hi all, I,m feeling a bit confused.

[Gigi1958]

I had HA and 1 stent (LAD) in Oct 2020. At the time my ef was 37% . I was told this was the only blockage but left with some damage to my heart. In march last year I had a heart scan and recieved a letter in May stating my heart was nearly back to normal, great news. Then in December I started to get more breathless and having heart /shoulder pain, eventually went to A&E and during an 11 hour wait I had 2 ecg,s and 2 blood tests. They told me there had been no changes in my ecg,s since my last one after HA and that troponin was only slightly raised in my blood results. They gave me isosorbide 10mgms twice daily. 2nd dose gave me an awful headache (known side effct) and the was not relieving my angina pain, which I sometimes get even when resting, I spoke with my gp who gave me Elantan 50mgms once a day. Unfortunately I am still getting some heart/shoulder pain. I also take 1.25mgms of Bisoprolol in the evening. I cannot tolerate more than 1.25 mgms because of the fatigue /falling asleep. I have also use of GTN spray which relieves the pain for a short while but it burns my mouth. So what is my next step, do I attend A&E again (I do not believe anything would be done there) or do I ask my gp to increase the Elantan 50mgs daily, even though I was told last year my heart is nearly back to normal. I am at a loss🤷🏻‍♀️ .

[Chappychap]

"I was told this was the only blockage"

You could interpret that statement different ways.

One person might say that, apart from that one blockage, all the arteries were completely clear.

Someone else might conclude that there was only one place in the heart's arteries that was fully blocked, but that doesn't rule out other places having partial obstructions. And in any case that was all based on a 2020 angiogram, so it's anyone's guess what the arteries look like today.

In addition, the statement that the heart is nearly "back to normal" surely relates to the heart's pumping capabilities. It doesn't say anything about the condition of the arteries, and it's arteries where heart attacks happen.

In any event, heart attacks aren't really caused by blockages growing in size until they completely block an artery. They are more usually caused by partial obstructions (plaque or atheroma) that burst, the liquid contents immediately solidify in the blood stream and cause a total blockage. This can happen with small atheroma or with large atheroma. Therefore an absence of large atheroma unfortunately doesn't mean a person is not at risk of a heart attack.

The only ways we can reduce our risk of future heart attacks or strokes is with medication and life style changes. Therefore we all need to maximise both of these to the absolute maximum.

So if faced with chest pains the only prudent course of action must be to seek medical assistance.

Good luck!

[Milkfairy Heart Star in reply to Chappychap]

Please don't forget us NOCADers

Those 10% of people who experience heart attacks without obstructed coronary arteries?

You can have the double whammy of a permanent obstruction in your coronary arteries and NOCAD.

Non obstructive coronary artery disease, is as my Cardiologist says a significant minority cause of heart attacks and angina 😊

[Gigi1958 in reply to Milkfairy]

hi milkfairy

I see. I get the feeling i ,ll just have to learn to live with this angina pain and hope for the best. My GP has sent an urgent referral to cardiology (3 wks ago) to see a specialist but I have no idea how long it will take.

Thanks for the info

[Gigi1958 in reply to Chappychap]

hi

I understand your point. As I said, I did attend a&e and was given nitrates which my GP increased , but i,m still having some pain. Thank you for your reply