Having being diagnosed with cardiac artery spasm which occurred during an angiogram which, incidentally, found arteries were clear I have a question.
I was on zero medication before I was admitted to hospital and now have plenty!
How do I know if the instance was a one off and I could stop the medication or an ongoing condition which needs the medication?
Normal functioning coronary arteries don't usually go into spasm during an angiogram. Nobody can say whether this was a one off event. However a severe prolonged coronary vasospasm can cause a heart attack or arrthymias.
Another way of viewing your experience could be that your coronary vasospasms have been identified, you can be offered the appropriate preventative treatment. It's an opportunity to see how you may need to alter your life style if necessary.
The cold, emotional, mental and physical stress are often triggers for an episode of coronary vasospasms.
In 2012, I was admitted to hospital with a suspected heart attack.
Because my coronary arteries were unblocked, I was told incorrectly that my chest pain wasn't heart related and I couldn't have had a heart attack.
I have just come home from my latest 12 day admission to hospital. My 16th admission.
My vasospastic angina was confirmed by an angiogram with acetylcholine during which I had spontaneous and acetylcholine induced coronary vasospasms accompanied by chest pain and ST elevations and depressions.
It took me sometime to come to terms with my diagnosis.
It felt like a grieving process at first. Why me? Anger, denial, sadness and then finally a place of acceptance.
I kept being told whilst I was in hospital that I am living with a rare, complex heart condition that Cardiologists don't fully understand.
This can increase the feelings of bewilderment and loss.
Perhaps write down all your questions and take your list to your follow up appointment with your Cardiologist.
Once again, useful information - thank you!
Begs the question though - has this condition always been there but never caused a problem before? Or did something bring it about?
Now there's a question!I had a pain in my stomach which used to radiate around my ribs and settle between my spine and shoulder blade from my late 20's.
This pain always took place at night.
Then in my 40's my pain became more noticeable. It morphed when I was prescribed beta blockers for my percieved anxiety. I kept being falsely reassured that ' no it's not your heart!'
This lead to my admission with a suspected heart attack.
I had a very stressful, physically, mentally and emotionally demanding profession. Overnight my body rebelled and told me in no uncertain terms that I couldn't carry on.
There is always a spectrum of how people are affected by vasospastic angina. Some have a one off episode but stay on medication as a preventive measure then at the other extreme people like me live with vasospastic angina that is resistant to treatment.
I truly hope you are at the former end of the spectrum 😊
Your Cardiologist seems to have recognised your possible Myocardial Infarction non obstructive coronary arteries MINOCA and coronary vasospasms.
The Diltiazem you have been prescribed is the mainstay with nitrates/ GTN of the treatment for coronary vasospasms.
Perhaps ask if you can be prescribed a GTN spray too.
Importantly you haven't been prescribed beta blockers which can make coronary vasospasms worse.
What was it that MacMillan said in the 1950s - events, dear boy events! Well an event at 3 am this morning happened - another attack - which lasted approximately 20 minutes. I still have pains in my neck, jaw and lip and around my breastbone and my heart feels bruised - again! Last night it felt as if it were in a vice. So I guess the question as to whether it was a one off event has been answered!
Meanwhile, I am still waiting for the hospital cardiologist to review and write up the MRI report and, hopefully, rule out a heart attack and definitively give just(!) cardiac artery spasm as the definitive diagnosis. Without this, the medications cannot be reviewed and further advice given!
I loathe this feeling of limbo and am unsure what my coping strategy should be if there is another occurrence!
I am sorry to hear you have had another episode of chest pain. I know it can be very scary.
I hate the episodes of chest pain that wake you from a deep sleep. When I start being woken by frequent night time coronary vasospasms I know it's time to go to hospital.
I would strongly encourage you to call 111 or 999 for further advice.
It's important to have an ECG and your troponin blood levels to check your episodes of chest pain are not causing harm to your heart muscle.
Also a review of your medication. There are other medications that you can be offered
A&E and hospital is not my favourite place either. I came home from my latest 12 day admission on Friday.
