Angiogram with Acetylcholine and Guidewires

[Mutley20]

Hi,

I wondered if someone could kindly let me know their experiences of this test. I have had an angiogram before which was normal. I have now received a date for this procedure and worried how I will cope.

Thank you very much.

[Sunnie2day]

I found it not much worse than the standard angio I had a few years ago, at the same time as that angio I also had a right-heart study (more wires) and had spasms during the last part of the simultaneous procedures. However, the spasms weren't painful, owing to being heavily medicated after I told the cardiologists doing it all that I would be 'eternally grateful' if they would give me the maximum pain and anxiety relief, lol! (It worked, I knew I was having spasms but the meds meant all I felt was pressure, not pain).

During what I call the provocation angio, I was told meds might interfere with accurate results. I decided any pain experienced would be worth getting a diagnosis, and I told myself if I became 'too uncomfortable' (hahahahahaha) I was in the right place to get quick attention. Talk with your consultant to see if he/she will give some meds and why not should that be the answer given when you ask - it does help has been my experience.

In the end, yes, it was a little 'uncomfortable' but doable and I got through it thanks to mentally preparing myself. Everyone is different in how they prepare mentally for a procedure that may cause 'discomfort' to achieve a diagnosis but in my case I found the above prep sufficient to the need.

[Mutley20 in reply to Sunnie2day]

Hi,

Thank you very much indeed for your reassuring response. I feel much better about the procedure following your reply. I hope you are now OK.

With thanks again and all the best.

[Sunnie2day in reply to Mutley20]

I'm doing reasonably well, all things considered (slowly slowly slowly recovering from an extended recurrent pericarditis acute flare), thank-you

Everyone really is different as to how they experience the provocation angio but hopefully your experience will be like mine - please update us after yours.

[Mutley20 in reply to Sunnie2day]

Many thanks Sunnie2day. You really have helped put my mind at ease. Take good care of yourself and thanks again.

[Milkfairy Heart Star]

Hello Mutley,

I had my angiogram with acetylcholine in 2014.

Firstly, I live with vasospastic angina which is unfortunately very unstable and difficult to treat.

I mentally prepared myself, as I anticipated the procedure would be uncomfortable. I had chest pain during my very first ' normal ' angiogram.

My coronary arteries are so trigger happy that I had spontaneous and acetylcholine induced coronary vasospasms during the angiogram. I was given morphine to help with the chest pain which was about the same as my usual level of pain.

What I found difficult was having to lie flat. I just breathed my way through it all. The morphine helped me stay even calmer.

The Cardiologist talked to me throughout. He asked for the morphine quickly for me as they could see the ST elevations and depressions on my ECG.

I hardly had time to say I was in pain before they gave me the IV morphine.

I don't regret having the test done. It gave me an accurate diagnosis, the information gained helps me and my Cardiologist understand my angina.

I was able to take early ill health retirement, successfully apply for my PIP and co produce my admission plan to manage my severe episodes of angina when I am in hospital. The oncall Cardiologists don't dispute my diagnosis anymore.

Before my confirmed diagnosis I had been told I couldn't have angina and the pain was in my head.

I end up in hospital once or twice a year for treatment with IV GTN and morphine to stabilise my coronary vasospasms.

Good luck with the test, the knowledge gained for me out weighed the brief discomfort that was quickly managed with morphine.

[Mutley20 in reply to Milkfairy]

Hi Milkfairy,

Many thanks for your helpful response. I feel much better knowing that you had a successful outcome following on from this procedure. I am rather claustrophobic but hopefully with the aid of something to keep me calm I will be fine. I hope that it will provide the definitive diagnosis that I am missing. Hoping you are currently in good health. With many thanks again I really appreciate your time in sending me your experiences. With best wishes,

[Milkfairy Heart Star in reply to Mutley20]

I hope you get a definitive diagnosis too!

Do say how you get on.

Where are you having the testing done?

[Mutley20 in reply to Milkfairy]

Hi,

Just to thank you again for your advice. I had the angiogram in Scotland and now diagnosed with vasospastic angina. It is a great relief to have a definitive diagnosis. I am getting quite a lot of chest and jaw pain and wondered if you experience this once it gets colder. The verapamil has been increased to 720mg a day along with Nicorandil, Isosorbide and statin. I am having a difficult time at work which is not helping.

I hope you are well and thanks again.

All the best

[Milkfairy Heart Star in reply to Mutley20]

I am so pleased to hear that you now have a diagnosis. I felt a relief to know what causes my chest pain.

My main triggers for my vasospastic angina are the cold, emotional, mental and physical stress.

In the cooler months I wear many many layers. I look like a Michelin man!

I cover my nose and mouth with a scarf before going out in the cold.

You are covered under the Equality Act and can ask your employers to make reasonable adjustments to your workplace environment.

I suggest you ask your Occupational Health department to make a formal risk assessment and recommendations about which reasonable adjustments can be made for you.

Take care of yourself.

[Mutley20 in reply to Milkfairy]

Hi,

Many thanks for your email. I certainly feel cold more and get more discomfort in cold weather. Unfortunately work is difficult as I am being bullied by a 26 year old and not supported by my boss despite having a share in the business. It has been very stressful and I have been told my pay will be reduced due to sick leave (6 weeks this year). I am thinking about a claim on insurance but not sure if condition is serious enough to warrant claim. I am sorry to sound feeble but I do feel a bit overwhelmed and angina is not making things easy. I am concerned about increasing verapamil to max 960mg a day.

Your advice has been super helpful and I am very grateful.

Take care.

[Milkfairy Heart Star in reply to Mutley20]

I am sorry you are facing these problems.

Stress certainly doesn't help anybody. Coming to terms with any life changing diagnosis takes time. It can feel overwhelming I agree.

Have you been able to talk to your GP? They maybe able to refer you for some psychological support.

Vasospastic angina is a serious heart condition.

I had poor support from my manager, who when I was given ill health retirement said 'oh this heart condition of yours, it serious then'