again.
You are doing everything within your power and the medical community is getting really good at treating heart disease.
I was admitted to hospital 10 years ago with a suspected heart attack.
I had ECGs changes, showing a lack of blood supply to my heart and slightly raised troponin blood levels.
I was incorrectly told I couldn't have angina or a heart attack because my coronary arteries are unblocked.
I was later diagnosed with vasospastic angina. My coronary arteries go into transient contrictions causing a lack of blood supply to my heart. I end up in hospital about once or twice a year when my vasospasms become unstable.
Non obstructive coronary artery disease such as microvascular and vasospastic angina are often overlooked. These types of angina effect women more than men.
One of the classic symptoms of vasospastic angina is chest pain rest, especially in the night . I am often woken from sleep by a coronary vasospasm.
Each hospital has it's own reference levels. My hospital uses a level of 16ng/L of troponin T for women and 32ng/L for men.
There is growing research to suggest that any troponin blood level above 5ng/L should be further investigated.
thankyou milkfairy. That’s very interesting to read - I do really want to understand why I would have had any troponin in my blood rather than just be sent home with a shrug and ‘you’re alright now’.
What treatment are you on for your vasospastic angina? I know I have non obstructive CAD diagnosed by a CT angiogram a few years ago. I fear my cardiologist sees me as a woman with unblocked arteries and dismisses me as I’m not ‘typical’. I’d really like to fully understand my situation so I can do everything I can to make sure I stay around to see my kids grow up. I’ve got a referral to the cardiologist so will see what he says…
I have lived with vasospastic angina for 10 years, although I had my symptoms from my late 20's. I also have migraines and Raynaud's Phenomenon. My understanding is that my medication is helping to prevent me having a heart attack or stroke.
I am on a calcium channel blocker, Isosorbide mononitrate extended release tablets, GTN patches, all to relax my blood vessels and help prevent my coronary vasospasms.
Nicorandil, another anti anginal medication.
Clopidogrel and a statin.
Lansoprazole to treat the gastritis caused by the Clopidogrel.
Oxygen at night
I also use a TENS machine and hot water bottles.
Other strategies, I use are all to help manage my triggers for my angina which are the cold, emotional and physical stress.
I walk my dog everyday, practice yoga, Tai Chi and Mindfulness to manage my stress.
I suggest you ask to be assessed to determine whether you have microvascular or vasospastic angina. It's important as the treatment options are different.
Beta blockers can help those with microvascular angina but make vasospastic angina worse.
The BHF has this information about microvascular and vasospastic angina.
There are several of us on the forum who live with either microvascular or vasospastic angina, a few with both.
Unfortunately the conditions are not well understood by some Cardiologists and you may need to ask for a second opinion from a more knowledgeable Cardiologist.
They do exist. I have a wonderfully supportive Cardiologist, who listens and takes my vasospastic angina very seriously.
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Non typical symptoms of a heart attack 
Bit of a disappointment 
Update from A&E visit 
Troponin level 
Post heart attack readmission to A&E
