angina triggers

hello

So I know I get angina to varying degrees as I start to walk - within a few metres, a good rare day is 4/10 pain level, but usually 5/6 out of 10 most days ramping up quite quickly to 7 (had an 8 earlier in week) and heart races / thumps dependent on what I then do.

But I now know two definite new triggers -

1. sudden movements (like sitting up really quickly from lying down and frantically finding my slippers when a family member knocked door - just had a 6/10 left sided bout of pressure / dull ache). Actually I was quite surprised how my heart reacted.

2. being nervous (not so much anxious just the nerves like when waiting for an interview) all day - the pain stayed at level 7 until the meeting was finished. Was exhausted after.

how much I can work on nerves I don’t know at present as I am faced with some life changing circumstances but am trying to keep calm (using distraction)

but I will be buying one of those fancy doorbells so I can see who it is and ask them to wait or just ignore them 😂

And there will be no suspenseful or horror movies with jump scares for me!

What triggers set off other people’s angina?

👍

[Tos92]

I also find that sudden movements trigger my angina, but I’ve been told this is more consistent with costochondritis as opposed to angina by cardiologists though. I do find pushing down at the time of the pain, on my sternum for example also hurts. Not sure if that is the same with you?

Being anxious can set off my heart palpitations, including physical, emotional and mental stress. Too much of this type of stress increases my chest pain, which is probably a 4/10 on a daily basis to about a 7/10. This type of pain is also more likely to radiate to my arm and upper back.

Breathing in deeply also triggers it - again, cardiologists say this is more consistent with costochondritis.

I do recognise that with having a myocardial bridge, our symptoms of angina are probably not as consistent, or behave in a similar way to others who do not have myocardial bridging because of the compression it causes.

[Hidden in reply to Tos92]

Hi the sudden movement was also in response to slightly panicky I always panick to get the door open just habit. It was definitely deep in left side of chest / left breast - dull ache / pressure - . My central chest pain is more pressure/tightness / heaviness and the gripping / squeezing. 😔

I tried the pushing down on sternum to experiment but that was just tiny bit of pain of pressing a bone 😊 and not like the central chest pain.

Yes MB pain can even present differently between two people with bridging let alone differently to non MB people. No two MBs present the same! I think that’s why diagnosis is difficult.

Have you had the dobutamine/ IVUS test for your bridge?

👍

[Tos92 in reply to Hidden]

I’m not sure if you feel this, but sometimes with my chest pain, I almost feel like a deep burning sensation radiating from my chest/chest muscle/wall. When I saying “burning” I don’t mean indigestion type of pain, this feels more like it’s sore and inflammatory in nature.

I’ve been advised against doing any types of procedures that risk inducing spasms / chest pain 🙄. Unfortunately, the dobutamine challenge with the IVUS is one of them. I am still deliberating it though and may go ahead and do it despite my cardiologists’ advice. I just don’t really feel like my cardiologist understands the importance of this test for those with symptomatic MBs, hence his reservations on it.

[Hidden in reply to Tos92]

I didn’t know that about the dobutamine test and spasms, you have the difficulty of balancing more than one condition ❤️

There is one cardiologist who knows bridges inside out, my local cardiologist referred to them as a “national expert”.

👍

[Tos92 in reply to Hidden]

Yes, I believe the “national expert” you’re referring to perhaps, is the only one in the U.K. due to the exclusivity of having symptomatic MBs.

I do know however, unroofing surgery is being performed in the U.K. now. Just recently, I know of someone through a FB group that has had theirs unroofed. So it is starting to pick up some momentum.

[Hidden]

I can have it when reacting quickly. If I get excited/or anxious. Walking up hills. But that's a huge improvement. Untreated it got to a stage where 5 mins on the flat resulted in chest pain. I'd have to stop.

I'm on long acting nitrates/CCBs so it's controlled. I don't get the pain. But I have a weird sensation in my chest. So I am aware that there would be pain. My heart rate does increase temporarily. And at the end of the day can feel a bit washed out. I have noticed that hormones play a part! Exacerbating my problem at certain points in the month.

Microvascular Angina/Corovary Artery Spasms.

[Hidden in reply to Hidden]

yes hormones certainly add their pennies’ worth to the symptoms!

[World1inmotion]

Hi , 7 months in from my initial cardiac incident (never had a definitive answer to my seemingly simple question of what happened when I suddenly started getting severe chest pain and pain in arm). I still haven't managed to identify exactly what triggers angina attacks, although I know that generally if I try to do too much of anything strenuous I will then get angina pains later. I rarely get pains when I am exerting although I try to be a bit careful , so it seems to be I get angina pains when I am at rest sitting down or lying down. one problem I have come across is medical professionals seem to be a bit dubious when I describe getting angina pain at rest rather than on exertion.

[Hidden in reply to World1inmotion]

hi I also often see a delayed reactions, that’s on the better days as I think I can do more but I pay for it later.

Sometimes it throws cardiologists when we don’t fit the norm and it needs one cardiologist who has the ability to think outside the box. Trouble is finding that cardiologist.

👍

[World1inmotion in reply to Hidden]

👍

[Milkfairy Heart Star in reply to World1inmotion]

Hello,

I experience my chest pain at rest as a delayed reaction to exercise. This is a common symptom of vasospastic angina.

I have a confirmed diagnosis of vasospastic angina after a specialised angiogram.

Vasospastic angina is a rarer type of angina that is poorly understood and under recognised by many Cardiologists.

The BHF has this information about the condition.

bhf.org.uk/informationsuppo....

[World1inmotion in reply to Milkfairy]

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[Tos92 in reply to Milkfairy]

Hi Milkfairy,

Sorry to butt in here.

Is a delayed reaction to stress also considered a symptom of vasospastic angina?

I remember my coronary spasm which triggered my heart attack was the following day after a really stressful event.

[Milkfairy Heart Star in reply to Tos92]

Good question. Much of the medical literature doesn't necessarily reflect our symptoms. I suspect nobody has asked us.

We all have our own individual version of microvascular or vasospastic angina.

Perhaps why we're such a challenging group of patients to treat.

I have over the years of living with vasospastic angina and my advocacy roles learned that there are some common themes.

A delayed response to any of our personal triggers seems to be a common symptom such as emotional, mental or physical stress.

There is also some growing evidence that microvascular dysfunction can play a part in Takostubo syndrome which leads to an acute presentation of heart failure that mimics a heart attack.

[Heartattackvictim]

Walking downhill after long fell walks. Also when things get on top of me psychologically.

[Hidden in reply to Heartattackvictim]

I get pain when in my house and walk a couple of metres after resting so I don’t think I’ll ever make it tot a fell walk! 😊