Hi all, I have recently been told I have Angina and am waiting for an angiogram. I have been prescribed Atorvastatin 40 mg, aspirin 75mg and been given a nitrolingual spray to use when needed. My question is how do I know when to use the spray ? I seem to be getting paranoid. I very often have a 'feeling' in my chest, it's not a pain but it's uncomfortable. I feel like I have a ticking time bomb inside me😱
GTN spray: Hi all, I have recently been... - British Heart Fou...
GTN spray
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Tryingtimes13
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Hi. Take it as soon as the Chest Pain starts. 1 or 2 Sprays under the Tongue. Might give you a bit of a Headache, but better that than Chest Pain in my opinion. Pain should go immediately, (does for me anyway), don't take it more than twice or more though. That's what I've been told and the Instructions will be on the Box. Good Luck 😊👍
If you use the spray and it makes no difference be aware your 'angina' diagnosis may be questionable. I had chest ''discomfort' not pain like you, was told I had angina (based on previous heart history), took the associated meds including a GTN spray which did nothing other than make me feel decidedly rubbish, but in the end it turned out to be gastro related. So if your spray does nothing you need to go back to the medics for clarification.
Tryingtimes13• in reply to
I did read a similar story ? I haven't seen the consultant yet, just a phone call from a nurse after I had a cardiomyopathy scan. She said I will be booked in for angiogram in 8 to 10 weeks. It's the not knowing . Ty so much for taking the time to reply
• in reply toTryingtimes13
Without wishing to be the harbinger of doom the estimates given to you by frontline staff are only that. After my chest discomfort episode I eventually saw a cardiologist at the follow up who gave me an 8 week time to an angiogram which turned out to be about six months. That might be different if you are down as urgent rather than routine as I was. Nonetheless in the meantime if your symptoms deteriorate significantly in a very short space of time, a trip to A&E is advisable to get yourself checked out.
Tryingtimes13• in reply to
I think with the current situation (NHS in crisis) I will most probably have a long wait 🤔
"If you use the spray and it makes no difference be aware your 'angina' diagnosis may be questionable"
This isn't always true. Many patients with microvascular angina don't seem to respond well to GTN spray.
• in reply toMilkfairy
Agree - and patients with symptomatic myocardial bridges which cause angina aren’t supposed to use GTN spray as makes symptoms worse.
Tryingtimes13• in reply to
👍
• in reply toTryingtimes13
I really do hope works for you, if I could use it I would as I get angina as start to move around. 👍
• in reply toMilkfairy
'Questionable' means not certain. Which is why then I suggested 'So if your spray does nothing you need to go back to the medics for clarification'.
Tryingtimes13• in reply to
👍
👍
Tryingtimes13• in reply to
Ty
It won't hurt you to use it, so if in douby just have a spray and see if it helps.
Thank you Heather, that's put my mind at rest
I tried GTN spray for my angina and it didn't seem to make any difference. I probably have microvascular angina myself and agree with Milkfairy.
👍
• in reply tojerry12953
If you have been told you have angina and the spray does not help I suggest you go talk to the medics to find out what you actually do have. Guessing your condition could have serious consequences if your actual condition is not identified and treated properly.
jerry12953• in reply to
I have had a number of tests, but not the gold standard one which conclusively identifies microvascular angina. I was told that I have no obvious blockages in my main arteries. I had to prod the Drs about MVA but they are now fairly sure that's what it is though, and I seem to be responding well to treatment with Diltiazem - or it's getting better of its own accord.....
Having access to the appropriate testing is an ongoing problem if you have microvascular or vasospastic angina.
Good to hear that you are responding to Diltiazem.
Yes, I'm on the max dose (300mg) and some days I completely forget the angina, even walking up steep hills!
Just ensure you are sat down when you use it
The action of the drug is to dilate your vessels, which in turn drops your blood pressure (significantly in most people) which can make you wobble!
The bitter taste & transient headache are normal. 👍🏼
Ty 👍
that particular piece of advice is important - it is also important to stop doing whatever you were doing when the pain started
Ty, it is so reassuring to have this advise and info from everyone
Angina is something my Consultant said ‘we’d rather you didn't have’. It’s when the heart is being strained.
