Would like some help, in understanding what Im going through, and if its in relation to my recent visit to a&e. So early Oct ending up in a&e with pain in left arm and chest pain, and the hospital ruled out a heart attack.
So diagnosed with angina, and prescribed medication, spray, aspirin and statins, and would be referred to outpatient department, currently been waiting 8 weeks
Was still going into work, and guess it want the best thing for me, as found myself exhausted, and getting pain in left arm, and chest pain. The spray did help me, but after a few days, felt it made things worse. So was signed of work sick my my Gp, just told to rest, which helped me greatly, and now hardly get any chest pain, but
When Im fully rested after a good nights sleep, no pain in left arm, not even chest pain, or exhausted. I will go out for a hour walk, mostly to get groceries, and dont have any issues of the first 30 mins
30 min into my walk, I slowly get pain in left arm, and over the last few weeks, my left arm goes numb, and soon find myself exhausted. Once home and rested usually pain in arm, and numbness will ease of, but sometimes, I now get numbness in both arms, more so if really tired
The odd day, especially at night time, I find myself so exhausted, my body just feels so heavy, and both arms are numb, I have to lie down, for a sleep. I will wake up around 4 hours later, and arms are no longer numb
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That's the problem with angina, the symptoms can accelerate very quickly. One day you're living your life without being aware of any problems, the next day you can't mow the lawn or carry the hoover upstairs without taking a break.
We're lucky to live in an era where stents and bypass surgery are now standard procedures. For our parent's and grandparent's generations angina meant the boundaries of your life would just continue to get more and more restricted, until you were virtually bed bound.
Another reason to feel fortunate is that the relationship between angina and heart attacks is actually much looser than you'd imagine. Basically the plaque that grows in our arteries can be of a stable or an unstable variety. If yours is stable then you can have really severe angina but the plaque is unlikely to burst. Other people however have no angina symptoms, and relatively little arterial blockage, but their plaque is more prone to rupture which is what causes a heart attack. Incidentally, a by product of statins is as well as reducing lipid levels they also stabilise plaque.
A few years ago I had angina that was every bit as severe as yours. Following open heart surgery (and a root and branch review of my life style) I'm fitter and stronger than I've been for twenty or thirty years. In fact I'm dashing to finish this post as my wife and I are leaving soon for our Tuesday night Salsa class. I can dance till the small hours, bang out eighty press-ups, swim for hours in the open sea, and walk all day at a cracking pace. And before long you'll be doing exactly the same!
Not all angina is due to permanent blockages of the coronary arteries.
Microvascular and vasospastic angina are much more common than previously thought. These types of angina are often overlooked, undiagnosed and under treated.
I had a STEMI 2.5 years ago. They could not insert a stent because of the width of the coronary arteries. They managed to clear the clot partly with a balloon and partly with drugs. A year later, I had an angiogram and the arteries are clear. I have exactly the sort of symptoms you describe to this day. The cardiologist puts it down to some form of non obstructive artery disease probably microvascular angina. For which there is no interventional treatment just drugs. e.g. Ranolazine which I gives me more symptoms than the angina.
Hi Richard I had 3 stents fitted in Sept 2022 after HA in July 2022. I am getting pains in both arms. I am on the usual meds. Ramipril Ticagrelor Bisoprolol Asprin GTN spray. I was wondering what changes were made to your meds to improve your condition
Some of the meds were changed to alleviate digestive symptoms (Atorvastatin from 80mg to 40mg lansoprazole to Famotidine, stop the clopidogrel and to stop me feeling like a zombie (Bisoprolol from 2.5 to 1.25mg).
This was done after a year
I had an angiogram a year after the HA. It showed no blockages in any of the coronary arteries.
However I am still suffering from chest pains if I exert myself for an hour or more. The cardiologist thinks they are caused by microvascular angina (blockage of the small vessels rather than the main coronary arteries (LAD, RCA etc.)) since the angiogram showed that the main arteries are clear. An angiogram is the gold standard for diagnosing obstruction of the main arteries, but does not directly show the state of the small vessels.
The cardiologist suggested Ranolazine for the angina. This med also is said not to lower your BP which other nitrate based meds do. For me that's good since I have low BP.
