Yet another trip to A&E. Fortunately spasm didn't result in increase in troponin levels so after monitoring me for entire day recommendation was to add isosorbide mononitrate to daily cocktail of drugs.
I have three questions please:
1. Has anyone struggling with this condition found an ideal cocktail of drugs which minimise the reoccurrence of the spasms. I have now had 3 since I left hospital just over a month ago. (Currently I am taking ramipril, Lansoprazole, Diltiazem, Clopidogrel, Atorvastatin, Asprin and Glyceryl Trinitrate as and when a spasm occurs. Suggestion is to add Isosorbide Mononitrate to the daily cocktail.)
2. Can anyone recommend a specialist in the Cambridge area which understands this condition and can genuinely help?
3. Immediately following a spasm I continue to have chest pains, neck pains and a numbness around the mouth and nose. Is this the same for those of you who also struggle with these spasms?
Many thanks in anticipation that someone out there can help!
Written by
Acompletesurprise
To view profiles and participate in discussions please or .
I am sorry to hear you have been back in hospital.
I am into my 11th year of living with vasospastic angina which is sadly resistant to treatment. I spent 12 days in hospital in February on IV GTN and morphine to settle my unruly coronary vasospasms.
It can be trial and error to find the best combination of medication that will work best for you.
The usual treatment offered
calcium channel blockers such as Diltiazem.
Isosorbide mononitrate extended release tablets.
Sublingual GTN spray and GTN patches.
Nicorandil is another option.
I am on clopidogrel, however not aspirin as it can cause vasospasms in some people.
Statins help to improve the function of the inner lining of the blood vessels.
Medication is only part of the treatment.
Lifestyle factors are important too.
How we approach our new life and learning to live with a challenging heart condition is something we all have to work through, when faced with a life changing diagnosis.
I suggest you keep a log and see if you can spot any triggers of your angina episodes.
Common triggers are the cold, emotional, mental or physical stress.
I keep warm. I manage my stress by practicing Tai Chi and yoga.
I also use a Transcutaneous electrical nerve stimulation TENS machine and hotwater bottles to help manage my pain.
I will experience a delayed response to exercise. I completed my stress echo without problems then got chest pain afterwards.
I have learned to pace my activities as a result.
I rest in the afternoons if I need to.
Exercise is important too.
Have you been offered cardiac rehab?
After a severe prolonged episode of coronary vasospasms, my heart feels bruised and I feel a lingering imprint of pain.
The forum guidelines ask us not to name individual doctors. I will message you the details of a specialist who hopefully may be able to help.
This website may help, it's written by patients for patients.
There is a section about triggers and coping strategies of living with coronary vasospasms.
Many many thanks! I thought you might be the first to offer help. One of the most puzzling after effects is the numbness in my mouth and nose - the hospital was equally puzzled by this one but A&E didn't have a cardiologist available so the comment came from a generalist.
I felt like there was a link between migraines and vasospasm. After my coronary spasm, my migraines have been awful to the point where they cause vomiting. They easily last 3-5 hours now. They are horrible.
No. My GP doesn’t feel like my migraines take place as often as they should to be concerned about them. I usually have a severe one which keeps me in bed half the day once a month.
"To be eligible for this treatment you must have headaches for 15 or more days each month, with migraine headaches being on at least eight of these. You must have also tried at least three other medications to prevent migraine before this treatment is prescribed for you."
My Neurologist knew because of my vasospastic angina. I can't have the usual medication for migraines such as beta blockers and triptans as they can make coronary vasospasms worse.
I don’t know how I feel about getting Botox if that ever was an option. My GP does not choose to treat my migraines with any medication. Naproxen was prescribed and I was quickly taken off it. I believe it was either interacting with my meds or had some link with a possible worsening of my angina.
If you have a heart condition you are advised not to take non steroidal anti inflammatory drugs NSAIDs.
I started having botox in June last year and it has helped reduce my neurological symptoms.
I have an ice pick headache, numbness to the left side of my face and arm, along with sensitivity to light and sound when I have severe episodes of vasospastic angina.
When I am in hospital I cover my eyes with a scarf, wear sunglasses and use sound cancelling headphones.
The staff turn off the main lights when they can. They always try to warn me before turning the lights on so I can cover my eyes.
