Yesterday evening I experience new and significant pains in the centre of my chest. At the same time I started to feel pain in my lower jaw. The chest and jaw pain lasted less than 5 minutes however then I developed tingly sensations in my left fingers and numbness, with a heavy/pressure feeling in that arm. I also started to feel pain/pressure across shoulder blades/upper back.
My husband called an ambulance and they gave me aspirin and 2 sprays of GTN. Due to my ECG showing irregularities and my symptoms I went to A&E when they did 2 blood tests which came back clear.
Subsequent ECGs showed irregularities but as the blood work was fine they think the ECG values may be my baseline but as they have nothing to compare it to they aren't sure.
They couldn't explain what had happened. I was advised to go to my GP should I experience any more symptoms.
Today I have a feeling of heaviness across my chest but none of the other symptoms.
I'm not really sure what I'm looking for from this post, perhaps someone has been in a similar situation? I assume the sensible thing is to go to my GP to discuss further?
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LoftyOak
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Hi LoftyOak sorry to hear about the way you been feeling its good your hubby called ambulance. It sounds like my experience few weeks ago at A&E, that is with ECG it shows some irregularities and bloods were clear they did have something to compare it to but they were still saying it looked a bit odd so they advised me to contact my cardiac team and then they contacted my GP and booked follow up appointment which I had today, and they want me to have bloods done and ecg so maybe worth contacting your GP about your recent trip to A&E hun x
I’m sorry to hear you were in A&E with chest pain.
I note that you say you had abnormal ECGs. Do you have any history of heart problems?
When they gave you the GTN spray, did you feel any relief from it?
The pain that you describe is something which I experience on a daily basis as a result of a type angina called vasospastic angina. This is due to one of my arteries called a myocardial bridge tunnelling through my heart muscle instead of sitting on the surface. However, you can have vasospastic angina without this too.
Vasospastic angina is also recognised under INOCA (ischaemia in non-obstructed arteries) where there is limited blood flow in your arteries without any blockages. This is also the same for microvascular angina which is when there is a problem with the smaller blood vessels of the heart.
It maybe worthwhile to keep a diary or log of your symptoms, including whether you have any triggers. Personally for me, my triggers are stress, the cold, and sometimes physical strain / exertion.
It was just a thought as I saw some of your symptoms were very similar to mine, but perhaps discuss the above with your GP and see if you can get referred for more testing.
Needless to say, if you experience this type of chest pain again, please call 111 or 999.
Thank you for the thoughtful and helpful responses. I was catching up on some much needed sleep after last night's drama hence my delay.
To answer some Qs, no history of heart problems, and I did get relief from the GTN. I started feeling pressure building in my chest again around 2 hours from the first dose so was given 1 spray in the ambulance which relieved it again.
I plan on calling my GP tomorrow morning for an appointment, I'll report back.
In the meantime, I'll have a look at the links posted above.
I also get these same feelings as you on a daily basis especially when I do any manual labour around the house, like garding or any kind of DIY which involves any kind of lifting. I get some tingling feeling in the fingers of the right hand and tightness across the chest, iam really scared when it comes on, it usely passes after about 10mins of sitting down. My friend rush me off in the car to hospital I got server tightness of the chest, my ECG came back clear, bloods came back all good, I asked the doctor if I was suffering from angina but doctor said unlikely but they did say they have found out I have a hiatus hernia. Iam seeing the doctor today to discuss the next steps.
I have lived with Vasospastic angina for over 10 years. Mine was confirmed by a specialised angiogram.
One of the classic symptoms of vasospastic angina is chest pain at rest, typically between midnight and 6am in the morning.
It's caused by the transient constrictions of the coronary arteries.
GTN spray usually promptly relieves coronary vasospasms and reduces the chest pain as a result.
You can also have vasospasms in the small blood vessels of the heart too.
Microvascular angina is thought to be caused by the inability of the small blood vessels of the heart, to dilate or stay dilated in response to exercise, this is known as microvascular dysfunction.
Unfortunately microvascular and vasospastic angina are often overlooked, under recognised and poorly understood by most Cardiologists. It requires specialised testing which is not, as yet, widely available.
Some A&E doctors will have no experience of how to identify patients with microvascular or vasospastic angina.
Many healthcare professionals, sadly have only limited understanding of these types of angina. Though it has improved over the years I have lived with vasospastic angina.