I think you should try to get your cardiologist to find out if you are indeed suffering from Ischemia, and if so if it's "normal" angina or one of the variants. If it's normal there might be some sort of intervention which can be done. Looking at your post, you don't seem to be on any anti anginal medication, so maybe that's the starting point. Does the GTN help when you get an attack? if so that's a good clue about what might be happening.
But remember I'm not a doctor, so write down your symptoms and see a doctor
Hi Richard Thanks for your detailed response. The cardiac nurse also advised to use GTN spray to relieve the pain. I tried it whilst she was on the phone. I couldn't really say if it had gone. Anyway I have tried it a few times. But the pains keep coming back. She said if it does they need to see me. At the moment it is very confusing.
I'm not a medic, nor do I have any medical training.
I think your description of symptoms could apply to Thoracic Outlet Syndrome (TOS). You might know of this already and have had it ruled out. A good physio can test for the presence of TOS; it takes a minute or so.
If you've not already been tested, it could be worth you having a word with your GP or a physio to get a qualified opinion. I don't recommend self-testing for TOS, it's wise to be tested under medical/physio supervision.
I hope you soon find some answers and feel better.
I had an extra left cervical rib which caused Thoracic Outlet Syndrome which was operated on in 1999, 2 years before my double bypass. Recently I’ve experienced chest and arm pains which I believe is due to a reoccurrence of my TOS but have also been diagnosed with micro vascular angina. I wake up with pain and numbness in my left arm/hand and it’s also exasperated by previous exercise. I’m currently doing Silver Swans but it’s becoming more painful when I do arm movements. See your GP and get assessed properly.
I’ve degenerative arthritis in the spine and neck. It causes pain in the neck, shoulders and upper arm. Also intermittent numbness in the arm and fingers. Problems with the cervical spine is known to mimic chest/cardiac pain. It’s important to get a proper diagnosis. But numbness is possible muscular skeletal from somewhere.
Same here, herniated cervical discs, very severe arthritis i left shoulder, moderate in right shoulder. COnstant pain and coldness in left arm but it's not the same pain as when I had a heart attack. If GTN helps then it is likely angina but I'd get neck and shoulders checked just in case. MUsculo skeletal pain is very similar to heart pain
i'm not going to add to the info on potential causes etc but would like to offer a suggestion, based on my own experience
if you get chest and arm pain 30 minutes into a walk maybe you could plan shorter walks for the time being - the pain indicates that your heart is struggling to keep up with the physical activity you are doing. Maybe you could try shorter walks, but more often. This would allow your heart to recover between the bouts of activity.
I know that we are always urged to exercise more and keep active, but angina is a sign that the heart is suffering and until you get a full diagnosis and more effective/supportive treatment it might be best to stay within your limits and avoid demanding too much of your heart
i know it's hard to slow down, even just for a while, but your heart does not seem to like what you are trying to do just now
I hope you get your appointment and more effective support soon
To that excellent advice I would add that cold weather /low cloud narrows the arteries and if they are already at the limits of coping then this might cause the symptoms you describe. Generally I find that once warmed up-a bit like a car-the smoother and easier I can travel
Always check with drs or hospital. Don’t assume anything. As a ‘first aid’ trained I would ring 999 if someone said this as I’d want to do the right thing. Left arm pain and chest to me says heart attack, I’m not qualified to diagnose.
I’m also a trained Complementary Tferaof 25 yeas with A&P
Just to update on my current health, and any progress being made
As of 15 Jan 2023, I'm still waiting on a proper diagnosis, to determine what is causing my current problems. Based on my visits to A&E, I have now been waiting around 12-14 weeks, but my out-patient appointment should be due
I see my doctor every 4 weeks, which is basically to renew my sick line, and discuss how I'm doing. There no real change or deterioration in my health, and things are more or less constant
So currently waiting for Glasgow Health Board to send me an outpatient appointment
hi.. woke up last February with really bad keft arm pain radiating from left side of chest and shoulder… definitely wasn’t heaviness or numbness… called 111 and they dispatched an ambulance… was told tropinin was 13 but i wasn’t having a ‘full blown HA’.. kept in overnight and released next day.. before i left i was asked by medical consultant to describe the pain.. which i found hard to do.. God forbid it happens again.. but if it does .. now in hindsight i know it was a painful squeezing type pain.. not heavy or numb.. plus i’ll ask if not a ‘full blown HA’. what exactly is it lol
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