GTN spray: I have been advised to use... - British Heart Fou...

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GTN spray

Aspenblue profile image
27 Replies

I have been advised to use my GTN sprat when I have pain in my chest to see if it helps relieve it.As yet I have not as I hate the side effects. The day I had my heart attack I was given several doses of it and the side effects were horrendous. I felt like my head was in a vise and eventually vomited.

I am really scared of using it again as my head felt worse than the heart attack itself.

Any advise would be very helpful

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Aspenblue profile image
Aspenblue
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27 Replies
baly_2023 profile image
baly_2023

Hi Aspenblue,

I haven't used mine yet but its one of the medicines I dread using, I asked a question on this forum about how it feels and headaches, dizziness were mentioned by some as its after effects.

I was told by my cardio nurse to treat GTN spray as my friend or plaster for the heart and use it when necessary.

I'm sure more experienced users of the spray will add more valuable information on your post.

Aspenblue profile image
Aspenblue in reply to baly_2023

That is my problem the dread of knowing what it to come, but if I can think of it as a friend or a plaster then that may help.Thank you

Tos92 profile image
Tos92

Hi Aspenblue,

I also avoid using mine, and the side effects partly have a role to play in that. I get a throbbing headache, which is as a result of the GTN dilating the blood vessels in the brain as well. I also feel dizzy as it causes a drop in my blood pressure, and also experience a very high heart rate with it. I always make sure I am sitting down or lying down when taking the spray. The side effects are not nice however, when you do get an episode of angina, the side effects prove to be the lesser of the two evils. Your body may eventually adjust the more you use the spray. I know my headaches have calmed down in comparison to the first few times I used the spray.

All the best and a happy new year!

Tos

Aspenblue profile image
Aspenblue in reply to Tos92

Thank you for sharing your experiences of using the spray with me. It has helped.

XmasEve24 profile image
XmasEve24 in reply to Tos92

Hi- yes I agree with everything TOS has said. But use your spray the advantage is it far out weighs chest pain and a possible hospital visit. Eventually you body will get used to it. Good luck 😊

Aspenblue profile image
Aspenblue in reply to XmasEve24

Thank you

AuntyEdna profile image
AuntyEdna

I have the same feelings with GTN spray . I probably don’t use it enough . I have Micro Vascular Angina and Mitral Valve Regurgitation . I do feel better after using it but it seems to take a while to work 🫤

Munners1975 profile image
Munners1975

just sit down whilst you use it. Relax. 2 sprays under the tongue. You feel light headed for no more than 30 secs. You must use it if you are worried. 4x 75mg aspirin too and a ramipril I was advised by my cardiologist.

Aspenblue profile image
Aspenblue in reply to Munners1975

Thank you

scentedgardener profile image
scentedgardener

I was reluctant to use GTN spray, but eventually did. One spray and got what I can only describe as like an ice cream headache, and very short lived. I found that side effect decreased the more I used it, which wasn't very much.I was told to use it when I had the symptoms that led to my multiple ambulance trips to A&E, which actually didn't include chest pain. I did tell them that I didn't get chest pain and got looked at pityingly and told to use it when I had symptoms. It all woke me up in the early hours of one morning so I dutifully took 2 puffs, and that was a huge mistake.

If you do use it try 1 puff not 2, I was told I should have been advised to do that, 2 puffs was too much. Another alternative is sublingual GTN tablets that go under the tongue to dissolve, but be aware that they are only half the strength of the spray, take ages to dissolve and only last a month when opened.

I hope you find a way of getting along with it, it doesn't help me but it does help most other people.

Qualipop profile image
Qualipop in reply to scentedgardener

I tried the sublingual tablets right after my heart attack on the suggestion of a paramedic because you can take them out if the headache starts to get bad but they did little to help any pain. I haven't had to use them for 5 years now but keep a sealed bottle just in case.

scentedgardener profile image
scentedgardener in reply to Qualipop

That's a good plan. I still have a spray, unopened, but doubt that I'll replace it when the expiry date has passed.They tell me they think I have angina, but I don't get pain, and GTN spray makes no difference when I have all the other issues. Happily that hasn't happened since they FINALLY started treating my overactive thyroid. Lobg may it last.

Qualipop profile image
Qualipop in reply to scentedgardener

They keep saying I too have anginas but I've never had any sign of it since my heart attack. Just in October when I was in hospital for 4 days with a bad arrhythmia, anginas was put on my discharge letter. I t old my GP who contacted cardio who then said, "Oh it probably wasn't then" and removed the comment. Makes me wonder just what criteria they use for diagnosing angina. I've never had any pain at al l. I do get breathless but heart has been thoroughly checked as have lungs and all were fine. The breathlessness is thought t o be my spinal problems making my back and chest muscles go into spasm.

Aspenblue profile image
Aspenblue in reply to Qualipop

Thank you

Aspenblue profile image
Aspenblue in reply to scentedgardener

Thank you

Crystal614 profile image
Crystal614

Hi, The advice I was always given is one spray under the tongue. The only time I ever used two sprays was when I ended up in hospital last week with ongoing chest pain. A nurse told me to use it twice. The side effects do tend to lessen the more you use it. Sometimes I may get a very slight headache which quickly goes, but most times there is nothing.

