How do you know if your Orthostatic hypotension is caused by the heart attack drugs you're on or by 'something else'?

[bee_bear]

When I was in hospital recently after an acute angina episode and they did a sitting/standing BP test. My sitting BP was 157/92 and my standing BP 125/75, going up to 130/78 on standing a minute later.

I exclaimed to the nurse, 'wow that's a big drop, why has that happened?' and she didn't join in the banter, just very seriously asked me if i felt lightheaded. I said yes but that I always do when I get up so it's nothing new. She didn't explain anything to me and neither has anyone else, so I'm afraid I went to Dr Google! I will ask a medical professional next time I see one but I'm avoiding them for now, I'm all doctored out.

My question is, how do you know if it's the heart meds you're on causing this (I see that bisoprolol might contribute to this) or something to do with your heart/vascular system? What does it mean?!

NB: I was diagnosed with high blood pressure before my heart attack and stents and I'm now being investigated for microvascular disease/angina and coronary vasospasm.

[Happyrosie]

I do feel this is one for the medical experts, not us forumites! But someone might have an idea?

[bee_bear in reply to Happyrosie]

It is but I thought I'd pop it on here just incase anyone had any experience of it. Trying so hard not to speak to any health professionals at the mo 😂

[Milkfairy Heart Star]

Hello,Perhaps give the BHF helpline a call and speak to one of the cardiac nurses?

bhf.org.uk/informationsuppo...

Which tests have you been offered regarding your possible microvascular or vasospastic angina?

Microvascular angina tends to lead to chest pain on exertion and is associated with high blood pressure, diabetes and is more common in women around the menopause.

Beta blockers can help treat microvascular angina.

Vasospastic angina's classic symptom is chest pain at rest especially between midnight and 6am in the morning.

Beta blockers can make coronary vasospasms worse.

Vasospastic angina tends to effect younger men and women more equally.

I was presumed to have microvascular angina at first over 11 years ago. I was prescribed beta blockers and landed up in hospital with unstable angina.

My vasospastic angina was later diagnosed by an angiogram using acetylcholine which induced lots of coronary vasospasms.

[bee_bear]

That's a good idea, I'll give them a try, thanks.

I can get angina on exertion but I'm also getting it a couple of hours after exertion, randomly at rest and 4 times now in the past 4 months chest pain has woken me up very early in the morning (between 3 and 5am).

I've got a stress MRI and a CT angio booked for Jan. Although the last cardiologist I spoke to acknowledged that if it is what they think it is then the CT angio may not show much.

I'm hoping to give all the results I've got from this year and what I get from the tests early next year to one of the INOCA specialists and see what they think. Perhaps I'll get a referral for an angio with acetylcholine.

I'm on beta blockers for a year due to this summer's HA & stents, I did ask them if there was a way to swap the beta blockers for something else to see if that will help with what they think are spasms but I need to stick it out for now. Will see what they say after the next lot of tests.

I hope you're doing well after your recent hospital stay!