Chest discomfort after eating ..anyone else?

[Catwifie]

7 weeks post ? NSTEMI now diagnosed as Coronary Artery Spasm...Have noticed after eating meals my chest feels tight and a bit sore..centrally. GTN helps a bit...Been to local hospital twice with chest pain and dyspnoea .both times ecg and Troponin levels OK.. so discharged. Is digestion of food causing this? Blood supply diverted to stomach?

[Bluehope81]

Not medical advice, opinions and suggestions only.

Have you had a cac scan? I would recommend continuing having heart tests, to get a full picture of your heart.

How have they diagnosed coronary artery spasm? The test where they inject acetylcholine into the artery?

It's interesting you mention food, it could be on the off chance it is your gallbladder, a rudimentary test for this would be too eat a non fatty meal and see if it has the same affect as when you eat a double cheeseburger from MacDonald's, the fat will aggravate the gallbladder and possibly your heart,

[Catwifie in reply to Bluehope81]

Have had an cardiac MRI with an injection of ?dye ..not sure what tbh.

At my angiogram only one of the very small vessels was seen to be calcified..otherwise it was clear of plaque.

It was a low fat meal...pasta and butternut squash sauce

[Bluehope81 in reply to Catwifie]

Ok thats good news that you have had further testing, I would dig out the report and see what it says, we can help decipher it, there are a couple of members who are experts on coronary artery spasm disease in the forum, they will probably chime in later however it is holiday time, or you can find them as they post often.

That's very good news that your were almost clear of plaque, the low fat meal means maybe not the gallbladder.

[Catwifie in reply to Bluehope81]

Haven't seen the MRI report...just a letter from Cardiologist to my GP with summary of findings and diagnosis/ treatment advised

[Milkfairy Heart Star]

Hello,

My coronary vasospasms causing my vasospastic angina was diagnosed by an angiogram with acetylcholine in 2014.

This is the definitive way of diagnosing vasospastic angina.

During an unstable phase of my vasospastic angina, as well as experiencing chest pain at rest, I start getting chest pain after exercise or eating.

Getting chest pain after eating is known as postprandial angina.

Coronary vasospasms are transient constrictions of the coronary arteries and are not able to be detected by a cardiac MRI. The ECG changes that can occur are difficult to catch too.

Saying that I had dynamic ECG changes during my last admission. The Consultant on call told me she was concerned and my Cardiologist came to see me too.

Coronary vasospasms are not harmless.

A perfusion MRI can diagnose microvascular dysfunction which is when the small blood vessels are unable to dilate or stay dilated in response to extra demands like exercise. Microvascular dysfunction causes microvascular angina.

Microvascular and vasospastic angina are types of ischaemia/ angina non obstructive coronary arteries.

It's important to have an accurate diagnosis as the treatment options are different.

Vasospastic and microvascular angina are complex conditions and they are not benign. I suggest you ask to be reviewed by a Cardiologist who understands or is willing to research into the condition and can offer you further testing to confirm your diagnosis. Then hopefully you'll be prescribed the appropriate medication that will work best for you.

You can request your MRI results in full.

I carry my angiogram with acetylcholine results along with my admission plan with me at all times.

The BHF has this information about microvascular and vasospastic angina.

bhf.org.uk/informationsuppo...

bhf.org.uk/informationsuppo....

You may find this website helpful too.

internationalheartspasmsall...

[Catwifie in reply to Milkfairy]

Thankyou...I will!

[Tos92]

I’m currently being investigated for oesophageal spasms which are spasms in the oesophagus. I also suffer with chronic indigestion and sometimes it can be difficult to determine between the two. However, oesophageal spasms are hard to diagnose. Mine cause heart attack like symptoms in my chest, they feel worser than my coronary artery spasms which is what I have as well. A manometry can usually rule these spasms in or out. I have noticed certain foods make it worse and it’s likely due to the fact that they contain high amounts of histamine. For example, pulses, carbs, certain processed and tinned foods, certain fruits and vegetables, dairy and chocolate are some of my triggers for the spasms. The GTN spray is one way which oesophageal spasms can be treated however, you need to discuss your symptoms further with a doctor to find a medical pathway which will work for you.

It might be useful to keep a diary of what types of foods maybe triggering the chest pain.

All the best.

Tos

[Brht]

I get that but I attribute it to things like red wine, coffee. If I have them too many days on the run I get a pain in the centre of my chest. If I ease off on them it goes. The pain started again over Christmas because I'd indulged in both. For the last 4 or 5 months I've steered clear of them and not had it.It's something you could look at but keep checking with your Dr etc in case it's something else.

[Catwifie in reply to Brht]

I've had a slice of toast and tea this morning and now I'm getting palpitations! Lying in bed doing nothing! 😩

[Brht in reply to Catwifie]

Oh no, you wouldn't have thought that tea and toast would have that effect. I was hoping it was something like in my case and you'd be easily be able to regulate it.I'd try keeping a diary of what you've done each day and see if a pattern emerges.

I had a problem with some of my meds and the Dr used that to help get a picture.

[Catwifie]

Yes..I'm recording it all though GP said to try not to over analyse and think about every little twinge...distract myself but its hard when your ticker is thumping away! I've never had heart problems before so not sure what is par for the course or barring chest pain and dyspnoea what can be ignored!

[Milkfairy Heart Star]

Hello,

How were your coronary vasospasms diagnosed?

There are quite a few of us on the forum who have vasospastic angina.

I hope your medication is helping.

[Catwifie]

Cardiac MRI...I think diagnosis arrived at after excluding other things really eg MI, myocarditis...Will try to see the cardiologist in the new year and grill him!

[Milkfairy Heart Star]

Usually people with vasospastic angina can exercise as it is caused by a temporary transient constrictions of the coronary arteries. Typically you experience chest pain at rest especially during the night.

I have vasospastic angina, I can exercise, I passed my stress test no problem, just got more coronary vasospasms later at rest.

Microvascular angina is another type of angina without blocked coronary arteries. In this case the small blood vessels fail to dilate or stay dilated in response to exercise.

People living with microvascular angina often have a positive stress test but not those with vasospastic angina.

Breathlessness is often a symptom of microvascular angina as well as heart function problems.

Bendopnea, getting breathless when you bend over seems to be associated with microvascular angina too.

Have you asked your GP to refer you to a Cardiologist who understands microvascular and vasospastic angina?

It sounds as though you may need further testing to find out what's causing your symptoms.

The treatment options are different for microvascular and vasospastic angina.

Have you been offered a NTproBNP blood test? This blood test can check if your heart muscle is working properly.

I hope you are able to access the care you need and can find a doctor to listen to you.

[Silvertail]

Is it possible you could have GORD, or a hiatal hernia?

[Catwifie]

GORD?

[Oaks6]

I get indigestion type discomfort on and off. It happens more when I’m driving or sitting on the sofa. I’ve had 3 stents fitted a few years ago and always suspect my heart when these pains occur. I’ve also had IBS type of issues recently so it’s a tricky combination.

I think the only way to get some solid tests done otherwise it’s literally about feelings and no solid facts. I’m hoping to see a cardiologist to sort out what’s actually happening. I hope you can get some definitive results or diagnosis as I know it’s worrying having these symptoms .

I forgot to say, I’ve had loads of test to check out if I have any gastrointestinal problems or IBD and they have come up with a few symptoms.

Stress can be a big factor in IBS / indigestion symptoms too.