Ischaemia/ Angina non obstructive coronary arteries INOCA/ANOCA are the umbrella terms for both microvascular and vasospastic angina.
Microvascular angina tends to more often affect women around the menopause, while vasospastic angina tends to effect both men and women.
You have been given some good advice about keeping a log and some links, which is something I usually do in any reply I make about microvascular and vasospastic angina.
Another good source of information is this website created by four patients with over 50 years of combined experience of living with microvascular or vasospastic angina. They are supported by 30 world expert Cardiologists.
I also suggest you discuss the BHF information with your GP and if necessary, ask to be referred to Cardiologist who has some experience of caring for patients living with microvascular or vasospastic angina.
Last night's episode happened at rest with GTN giving relief.
Milkfairy & Tos92 , do either of you ever experience a burning sensation in the middle of your chest under the breastbone?
Is it likely the GP would prescribe something like GTN as an interim measure as it gave me relief until I would get a referral? My BP dropped significantly after the initial 2 sprays, but no marked difference after the "top-up" dose.
Yes, personally I experience that burning sensation which you describe. If it’s not normally relieved with Gaviscon for myself, it usually indicates to me that it is cardiac in nature as I’ve had a few other things ruled out that may cause it, such as stomach issues.
If the GTN helped, I don’t see why it wouldn’t be prescribed however, your GP may send you for some more tests before prescribing it.
A burning sensation under the breastbone is what I get from reflux (GORD). I have a hiatus hernia as well. Sometimes I get a severe pain, worse than my heart pain, instead of burning, in the middle of my chest. GTN relieves this as well.
I’m just wondering if anyone has discussed the possibility that you may have oesophageal reflux disease? I’ve been through A&E with chest pains similar to yours including the pins and needles down my left arm into fingers, it’s very frightening. Recently had another attack if this and spent the night under observation in hospital. I’ve also had angiograms before. I do have CAD but not significant enough to stent.
Ivee Ed been reading the replies and you mention further that you experienced burning under the breastbone? This can definitely indicate acid build up.
My last bloods and ecg were ok so one of the consultants actually explained to me that GORD/GERD however you want to pronounce it, mimics heart attack in some people. Including the left arm/shoulder and central chest pain. I’ve been put on PPis now to see if it stops me waking with these pains.
It was just a thought.. but always still get checked out if you get sudden chest pain as best go be safe than sorry.
Speak with you Dr though it might be worth trying a PPI for a bit?
Interesting points, thank you. I'll mention to my GP.
I first experienced the burning in April 2020 as a symptom of COVID, it stayed for months after I recovered, then lessened, but returned after some exertion for many months. I've not experienced it for over a year I would say, until today. I'll need to have a think and try to remember time periods.
We can all experience our angina differently. There are some non heart related conditions that can mimic the symptoms of angina, even cause ECG changes, such as reflux and oesophageal spasms.
A response to GTN or gaviscon isn't recommended by the National Institute of Clinical Excellence, NICE, as a reliable way to say whether a person has angina or reflux.
GTN spray is a possible treatment for oesophageal spasms, as it relaxes smooth muscles whether it's in your gut or blood vessels.
I personally don't experience burning pain behind my breast bone.
I feel my chest pain to the left of my breast bone which radiates through to my upper left back and left kidney.
Last year I did start feeling a different type of pain in my stomach and a burning sensation.
My GP screened me for gastritis caused by Helicobacter pylori which is a possible cause of gastric burning pain.
I was all clear of H.pylori and prescribed a proton pump inhibitor, Lansoprazole.
My gastric symptoms have now resolved.
Vasospastic angina is rare, myocardial bridges even rarer.
Your GP may well wish to consider non heart related conditions as a possible cause of your symptoms too.
Women experience different symptoms to men so if you know something is not right keep going to your doctor until they diagnose. I was made to feel like a hypochondriac over 10 years but I kept persevering because I know my body and it’s a good job I did as I need a pacemaker defibrillator now. I was told I had depression and anxiety which is so upsetting. My arteries are clear it’s other reasons for my heart so that’s why it was hard to diagnose. I haven’t got the same symptoms as you but just wanted to say never give up you know your own body when something isn’t right. Good luck.
Thank you. I am still feeling like something isn't right this morning, it's not like the other night which felt like an emergency but something is still "there" in my chest. I've called my GP surgery and have an appointment on Friday. It's not the first time I've had to advocate for myself so I won't give up 🙂 I'm tired with everything being an uphill battle though.