I also understand GTN spray is not diagnostic. If your chest pain goes after spray(s) it could still be something else (like digestive problems) which is also helped by the vessels dilating.
If your "discomfort" is brought on due to exertion, use it straight away. You shouldn't try to work your way through an angina episode. The rules are straightforward, use it once and if the pain goes brilliant. If there is still pain after 5 minutes, use it again. If there is still pain after five minutes, use it again and dial 999!
Some people (including me) use it before an event that might normally cause angina. So before a walk or even putting the bins out use the spray, this helps with getting through any "warm-up" period and can actually reduce the need to use the spray later on. The important point with the GTN spray is to remember that it doesn't cure but it does provide symptomatic relief and eases the stress on your heart.
I had an angiography and angioplasty in June and have been angina free for 9 months now so good luck!
That must be a huge relief xTy for the reply
I only knew I had unstable angina for about 8 days in December 2006, because I had an urgent CABG×4 after those 8 days because my arteries were so diseased.
But I tell you what, the immediate and instant relief when paramedics gave me GTN when they picked me up on the first day of my cardiac crisis was fantastic. From stabbing, sharp pains to none only moments after the pill, GTN was amazing. I was pretty lucky not to have a heart attack. I knew from how effective the drug was in alleviating pain, that the paramedics (and then the Drs) were on the right track of figuring out what was going on.
In the 16.5 years since that dodgy December, I have had various feelings of discomfort around the chest area. Mostly I've attributed this to nerve and skeletal damage from the CABG op. They've been nothing like any of the cardiac pains from all those years ago.
Of course, until people have adjusted to how their bodies feel after cardiac events, anxieties are understandable. But if I felt I needed GTN (which I don't actually need after my CABG) I would take it, with some sort of strategy as to what to do next if things didn't feel better/right:
1. Worried but sort of well, call 111 (or GP)
2. Worried and not too well, call 111
3. Very worried and/or decidedly unwell and/or more serious unexpected chest pains, call 999.
Hope these comments help.
Cheers.
can I ask how diseased your arteries were ? Did they tell you ?
I have moderate in RCA moderate in LAD and circumflex
I had 80-90% blockages in at least 2 of the 4 arteries they bypassed. Those estimates were post angiogram.
thanks for your prompt reply.
I had angio and stent in a 90% block in LCA
The cardiologist told me they don’t really use percentages any more but I have moderate 50%-70% in other arteries,
I had started feeling better but now getting more pain when doing light activities and pretty much constant discomfort!
Obvs, you should go back to cardiologist if this is how you're feeling. It might be worth discussing the effectiveness of the stents, and what the expected service lifetime of the stent(s) is/are. It might also be worth asking if CABG was considered, and why they recommended the treatment you had. I wouldn't wish an operation on anyone, but sometimes something like a CABG can better long time outcomes than stents. If you're happy with what your cardiologist says, that's great but you can also ask if it's worth seeing a cardiothoracic surgeon for a second opinion. 😉
As somewhat of a fluid dynamicist, I can understand why they don't use % blocked. I'd ask how they measure blockages these days.
Echo24uk , I hope you get to the bottom of things ... and feel better soon.
thanks yep when I can actually speak to my cardiologist without a&e and a three days in hospital def will raise this !
Phone his/her secretary and leave a message and ask him/her to call back. 
Usually works for me. 
tried that last week and secretary called me back.. opening line was
You know you can’t just ring and speak to a cardiologist you have an appointment in 6 weeks speak to him then
Mmm. I guess it depends how long ago you had the intervention from the cardiologist. If it's days or a short number of weeks, you may be able to sweet talk the secretary ... but if it's months then she may have a point. If this is the case, you'll probably have to revert to your GP. 
Sorry I can't help more.
Aww ty so much. It must have been very scarey for you and such a major op !I've been fine today but I will definitely use the spray if I think I need it. I have calmed down now 😊
Agreed. Try a squirt as the ache starts. Wait a minute, then i f the ache persists, a second squirt. You`ll get used to it. At first (10 years ago) I used it BEFORE climbing; steps, hills, etc. before my body got used to the extra exercise.
RELAX...use the spray and you`ll feel the difference.
Ta-ra Chuck.
Aww ty Kwackers 👍
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