I think I also have vasospastic angina,but did not have an angio .I spent 8 hours in ER 2 days ago with severe chest pain .The nitro spray did not help and actually made my chest pain worse ! I was unable to tolerate Diltizem and have no meds . My ecg and troponins were normal so I was discharged. Today after a short walk , I developed chest pain , arm pain and sweating and then felt as if I was lost and detached ! It lasted about 30 minutes and I was very tired ,but back to baseline . All of this to say that the symptoms are terrible and unpredictable. Good luck and hope you feel better .
Hi since having a heart attack last July & being diagnosed with prinzmetal angina. My angina doesn't stop spasming, I only have to move. So between heart foundation website, facebook, my gp I take the following 2 x nicorandil at 7am
2 x nicorandil at 4pm
1x 60mg monomil (isosorbide) at 8pm
This covers me for 24 hours but if I walk fast or move about quick I have a gt spray. After 5 days in work I get spasms even when I'm sitting so I have to regulate my activity levels on the weekend so I can go to work in the week. I also have to go to bed for a couple of hours when I get home in the evenings. This condition has changed me from someone who didn't sit down to a mess!
I am paying to see a specialist in Glasgow in a few weeks (I live in wales) because they are few & far between. I was recommended a Prof Perera @ st.Thomas but he doesn't do private & my gp can't refer me. But your gp might be able to. Look on St.Thomas website his secretary contact details are there. Good luck, it's a long road!
You'll find that the specialists now use the term Vasospastic angina rather than Prinzmetal angina.
The definitive way to diagnose coronary vasospasms is if during an episode of chest pain that certain ECG changes are seen, or a vasospasm is seen during an angiogram.
The other way is to have a functional angiogram when the way the blood flows through the small blood vessels is measured, to detect microvascular dysfunction then acetylcholine is used .
Normal blood vessels should dilate in response to acetylcholine if they constrict accompanied by chest pain and ECG changes then vasospastic angina is diagnosed.
The forum guidelines asks that we don't name Doctors directly on the forum which is why I usually message directly recommendations of whom to see to forum members. I believe I did this for you too.
I also give links to the research being carried out and try to point people in the right direction to find a hospital where I know there are supportive Cardiologists.
Hi there, I also suffer with coronary heart spasms, I was diagnosed 3 years ago after a heart attack to the LAD, my medication is a cocktail of aspirin, candasartan, tildiem 400 (dilitazem) atorvastatin, GTN spray, omeprazole, I find in the winter months I can have spasms a few times a wk, occasionally they get so bad I need a trip to A&E, I was there 3 weeks ago, I was having really bad chest pain, it was more like a crushing pain and I had numbness in my face, which I’ve only been getting the last month or so, my BP was 187/45 (crazy BP) for a few hours, Triponin levels were fine, Dr did lots of tests for stroke, because of the facial numbness, but all well there! Dr was happy to send me home after many hours of monitoring BP ( which eventually came down) and more bloods etc, I called my consultant’s secretary next day and I have an appointment this coming Thursday, I’m not sure what can be done medication wise, the highest doze of tildiem is 500, and I’m reluctant to go any higher than the 400, I’m fortunate to live in Liverpool were we have a really good Heart and Chest hospital, with you being in Wales maybe your GP can refer you there, there are many Cardio specialists at the Heart &Chest Liverpool, It really is encouraging to hear that we are not suffering this horrible condition on our own, I’m always very grateful to receive any help and support, Milk Fairy has much knowledge of this condition, and is always ready to help. Bless you all my fellow hearties keep encouraging one another
Thanks Ruth good to know but Gp can only refer me to local hospital & the cardiologist doesn't specialise in spasm angina & he discharged me with out telling me. His secretary told me! Have a good day. D
I’m sorry to hear that D, that’s not good discharging you, you really need to be under a medical practitioner, I really hope you get good treatment and guidance from the consultant in Glasgow. Ruth
Good luck ! The support from all of you is remarkable ! I am ready to move to England . I feel so undertreated and not believed in Canada . Because I have no evidence of ischemia I am sent home from ER every time no matter how severe my pain ! I can't take the nitro and I have no other meds .I have to wait a bother 3 months for the cardiologist and more for the angio . Have a quiet weekend!
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
coronary artery spasm
The mysteries of coronary artery spasm
coronary Artery spasm
Coronary artery spasm.
