I am very interested in TOS 92’s reply to a letter, talking about oesophageal spasm & C A spasm, as I may be suffering from this.
Had HA& 5 stents placed 19 months ago& still suffering from tightness in chest, into throat, a choking feeling, having to clear my throat constantly& hoarseness. I tried everything to find out what is causing this, it’s comes& goes, all the time& is causing me a lot of distress. Cardiologist did a rest & stress test in August, told blood flow ok, & said it’s not my heart. As well as Lansoprazole 30 mg, I take gaviscon, but if it’s there nothing seems to help, as you can tell I’m now at my wits end. I’ve decided to check out oesophageal spasm with my gp when I get home, Im in US for Xmas, but if anyone could advise me I’d be most grateful.
Thank you!
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Maidenhead1
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I’m sorry to hear about the symptoms you are having. What other tests have you had apart from the stress and rest test to rule out issues with your heart?
In order to test for coronary artery spasms, or vasospastic angina, a confirmed diagnosis can come about from a provocative angiogram with acetylcholine. This is considered the gold standard for ruling in/out coronary artery spasms. However, you may find like myself that there are cardiologists who are against sending patients for this test due to the potential risks involved and the GP or cardiologist usually needs some sound evidence which indicates coronary artery spasms before considering this test. I’ve had 3 cardiologists advise against it so far however, you may have a higher chance of being referred for a test like this by a specialist in INOCA (ischaemia in non obstructed coronary arteries). My coronary artery spasms were diagnosed during a normal angiogram where my myocardial bridge was seen spasming after a MINOCA (myocardial infarction in non-obstructed arteries) last year.
My coronary artery spasms cause daily pain in my chest, arms, upper back, and sometimes jaw. They are more commonly associated with rest however, I do find that they can be present on movement too. It might be worth keeping a log of any triggers. I find the current cold weather to be a trigger along with any kind of stress.
Recently, investigations have started for possible spasms in my oesophagus as well. This can cause what I describe as heart attack like symptoms. It feels like a tight gripping pain in the centre of my chest, and I feel it in the right side of my throat and ear. It is thought that the muscles in the oesophagus fail to contract properly.
A manometry test can rule in/out oesophageal spasms. However, your GP may send you for GI tests first such as a endoscopy which may be contributing to your symptoms. This can help rule out hernias, ulcers, and reflux build up for example. I’ve attached the link below on achalasia which has symptoms and tests that both overlap with oesophageal spasms in case you want to read into it further.
It could be none of the things above, but this is why it is important to follow up with your GP when you are back. If you have a GTN spray, it might be worth trying this next time you get an episode to see if that helps relieve some of your chest tightness.
All the best and wishing you a happy, and healthy new year!
Have you seen this article about myocardial bridges? It suggests that CT angiograms can be a more accurate non invasive way of assessing myocardial bridges.
Maybe something to discuss with your Cardiologist?
thank you Tos for your very detailed reply. Apart from myocardial infusion test, I saw a gastroenterologist privately in Jan last, had an endoscopy& Ct scan which showed a hernia, that I’ve had for years, unless the hernia has got bigger& I am experiencing worse symtoms 🤷♀️anyway I have the link for achalasia, which I’ll see the gp when I’m home, thank you again& wish you a very happy NY!
I have lived with coronary vasospasms causing vasospastic angina for over 11 years. It is a rarer form of angina which is poorly understood and often overlooked by Cardiologists.
I had an angiogram with acetylcholine in 2014 to confirm my diagnosis.
I am not sure it's true to say that Cardiologists are 'against sending patients for testing' it's probably more to do with Cardiologists not having the appropriate skills and permission to use acetylcholine during an angiogram.
I have not had problems accessing the tests required. I have been fortunate to have been referred to world experts in caring fir patients with vasospastic angina over the years.
I have a fantastic Cardiologist whom I see every 4 months and the whole cardiology team at my local hospital are very supportive.
I am admitted to hospital for treatment with IV GTN once or twice a year. I was last in hospital for 10 days in November.
There are several other forum members who have had a functional angiogram with adenosine and acetylcholine to confirm their diagnosis of microvascular or vasospastic angina.
It can be difficult to tell oesophageal spasms from coronary vasospasms especially as GTN relaxes the smooth muscle in the gut and blood vessels.
I suggest you keep a diary of your symptoms and see if you can identify any triggers of your symptoms.
I developed gastritis a few years ago. I had an endoscopy and prescribed Lansoprazole which has helped.
I still experience my heart pain in my stomach and after eating. It feels different to gastritis which I found was a burning, gnawing pain. My coronary vasospasms feel like being in labour in my heart, upper left back, stomach and kidneys. I also feel as though the air is squeezed out of my lungs and I can't breathe in.
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