Hello, I am new here. Hoping everyone is well 
I had a question regarding the GTN spray. I do not use it frequently however, whenever I do, I have noticed that my BPM (heart rate) accelerates quite quickly and is up and down for the first 10 mins or so. Is this a normal response to the spray as I know it causes the blood vessels to dilate?
I have vasospasm, so this is what causes most of my chest pain. If not, when should I be concerned and raise this issue with with my doctor.
Thank you.
Hello please do not wait. Speak to your GP as soon as possible.
I have just started using this the past two months and my GP told me this is ok after use ie heart rate increases.
I hope Hidden who also lives with a myocardial bridge has seen your posts and will be along to share their experiences with you about using nitrates when you have a myocardial bridge.
GTN can lower your blood pressure in response your heart rate can rise.
Maybe give the BHF helpline a call and speak to one of the cardiac nurses for more advice ?
I actually had a heart attack right after using a GTN spray waiting to be seen to in AnE. had low blood pressure and had taken 2 viagras beforehand which i did tell the medic. They still gave me GTN spray even though i had no chest pains but only fainted, wiped out and fast heart rate.They found my arteries to be crystal clear but the following week was the worse of my life. Clinging on to dear life. Had 12%ef and severe heart failure. I am sure the GTN spray had caused a negative effect and was not needed.
Now i have GTN spray for times i get chest pains but as you can imagine, i really dont want to use it
Sorry to hear about your experience. GTN and Viagra meds are known for interacting with each other. Glad your doing better now.
Viagra is dangerous
as a few have already said, it is always good to chat with your GP. In the mean time, GTN dilates the blood vessels (think of them as hose pipes if you like), as they dilate the pressure drops, so to maintain pressure, the heart (the pump or the tap if you like) need to be increased to compensate. Hope that help
hello apologies for not picking up on Milkfairy ’s mention above earlier . I was advised in September 2022 by my cardiologist not to use GTN spray ( I get angina with very little exertion and every time I start to move from sitting and increases dependent on what then do). My bridge at its deepest is 24mm over my LAD.
I also could not tolerate isosorbide mononitrate as did nothing for chest pain but caused headaches appreciating these should have passed.
Research I’ve found / was highlighted to me states nitrates are contraindicated in people with myocardial bridges as they accentuate the impact the bridge has on an artery.
The below might help as one of the most informative articles on MBs which also mentions spasms. There is a tricky balancing act as the nitrates are good for spasms I believe but to be avoided for bridges.
ecrjournal.com/articles/bri...
Wish you well.
Hi Fishface101. Thank you for your response.
I was able to speak to the BHF and they advised that the use of a GTN spray varies depending on the individual’s circumstances. They have suggested that if my cardiologist has told me to use it during times of chest pain, then I should follow this advice. I have also read online that GTN is contraindicated in patients with an MB. Despite this, my cardiologist is aware that I have an MB, so I will continue with his advice until I see him next. I do however, for the most part, avoid using the spray where possible.
My pain is there upon rest and movement and comes in varying degrees of severity. The issue is that I have vasospasm which I believe is linked to my MB. So that leaves me in a slightly tricky position, and I have not been fortunate enough to try a range of medications as most cardiologists have been unwillingly to acknowledge the MB as a cause for my chest pain and spasms.
Thank you for attaching the article, I will be sure to read into it further.
Wishing you all the best as well
absolutely always a yes to following our individual cardiologist’s advice regardless. 😊 sorry if read like I was saying should not take them.
The cardiologist who acknowledged the bridge was my third and was the only one to give this advice so it’s very very dependent on our individual cardiologist, their view points and knowledge especially when we have something out of the norm like coronary artery spasms / NOCAD / bridges.
A lot don’t think MBs can be an issue and often they are not, it’s difficult to get a definitive prognosis though but I’d be happy to message who I was referred to by above cardiologist for testing.
This finally confirmed my MB. But I was also cleared for vasospasms and microvascular dysfunction (albeit I was not given the definitive acetylcholine test).
We’re all different.
Good luck, would love to hear how you get on
I am always willing to understand other people’s experiences with MB/vasospasm/prinzmetal angina as it’s rare to come across and I am still trying to navigate how to manage mine, so I am grateful for any input really - thank you for sharing yours.
My situations a bit tricky as my MB was discovered in Dubai whilst I was on holiday. Although I have all my medical reports etc, I think where my cardiac episode didn’t happen in the U.K., it’s become challenging for cardiologists here to really understand what happened. However, despite saying that, there’s also the challenge of finding a cardiologist that’s really prepared to investigate my symptoms here in the U.K.
I would be happy for you to message me with the cardiologist/ tests you had.
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