Yes, I had similar experience just a fortnight ago. I have in the past had minor angina but only on exertion. However on this occasion I had a severe, stabbing pain in centre of chest while sitting resting. This alarmed me so I called 999. Paramedic did BP and 2 ECGs, then sent me to A&E for blood tests. Long story short, after eight hours, 3 blood tests, 2 more ECGs and a chest X Ray, they said cause unknown, not cardiac, no further action. But to call 999 if it happens again.I know these things are worrying so if you're lucky enough to have a nice GP who is available to reassure you, then ask them.
Sad to say my GP service is unfortunarely nothing less than dire. There is a 3-4 week wait just for a phone appt. Ive seen the A&E discharge letter and feel I had a good assessment. A few years ago I experienced slight angina on hill walking, had an angiogram which detected less than 20% plaque in one area only and the cardiologist prescribed statin and aspirin. Since then l get an annual MOT and all is well. The fact that A&E found nothing wrong heart wise is reassuring.
I was admitted to hospital in February and I had just a couple of sharp pains and felt unwell. My Troponin levels were raised a bit so they did an MRI and other scans of my heart and it turned out it was Myopericarditis. That’s inflammation of the heart and the lining. I was already diagnosed with heart failure so that’s why they were worried and they did everything they could for me and were really lovely. I’m waiting for a pacemaker & defibrillator now but not because of the myopericarditis. They said the Myopericarditis takes up to 6 months with rest and it goes better on its own. Make a note if you get sharp pains in your heart or it could happen in other places as-well like your arm or leg and how you are feeling at the time so you have a record to talk to your GP.
Thank you. I'm glad you were well looked after when you had your incident. In my case , I had 3 blood tests over the immediate 12 hours, and no troponin present. That plus normal ECG and X ray, concluded not cardiac related. But yes, I will certainly react quickly if it happens again.
Feeling a bit down today and anxious. Didn't expect to wake up still having discomfort in my chest. And then finding out I can't discuss it further until Friday with my GP.
I paused halfway through writing this and called my surgery again to explain about the ECG irregularities and that A&E didn't have access to my previous ones taken by the GP to compare it to. They've arranged for the duty doctor to call me today to discuss further and I'll get an appointment today if they think I need one.
There is an issue of patients being misdiagnosed with reflux or gastric problems when they are actually having a heart attack. You may find this Heart Sisters blog by Carolyn Thomas interesting.
Paramedics are absolutely brilliant. I had 3 days of horrific indigestion before I felt tingling in my jaw and arm at which point I also rang 99 9. They saw irregularities on my ECG and whipped me to A&E. Mine WAS a heart attack although mild. If you s till have symptoms definitely speak to your gP ASAP b ut if they get any worse don't hesitate to ring 999 again
Quite a positive GP experience today. Had a call with the duty GP then was asked to come in, or go back to A&E as still having discomfort.
Took the appointment with a female GP who took it very seriously. They don't have the notes yet from my discharge so I'm back in this afternoon for an ECG with them and she'll call the lab for my thyroid to be checked.
She said, based on my symptoms, it sounds like coronary artery spasms. She's going to contact the cardio dept for advice on next steps and has prescribed me GTN as it gave me relief.
Good to hear you have had a positive outcome to your discussion with the doctor.
I suggest you ask for a referral to a Cardiologist who has some understanding of microvascular and vasospastic angina and can offer you further testing.
As I indicated before, not all Cardiologists are knowledgeable about microvascular and vasospastic angina and you may need to be seen at a larger heart centre
The symptoms of microvascular angina can over lap vasospastic angina.
It's important to know the difference as the treatment options are different.
Eg. Beta blockers can help with microvascular angina but can make coronary vasospasms worse.
I was presumed to have microvascular angina originally. I was prescribed beta blockers and landed up in coronary care with severe coronary spasms.
Where in the UK are you based?
There are about 25 centres in the UK, taking part in a study into diagnosing microvascular and vasospastic angina.
Heaviness across chest and breathing issues when moving was symptoms I had about 3/4yrs ago I was rushed to hospital from GPS hope this is helpful unfortunately 2yrs ago diagnosed with 2 heart defects from birth I had major to correct 1 defect the other nothing can be done life expectantacy has been improved but not sure how long have defibrillator fitted on right side of chest due blood circulation bad on left side
My ECG was normal at the GPs yesterday which is good. I still have a heavy/pressure feeling in my chest but more localised to the left of my breastbone as opposed to across the whole of my upper chest.
