Right advice?

[Thorndog32]

I was told by one GP a while back (when I asked) that it didn't matter how often I use my GTN spray as long as it relieved the symptoms. On a recent visit, as I was concerned that I was suffering more fatigue and a bit of an increase in pain (still not as bad as when first diagnosed), I was told that my angina wasn't being controlled and, if I'm using the spray more than once a week, it means my symptoms aren't controlled and his manner was as though I should have known this. Any ideas on where to get reliable advice? Had my telephone consultant's appointment cancelled and still haven't had a new one come through.

[Tos92]

Hi   Thorndog32

I’m sorry you seem to be having to use your GTN spray more often and your GPs guidelines don’t seem to be very clear on this.

The normal rule with using the GTN spray is that you spray 1-2 puffs under your tongue, every 5 minutes for up to 15 minutes. It should not exceed 15 minutes. If the pain has not subsided, it is a call to 111 or 999 for further advice and checks.

The BHF has the following information on how to use GTN. They also mention calling 999 if the pain hasn’t subsided after a few attempts a couple of minutes a part.

bhf.org.uk/informationsuppo...

Personally, if I find that I am using my GTN spray more often, although I try to limit it’s use as there’s some contraindications around my congenital heart defect (myocardial bridging) I have found myself calling 111 or my GP for advice.

If I’m particularly worried about the chest pain, or felt that it’s increased in severity or has not subsided with the spray, I have previously made visits to A&E so that they can check my troponin levels and anything else which they deem necessary to ensure my heart is safe.

I hope this helps.

All the best.

Tos

[MichaelJH Heart Star]

Hello and welcome to the forum!

Tos92 has given you good advice on the use of GTN spray. However, I am concerned about you GP's attitude. Mind you mine was not much better when I first raised concerns about my family history and then about chest pains and breathlessness. When I developed chest pain he referred me to the Urgent Chest Pain Clinic. I had to wait six weeks for an appointment and then after an ECG and chat was told I needed an angiogram and that there was a four month wait. I then decided to go private. A few days later I saw the senior consultant (from the same hospital). He was very through and at the end prescribed me two anti-anginals, Isoboride Mononitrate and Diltazeum. These made a tremendous difference and the only time I used GTN spray thereafter was for CT scan to open up the arteries further. Subsequently I had an. Angiogram that showed four arteries over 70% blocked with my LAD over 85% blocked. I then went back to the NHS and could help feeling there were deliberate delays as the quadrue bypass happened a few days after the angiogram expired (one year). An initial consultation is about £250 but well worth it! Good luck!

[MichaelJH Heart Star in reply to MichaelJH]

My GP retired a few months after my bypass although he has popped up on private practice. Subsequent to that one of the younger GPs (another senior partner had also retired) referred me to a vascular surgeon. Unfortunately I had a long wait and my appointment at the start of April was cancelled and when I saw someone (not the intended hospital) I ended up having the leg chopped off. My conclusion - be wary of older GPs!