I sometimes reply to the questions and experiences of others but I don't instigate threads, so this is an exception.
Two years ago today, age 64, I was in surgery for triple CABG following a heart attack and one stent in 2019, and a return of some symptoms such as pressure in upper chest and awful jaw pain (which was the signal for the original heart attack) around March, April 2021. Recovery was slow but steady. They'd warned me that it could be "2 years before you know what you'll finish up with".
Recovery was slow but steady, and I had problems with my left lung which collapsed during surgery, had to be reinflated and afterwards repeatedly filled up with fluid, leading me to A&E on one occasion. Three months after surgery I went back to playing my badminton in a "not pushing it" way. I did cardiac rehab which I can thoroughly recommend, and I keep fit in the gym and with walks that can be up to 10 miles. After a year I felt much better.
So where am I now, what are my concerns, and how does my experience compare with others, I wonder?
Taken all round, I guess I'm ok. I can do much of what I did before. Work out at the gym, play badminton almost back to my former level and even do a Parkrun now and then. Life is good and precious. I'm thankful for the expertise that got me to here.
Concerns/problems:
I do get discomfort in the chest. A lot of it is to do with the surgery, I know. The cutting of the flesh, nerves and bones has certainly left its mark and I experience numbness, tingling and soreness even now. I doubt at this stage that it will ever resolve. It's a fairly low level nuisance in the grand scheme of things though.
More concerning, I can occasionally get what I term as angina pains and I am not sure why this should be after the bypass. A sort of burning in the upper chest that seems to permeate from back to front. The GTN spray has never had any effect on me so I've given up using it. Such pain and discomfort in my case is never exertion related. It's invariably at rest, perhaps after eating a meal or it will wake me in the small hours. If I followed the guidance to the letter I would be at A&E on every episode of this, but I think after a while you get a feel for what is the new normal for you, and somehow, although it is not nice it doesn't FEEL like I'm having another heart attack, if that makes sense. I wonder if it's some other deterioration in the condition of the heart. Perhaps a declining ejection fraction. I just don't know, but after it clears up, I'm as good as before, playing my badminton etc.
I've considered the possibility that the phenomenon is subconsciously mental, perhaps anxiety related, but I'm not an anxious person in any way. Even immediately before the CABG I wasn't particularly concerned. I knew I needed to have it done and just thought what will be will be, and now I never lie awake worrying about another heart attack.
So there it is. Heading for 4 years after HA, 2 years after CABG, I'm still here doing my thing. Plenty of good life quality, but with these few niggles and concerns.
Does this ring true with others who have travelled a similar road? I'd be fascinated to know.
Written by
RailRover
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I’m sorry to hear you’re experiencing chest pain even after your CABG.
I can resonate with the chest pain on rest however. I have a congenital heart defect in the form of myocardial bridging which causes vasospastic angina. This is when my arteries become constricted and there is a lack of blood supply to my heart. I experience the chest pain on a daily basis, but have noticed it can be more severe and higher in intensity during rest.
You mentioned that you have not been responding to your GTN spray. Vasospastic angina can also be resistant to nitrates.
Have you checked in with your cardiologist and let them know about your symptoms? If not, I would recommend you do this as further testing may be required to rule out anything new.
'Vasospastic angina can also be resistant to nitrates.'
Responding to nitrates during an episode of angina is a diagnostic criteria of vasospastic angina.
For more information please see the Coronary Vasomotor Disorder International Study Group COVADIS, definitions of vasospastic angina and the BHF website information about vasospastic angina.
Interesting. I do not always respond to my GTN spray during a spasm. Perhaps I should’ve phrased that as “my vasospastic angina” instead of “vasospastic angina”.
There is growing evidence that nitrates are not effective for people living with microvascular angina.
It's really important to be able to work with a Cardiologist who understands microvascular and vasospastic angina as well as being able to offer the appropriate testing.
Without appropriate testing we are left with assumptions and uncertainty, which isn't helpful.
Have you been able to access a knowledgeable Cardiologist to help you?