For those of you who suffer spasms, do you usually feel sore in your chest for a few days afterwards?
I've been told my GP from yesterday will get back to me today so I'll see what happens from there.
She mentioned in my morning appointment yesterday that there could be a link to the spasm (if that's what it was) to medication I'm on so I think that will need to be explored.
My coronary vasospasms can be so severe that I need to go into hospital to be treated with an infusion of GTN, nitrates. I am admitted to hospital once or twice a year for about 8 days.
I feel a lingering ache or imprint of pain over my heart area on my chest after a prolonged episode of coronary vasospasms.
It feels sometimes like a horse has kicked me.
I was originally presumed to have microvascular angina as this is much more common than vasospastic angina.
I was prescribed beta blockers, which I now know are contraindicated if you have coronary vasospasms. I landed up in Coronary Care as a result. It's clearly written on my medical notes that I mustn't be give beta blockers.
Adrenaline and caffeine can have the same effect.
I can't drink coffee any more.
My main triggers of my coronary vasospasms are the cold, emotional, mental and physical stress.
It sounds as though your GP is on the ball which is good.
As coronary vasospasms are transient, intermittent constrictions of the coronary arteries it's very difficult to catch the ECG changes they cause on an ECG.
I do have ECG changes when an ECG is done whilst I am having chest pain. The ECG then returns to normal.
My vasospastic angina was confirmed by an angiogram when they injected a chemical acetylcholine into my coronary arteries.
I had spontaneous and acetylcholine induced coronary vasospasms.
My GP said that a treadmill ECG likely won't help with diagnosis as the symptoms came on at rest, so they'd need to look at another way of inducing the symptoms which I presume is what you've referred to at the end of your post. I really don't fancy having the symptoms induced!
Your hospital visits sound awful. I'm sorry to hear what you endure.
Having a look at the possible triggers, a lot of them could have been the culprit. I vape, drink coffee, and the night before would definitely have been classed as binge drinking as I was at a friends birthday bbq. The host was pouring everyone 1 after the other homemade cocktails. It was a lot of alcohol in a short space of time. Stress could possibly be another one.
However, I think my prescription medication is definitely one I need to consider as it's an amphetamine that I've been on for 1.5 years after being diagnosed with ADHD.
Thank you for your kind words. After 11 years, I am well seasoned patient. I have a very supportive Cardiologist and a written protocol for the staff to follow when I am admitted.
My angiogram with acetylcholine wasn't fun, however I did feel safe. There were 8 people in the room. I waa given morphine for my chest pain.
The amphetamine could be an issue.
Some people also can have coronary vasospasms in response to an allergic reaction. Kounis syndrome. Aspirin and antibiotics are the possible culprits.
I also avoid artifical sweetners.
I have to manage my stress. I find Tai Chi and yoga help me.
My daily walks with my dog keep me fit.
Be patient and kind to yourself. It can take time to come to terms with having a heart condition and the adjustments you may need to make in your life.
I have been thinking of getting a dog for some time now and, funnily enough, it was something that's crossed my mind after my recent episode. I figured if I have to give up alcohol and vaping then I need something else to occupy me! The health benefits of dog walking is a definite bonus 😊
I haven't heard from my GP as yet so I think I'll give them a call. The nurse who did the ECG said to call this afternoon if I hadn't heard anything. Hopefully there will be some developments.
I feel in limbo at the moment and a bit reticent to make plans/do anything. I was finishing up work tomorrow for my 2 weeks annual leave. I feel like I'll just spend it waiting. I'm glad we never booked anything now, we'd been toying with it for some time and right up until last week. I don't want to be far from home just now.
It sounds like you and your medical team are well prepared and have your care fine-tuned.
Gorgeous! 😍 I've always been a dog person but my husband isn't so keen... We have a rather old cat and 2 primary aged kids. Until last year we had been renting so we weren't in the position to take on a dog. Now we've bought a house and the kids are onboard, it's just the cat and the husband to deal with now 😉
Had to take the GTN spray earlier. Felt the pressure building about an hour after taking my prescription meds. Left an urgent message with my psychiatrist earlier who prescribes it. Still waiting.. But after this episode I REALLY don't want to take them again.
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Storm in a teacup.
Worried
A&E visit at 5am 
Last week was challenging - chest pain and visit to A&E
A & E Expectations and Outcomes.
