Change of meds

[unknownguy1]

I have been taking isosorbide mononitrate for coronary artery spasm but recently changed to amlodipine following the cardiologists discharge notes. Obviously I need to give the new meds time to work after 10 days of taking them. The symptoms still come and go and can feel my heart sensations more. Anxiety plays a big part in my symptoms I think and I barely go outside lately. Maybe I should seek advice after 2 weeks?

[Tos92]

Hi unknownguy1

When I was first released on medication after my coronary spasm, I found that it took me about a month to adjust to them. I have now been on one for over a year and a half and barely feel the side effects anymore. Does your patient information leaflet say how long you should wait after experiencing side effects to contact a doctor?

I will tag another user on here Milkfairy who has knowledge on vasospastic angina and may be able to offer advice on the medications you’re taking and its side effects.

All the best.

Tos

[unknownguy1 in reply to Tos92]

Thanks. Well I think I have to complete a month worth of meds and then see the GP about increasing the dose of amlodipine to see how that works, but obviously I'm still getting pressure and tightness but sometimes it doesn't feel as bad unless I move around

[Milkfairy Heart Star in reply to unknownguy1]

Hello,Did the Cardiologist explain to you why they were changing your medication?

Have you had an invasive angiogram using acetylcholine to confirm your diagnosis or have you had an ECG that showed a ST elevation or depression during an episode of chest pain that was relieved by GTN/ nitrate? This is the usual way a diagnosis of vasospastic angina can be confirmed.

Microvascular angina is another type of angina without blocked coronary arteries and the symptoms can overlap with vasospastic angina.

The treatment options however are different.

The usual treatment offered for vasospastic angina is calcium channel blockers such as Diltiazem, Verapamil or Amlodipine.

If these are not effective then isosorbide mononitrate extended release tablets can be offered too.

There are other medications that can be offered too.

Do you feel your Cardiologist has an understanding of both vasospastic and microvascular angina?

A common problem those of us who live with either microvascular or vasospastic angina face is the lack of knowledge within the cardiology of these conditions.

I suggest you keep a diary of your symptoms and how you respond to the medication.

If there are no improvements in your symptoms in about a month then discuss this with your GP and Cardiologist. Maybe also ask about further testing to confirm your diagnosis.

Have you had the opportunity to discuss with your GP about how to manage your anxiety?

I know from experience how emotional, mental or physical stress can trigger an episode of chest pain.

[unknownguy1 in reply to Milkfairy]

Hi thanks. No GP anxiety appointment yet as I keep putting it off! I'm guessing the cardiologist is trying to see what meds work best. The doctors at a&e changed my med after following cardiologist notes, who I haven't spoken to since my diagnosis, or apparent diagnosis as I'm not sure which angina I have. I did have a CT angiogram before initial diagnosis

Now i seem to have more palpitations than before but they are a side effect of amoldipine so not sure what's going on

[Milkfairy Heart Star in reply to unknownguy1]

Have you been seen by a Cardiologist or just the A&E staff?

Vasospastic and Microvascular angina are complex conditions and really need the input of a Cardiologist.

I suggest you ask your GP to refer you back to be seen in clinic by a Cardiologist who understands microvascular and vasospastic angina.

A CT angiogram will be able to see pernament blockages, however not transient coronary vasospasms.

[unknownguy1 in reply to Milkfairy]

I was seen initially by a cardiologist but he didn't see me after my angiogram. There is a plan in my notes to be referred back to cardiology if the amlodipine isn't working

[Milkfairy Heart Star in reply to unknownguy1]

I would encourage you to be referred back to a Cardiologist as sooner rather than later.

I am seen 2 or 3 times a year. I am prescribed other medication to help manage the long term effects of living with vasospastic angina.

[Anwarhussain]

Amlodipine is vasodilator and anti hypertensive.if you don't feel angina pain after change of medicine then it is okay.amlodipine is mostly well tolerated.try to decrease your anxiety.start walk and gradually increase it.what is your age and angiography report