I’m currently taking a medication which can help with the symptoms of MVA. It’s still early days, so I am just monitoring its effects on my symptoms for the time being.
Medication changes were made by a cardiologist who treated me abroad. He seems to be more knowledgeable about coronary artery spasms in comparison to the cardiologists I have consulted in the U.K. so far. This includes both the private sector and NHS.
The UK has some of the leading researchers and world leading experts in caring for patients living with microvascular and vasospastic angina. I believe I have already provided you with some suggestions of some Cardiologists who maybe able to help you.
I have a very good team of knowledgeable and empathetic Cardiologists at the hospital in north London I attend.
Microvascular and vasospastic angina are often mistakenly considered to be the same. They are different with different underlying causes with different treatment options.
I hope you can find the support you need here in the UK.
Thank you RailRover, you have given me such hope!!! I am also a survivor of double cabg in January of this year, so still in early days of recovery. I dont know about you, but I got very little advice post op? I've had to find things out in my own as I've recovered!! I'm hyper aware of any niggles in chest area now!! The emotional part of the recovery is the hardest !! So much crying!! Have you experienced the same? I'm trying to be as positive as I can and hope that this is it for me now and that the op has worked. My condition is hereditary..I've had 3 heart attacks since 2021 and 2 stents which collapsed so needed the bypass. I'm also a member of the pumping marvellous forum but am considering coming off it for a while as there seems to be an awful.lot of people posting scare mongering replies to people who just ask a simple question!! For new members, or people like me with health anxiety it's not good. It was so nice to read a positive uplifting story for a change so thank.you!!!
I'm glad you got something from it! Not really a crying sort of person. More a "what will be, will be" sort. You are right. The acute care is top notch, but the further from that you get, the support soon drops away. Have you done rehab? If not, I urge you to go. It will put you on your feet again.
hi- I can def relate to the chest discomfort but this year 4 years on it’s hardly there & the tingling has finally gone- so don’t give up on it getting better. I too thought it would never go but it did eventually!!
I'm coming up to 6 years post HA and stents and 5 years post triple bypass. I get many of the physical issues related to bones, nerves and skin as you do, but absolutely none of the internal pain. What is interesting is that you still are prescribed GTN whereas for me it was noted as being "contra-indicated" and I stopped having a spray when I had the bypass (not as though I ever used it anyway). I wonder whether that is down to our personal situations or local protocol at the hospital we had our ops.
As far as physical abilities are concerned, I've definitely recovered my health to pre-HA levels. Two months after my op, I walked 10 miles non-stop. I've managed 17 miles non-stop and was on for 20 miles last year, but had to stop for a rest as the day was too hot! I now climb Munros up in Scotland, indeed on occasion have done pairs of Munros. I do feel I am starting to slow up a bit, but at 71 carrying a 11kg backpack up these lumps of granite (so I can participate in my other pastime of Amateur Radio from the summits), well it can't be that bad.
I would certainly get any "unexplained" symptoms checked out. Prevention is better than cure. The way I look at it is that the NHS has invested in us by doing the bypass operations and it is our responsibility to protect that investment. Just like a car needs maintenance from time to time, we need to be maintained. Maybe you just need a drop of Castrol R in your tank. Now I am showing my age! 😀
My stories on here somewhere not sure if it’s possible for you to go and find it?To précis my experience I had my triple by pass aged 31, I am now nearly 77.Never had a heart attack got angina at the limits of exertion and a great doctor not happy with a normal ecg at rest insisted on an exercise test as HAs were becoming more frequent at younger ages.
Thanks to a great late surgeon Mr Parker at St Georges Hyde Park Corner and after cancellation after my first attendance,(my blood a rare B Rhesus Negative was used for a poor lady in a road accident),I had a successful op in August 1977.
These days I cycle and age 77 play a tough game of walking football twice a week.Of course after major surgery like that you pick up on every strange feeling you get as a portend of something sinister, which before in the normal course of life you wouldn’t give a thought to.So there’s certainly HOPE I am hoping to get an entry in the Guinness Book of Records as the longest surviving triple bypass patient.Tempting providence but how far I’ve got astounds me when at 31 I thought I would never reach here.
