hello as per my other post but will cover here, medical therapy for me now is to be diltiazem working up to max dosage and alongside it consider an anti depressants with “anxiolytic” properties. These may be last medical hope (but they learn new stuff all the time). Surgery is extremely unlikely option in case anyone’s wondering, (my condition is in my bio).
The aim is for it to reduce cardiac strain especially for when symptoms come on due to work (this can be just low level stress like meeting deadlines which I actually used to thrive on / relished).
has anyone had experience of being prescribed anti depressants to address cardiac strain and associated chest pain etc? And did they help? Any side effects?
I haven’t researched anxiolytic properties yet so any info on this most welcome.
(again after lived experience / knowledge not medical advice).
Low doses of antidepressants have been prescribed in the past to treat in particular microvascular angina. Not so much now as they don't improve the quality of life of patients as there are so many unpleasant side effects.
There is a Prof at the Royal Brompton Hospital who used to refer to microvascular angina as Cardiac syndrome X, saying it was a benign nuisance of a condition, who is still very keen on prescribing these medications.
Patients are told they have 'an abnormal pain perception' which isn't helpful.
I was prescribed imipramine many years ago before my vasospastic angina was confirmed.
It didn't help. The side effects were awful.
It felt like I was walking through treacle.
I still had my pain, I just couldn't be bothered to complain about it anymore.
In my experience Cardiologists do not necessarily understand pain.
I found alternative ways of managing the pain of my refractory vasospastic angina.
I attended a Pain management programme.
Saw a Clinical Psychologist who specialised in Pain Management.
I use the breathing and relaxation techniques that women use when in labour.
I also use a Transcutaneous electrical nerve stimulation TENS machine.
The psychology of physical and emotional pain are complex. However the brain and body connection is much under appreciated.
Meditation, yoga, Tai Chi, self hypnosis are examples of how you can help manage stress and anxiety without medication.
Perhaps ask to be referred to a Pain Management Service.
Maybe try the medication, keep a log of how you are feeling and your pain levels and see how you get on.
There is no right or wrong way. Just what will help you best to live with your heart condition.
there are several things there I can look at as a means to manage the stress side of my situation and condition.
I’ve had reason to be prescribed anti depressants for mental health issues way before I had heart issue but the side effects put me off taking them. However I was still able to function in life and work, and I worked on “removing “ some of the things in my life that fed the depression.
now my heart condition limits my ability to function in life and work and probably has hit me harder than having the heart condition.
I’d prefer the pain management and lifestyle changes though than anti depressants and their side effects but keeping an open mind. I shall ask about pain management as a start. Thanks
I don’t know if my experience is relevant but I was prescribed antidepressants for nerve pain when I had two prolapsed discs. The pain was horrendous and I was getting no sleep. The antidepressants did nothing for the pain, and when I saw a consultant neurosurgeon he told me that antidepressants are often prescribed for pain and they don’t work. In fact he said they are only useful as a placebo
hello yes that is useful, thanks for replying, cardiologist did mention nerves. They talk really fast sometimes not sure I take it all in. The anti depressants don’t sound very promising. Pain relief is my priority as fixing the actual / underlying problem is extremely unlikely (I.e. through surgery).
Work stress - when I get back to work, I need to find coping mechanisms I think rather than meds, say no more often and be more realistic about what I can cope with as I’m often overloaded with work due to lack of resource. Thanks.
it's not unusual to find one hasn't taken in everything from a consultation. So consider asking if it ok to record the consultation, and offer to share it back with the consultant at the end. Then you can listen back and if there's stuff you really didn't understand you know what to ask next time.
My wife was prescribed the anti-depressant Amitriptyline for severe sciatic (nerve) pain. She took it for over two months but it did nothing except cause an annoyingly dry mouth. You also have to come off it slowly over a period of weeks to avoid withdrawal symptoms. She stuck with paracetamol and was eventually able to move around, which is apparently the best thing for nerve pain. She's currently free from sciatica.
thank you, starting to see probably (and should) help for it’s intended purpose to support mental health but not necessarily pain / nerve issues. The cardiologist explained it using the analogy of viagra which apparently is actually a heart med but is used for certain non heart issues due to its better known “added benefit”.
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myocarditis chest pain
Undiagnosed Chest Pain
chest pain / anxiety/ somatic syndrome disorder
progressive increasing of diltiazem dosage
chest pain triggered by walking uphill 