Thanks ..... if it happens again I will go to the hospital but right at the moment I just want to rest in familiar surroundings and hope that a final diagnosis comes when the consultant gets round to reviewing the MRI
Please go to hospital sooner rather than later. It sounds as though you need your medication reviewed ASAP.
A severe coronary vasospasm can cause a heart attack or arrthymias. It's not a trivial heart condition.
The reason I was admitted to hospital was to be treated with IV GTN and morphine to stop my coronary vasospasms causing these problems.
I had ischaemic changes on my ECGs throughout my admission and my troponin levels were beginning to rise.
At least ring 111 for advice.
Spoke both to hospital ward and British Heart Foundation. Both recommended a conversation with GP to increase dosage of Diltiazem. This is in hand!
My experience of over 10 years of living with vasospastic angina is that very few Cardiologists, cardiac nurses or GPs have sufficient knowledge of the condition.
Can you ring your Cardiologist's medical secretary and pass on a message to your Cardiologist?
I would still encourage you to call 111 or 999 especially if you have another episode of chest pain.
I am also surprised that you have not been advised to use GTN spray either.
You can buy GTN over the counter in a Pharmacy in the UK.
Good luck.
Thanks for that, especially the bit about being able to buy GTN over the counter. I did tell secretary and she told consultant and consultant finally wrote letter - "Reviewed the MRI and no inflammation or scar was noted, scan was normal. Reason for admission was an episode of a coronary spasm. which caused a small heart attack (NSTEMI) which thankfully has not caused damage to your heart as per the MRI"
Hopefully will see my GP tomorrow
It's encouraging that your heart attack and coronary vasospasms have been recognised.
The Cardiologist's letter suggests you have had a Myocardial Infarction non obstructive coronary arteries MINOCA caused by a coronary vasospasm.
Vasospastic angina is caused by coronary vasospasms.
I suggest you ask your GP to refer you back to a Cardiologist to review your medication to ensure you have the appropriate treatment for your coronary vasospasms.
There are other medications that you can be offered to help manage your symptoms.
Asking for a referral is a good idea - I will do that tomorrow if I get to see my GP.
Thank you for all your help and guidance - it has helped and reassured me immensely
Hi Acompletesurprise
I was told that my coronary spasm was most likely a “one off” episode because of having no risk factors for cardiac disease or conditions. I was released on a calcium channel blocker, Verapamil and told that this should ease any pain left from the coronary spasm, as well as maintain my heart rate.
Unfortunately, although I was really hopeful that it was perhaps was a “one off” episode, I have continued to remain symptomatic. I have made several trips to the hospital as it seems that the spasms that I thought were under control, are not. So for me it’s just become an ongoing process of logging my spasms and symptoms when I do have them to inform my cardiologists and doctors better on how to proceed with the correct treatment.
I have my fingers crossed for you that with your medications, you remain free of symptoms - although can be difficult with vasospastic angina and it was what you call a “one off” episode.
Thanks, but as you can see from my reply to Kwakkers below, it wasn't a one off event!
Meanwhile, I wait!
The follow-up checks are your opportunity to ask. If the medics hook you up for readings there may be an answer there.
Without wishing to be a `pain` I have kept every piece of paper since my cardiac arrest 11 years ago and cross reference with the medics when I`m there. I enjoy living and don`t need the hassle of who knows what and what aren`t I`m being told. Get my drift?
Luck always,
Frank.
What was it that MacMillan said in the 1950s - events, dear boy events! Well an event at 3 am this morning happened - another attack - which lasted approximately 20 minutes. I still have pains in my neck, jaw and lip and around my breastbone and my heart feels bruised - again! Last night it felt as if it were in a vice. So I guess the question as to whether it was a one off event has been answered!
Meanwhile, I am still waiting for the hospital cardiologist to review and write up the MRI report and, hopefully, rule out a heart attack and definitively give just(!) cardiac artery spasm as the definitive diagnosis. Without this, the medications cannot be reviewed and further advice given!
I loathe this feeling of limbo and am unsure what my coping strategy should be if there is another occurrence!
How do you deal with it?
how do you deal with the fear?
Advice about an ongoing condition 
How do I know it's \"end of life?\"
How do we get a second opinion?