Sazznyre profile image
Sazznyre

I have used mine on handful of occasions and directed to use 1-2 sprays. I use one and if pain does not subside in 5 mind use one more. You normally get a headache if used too much and it is best to sit still for a while. I have been put on a tablet form to half a tablet a day which leaves a trace in your bloodstream which helps any consistent angina.

Aspenblue profile image
Aspenblue in reply to Sazznyre

Thank you

theonethatgotaway1 profile image
theonethatgotaway1

When I fell ill and was taken to hospital it was only after they given me the GTN spray that I then started to have a heart attack. I had no chest pains before this. I had fell ill with faintness and burning up with flu type symptoms. I had told them I had been taking viagra that evening too but still they gave me a gtn spray. This is a big no no apparently. Once they checked my heart, my arteries were crystal clear being a fit 35 year old man. They were gobsmacked. Why had this happened. Could the triple dose of nitrates caused a huge drop in blood pressure and had a negative affect. After all, the arteries were clear and no blockages were found.

The heart then failed massively dropping down to 12% ef rate and 10 days iCU.

Anyways for me, this has put me off using GTN sprays for good. I am convinced they had a damaging impact on me that day.

Milkfairy profile image
MilkfairyHeart Star in reply to theonethatgotaway1

Hello,

I am sorry to read about your experience.

You can have a heart attack due to a mismatch of the blood supply that your heart demands and can provide, without any permanent blockages of the coronary arteries.

A myocardial infarction non obstructive coronary arteries, MINOCA.

This supply demand issue can happen if your blood pressure is very high, low or you have a very fast or slow heart rate.

Other causes are transient constrictions of the coronary arteries, coronary vasospasms.

I live with vasospastic angina due to coronary vasospasms. I am at risk of a heart attack, heart failure and major cardiac events.

When I am in hospital on IV GTN to treat my severe episodes of vasospasms, my blood pressure and heartrate are closely monitored.

My Cardiologist has warned me that my blood pressure dropping or my heart rate increasing too much, could cause big problems for me.

I don't use sublingual GTN spray anymore as it relieves my chest pain briefly, but I then experience worse rebound coronary vasospasms.

Another condition Takostubo syndrome can be difficult to distinguish from a heart attack. It's an acute form of heart failure.

A Takostubo event can occur if you experience a ' shock' to your body either physical or emotional stress. Sometimes it can just happen without an obvious trigger.

Have your Cardiology team offered you further tests to determine the cause of your MINOCA or considered Takostubo syndrome ?

Aspenblue profile image
Aspenblue in reply to Milkfairy

The cardiology consultant discharged me during my follow up telephone call 8 months after my heart attack. Not very helpful at all.I will speak with my GP to see if any further test can be done.

Thank you

MrsNails profile image
MrsNails

Hi, l have had a GTN Spray for a long time & at first it gave me an an almighty headache!

I had Stable Angina & it invariably happened half way around the food shop in M&S (when l reached the freezers!) but l learned to sit down & take just two puffs & found it worked.

The headache doesn’t last long & eventually they stopped. I now have Unstable Angina & am going for an Angioplasty next week so hopefully it will improve 🙏🏼

Try not to worry about the side effects before they happen, you may have been given a much higher dose when you had your heart attack.

Take Care ❤️‍🩹

Aspenblue profile image
Aspenblue in reply to MrsNails

Thank you for sharing your experience it is hugely appreciated

Jako999 profile image
Jako999

You need to understand what GTN does and how and when to take it. The big problem is at the doctors give it out but never explain what to do it properly. You get get the chest pain because the blood can’t flow correctly due to a problem with your heart, basically it’s trying to be pushed through a drinking straw when needs to be a hose pipe, think of it as like blowing a balloon up, it’s really hard at the start but gets easier as the balloon expands.

GTN is a really good drug basically what it does is dilate (expand) all your internal pipework, that means that blood in your body can suddenly flow much more freely, this intern will cause your blood pressure to drop which can make you feel dizzy and unwell but it doesn’t last for long.

First of all try and work out what the pain is before panic sets in, touch the area, lift your arms up, push your chest out, take a deep breath, if any of these change the pain then it stands a chance it’s one of your intercostal muscles. It still may not be and taking your GTN will not harm you and in fact may save your life.

You need to sit down relax take one spray under your tongue and wait still trying to relax, wait and see what happens you may need a second or third spray. NEVER TAKE GTN STOOD UP and more then to spays at once or too close together will make your head spin and start banging it also quite often makes people faint. You need to explain this to the people around you as well before you take it.

Hope this explains it?

Aspenblue profile image
Aspenblue in reply to Jako999

Thank you

Jack2019 profile image
Jack2019

When I was in hospital I had my spray with me and decided I needed it so I took a spray, and had a bad reaction as well. I called the nurse and she was stern with me that I had it and used it. It was taken away. The reason for the reaction , as explained to me, was because I had been given a bunch of other drugs and this was amplifying their effects. So, maybe you reacted badly as well because you were likely given other powerful drugs, like clot busters. They deemed it necessary, at the time, in your situation to have the spray and I am sure they were watching you carefully. I just yesterday used my spray, I have never needed it since then, which was in 2018, and I had no bad reactions. Give it a try, it really is effective.

Aspenblue profile image
Aspenblue in reply to Jack2019

Thank you

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