You're an inspiration, Bigscar and I'm sure we're all looking forward to celebrating your entry into the Guinness Book of Records. (Oh, and you're making me feel like a couch potato and encouraging me to get out there and do some more exercise! 😂😂) Carol
hi bigscar this is inspiring I’m only 5 years post quad bypass and just recently have felt down due to tiredness the docs have said don’t do so much and some people just get tired so no help there coming on here has shown me that all people are different and react differently to the same medication or operation I was beginning to think I was coming to the end of my journey but you have helped me realise it’s part of the journey and I could still have years to go
Hi RailRover I’m still quite early days 18 months compared to you, mine was a Stemi couldn’t fit Stents so bypass it was it all happened so quickly, I would also Recommend I’m walking with our dogs do at least 3x 5 miles a week and the other 4 between 2& 3 miles along with some utube workouts, I too have a GTN spray only used it twice had to go back to A& E a couple of times
If you feel any different please go see someone even a call to the doctor get some checks done, I think like you say it’s a new normal and we will have little niggles but we also need to act upon these if unduly worried
Hello RailRover. You should speak to your GP. Angina symptoms aren't usually an emergency but they do need investigating. You need your GP to refer you to a chest clinic for a proper evaluation. Probably nothing, but better safe than sorry.
From your symptoms and the fact that it happens at rest and after eating might point towards acid reflux. I suffer from this and what you’re describing sounds very similar to what I experience.
Have you tried Gaviscon or similar when your symptoms appear? Might be worth a try?
Hello RailRover. 8 years on from Heart Attack and triple CABG. No symptoms of any angina or breathlessness and pain pre op. No GTN prescribed after op or indeed needed. However, 6 months ago I had an OHSCA (Out of Hospital Sudden Cardiac Arrest ) treatment for this was a defib/pacemaker implanted. Had GTN spray prescribed as now seem to be back to square one with low level breathlessness and tight chest on to much exertion. So feel a bit peeved. But im
I'm four years on from a double bypass, and much of what you say resonates with me. I don't think there's been a day when I wasn't aware that my chest had been operated on. Whilst I've no signs of angina, there have been odd days, maybe once a year, when it's been significantly worse, and I have got so uncertain that I have reported for medical advice. However, I've always been given a full working over followed by a clean bill of health, so I completely agree that there are signs that, otherwise, I might have taken as indicators of heart problems, that appear instead to be just consequences of being pulled around in the operation.
Like you, I don't tend to worry much, but to take things as they come. I've made a full recovery, gone back to club cycling and, last year, did RideLondon (100 miles).
I did have a couple of passings out at Easter, resulting in a trip to hospital, but that seems to have been more to do with naturally-low heart rate exacerbated by my bisoprolol. The consultant has stopped that and it looks like that's going to be it.
Yes. Bisoprolol had my pulse rate down under 40 at times. They were reluctant to take me off it, but falling about all over the place isn't really my bag. Off it and back to my pre HA resting pulse rate of 52 now. I think they can be guilty of a little too much "one size fits all" with the prescribing and they aren't keen to deviate from it.
I actually did the passing out thing again at the beginning of August, while on a Scout expedition to Scotland of all times and places. Off to the nearest hospital, usual checks, nothing untoward found, ordered to report back to the local team when I got home (same ones as took me off Bisoprolol at Easter). I've now had a loop recorder implanted, to try to find out what's going on. But apart from those two incidents I've been fine, as usual (which of course means that there doesn't seem to have been much of interest for the recorder to record...) bhf.org.uk/informationsuppo...
RailRover, I am nearly 24 months post double LAD CABG and I am mirroring everything you’ve said post Op regarding aches pains and worries. Ive looked after myself my whole life keeping super fit, watching my weight, drinking in moderation and having a reasonable diet yet I still have coronary heart disease.
I’m still coming to terms with my new normal but getting on with my life without clogging up A&E.
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