still getting angina

[BlueTosca]

in Sept, 2023 I had a pacemaker fitted. Angiogram showed I had the start of plaque in 2 arteries, but not enough for a stent.

cardiologist said that I am fine, but I am still struggling with my breathing, especially uphill.

Last week I walked for an hour up a downhill and it took me 24 hours to recover.

I’m 74. Any advice?

[Tos92]

Hi BlueTosca,

Has your cardiologist put you on any anti-anginal meds considering you have plaque build up? This may prevent the angina and breathlessness you feel.

I probably wouldn’t do anything too physically demanding until you speak to your GP or cardiologist just to be on the safe side.

Tos

[BlueTosca in reply to Tos92]

Hi Tos 92,

I am on 40mg of atovaratatin and 1 aspirin per day. I have neurolongual, but the headache is so bad, I will only take that if I think I’m having a heart attack.

I don’t think the cardiologist plans to see my again, but I have a blood test next week and have made an appt to see my doctor.

Thank you for replying

[Tos92 in reply to BlueTosca]

It might be worth discussing a short acting nitrate like GTN with your GP. It can also be used as a preventative measure before embarking on a physical activity that you know will bring on your angina.

Also ask for a medication review at your appointment. It could be that your statin for example needs to be increased.

Good luck for the appointment.

Tos

[BlueTosca in reply to Tos92]

Thank you- I’ll follow that up. Best wishes

[Milkfairy Heart Star]

Hello,

If you have too low a heart rate it can lead to not enough blood getting to your heart when it needs it.

Called supply demand mismatch.

This can cause angina and breathlessness.

Were you given the contact numbers of the Pacing Team when you had your Pacemaker fitted?

If so perhaps get in contact with them and ask for your Pacemaker settings to be checked.

Alternatively discuss this with your GP when you see them.

[BlueTosca in reply to Milkfairy]

Hi Milk fairy,

Thank you for responding.

Supply demand mismatch sounds a possibility.

I had the angina symptoms both before and after the pacemaker. It was checked three months ago and found to be fine.

I saw the cardiologist about 8 weeks after pacemaker fitted ( due to wait for angiogram).

he said I am perfectly fine and they do have other patients who react like me and they don’t know why.

I do, however have a condition called complex regional pain syndrome. Whenever I’ve had a lesion, it heals and then usually about six weeks later the pain starts again and ramp up and up and up. If we can work out that it’s my brain and not the disease I can bring the Pain down with pain management techniques. In the last few years, I’ve had this in my back, my ribs and for five months I couldn’t sit down. I have been trying to use the same techniques on my heart, but it’s almost impossible to do if you still think there’s something wrong.

I’m going to ask my doctor if the regional pain syndrome stuff can give me phony angina symptoms.

A bit fed up. I’m going to follow up I. Supply mismatch.

Thank you

[Milkfairy Heart Star in reply to BlueTosca]

Pain belongs to us as individuals, cannot be seen or measured however many healthcare professionals make biased assumptions about pain.I am sorry that you live with such a complex pain condition.

I live with alot of pain in my life too, but I know it's due to my coronary arteries going into transient constrictions, vasospasms causing vasospastic angina.

Just knowing why I have my pain helps me to cope psychologically.

I also use pain management techniques to help.

One thought, has your Cardiologist considered that your angina maybe due to your small vessels of uour heart not working properly, microvascular dysfunction?

Microvascular angina is often overlooked and effects women more often than men.

The BHF has this information about microvascular angina.

bhf.org.uk/informationsuppo...

I acknowledge your feeling of being fed up.

My coronary vasospasms have been very unruly for the last week.

[BlueTosca]

Hi Milk Fairy,

Thank you so much for your help. Dive never heard of microvascular dysfunction and it could be that. I’m seeing my doctor next week and will ask her.

pain management is tricky. During Covid I came across a brilliant app for pain called ‘pathways’ and bought a life membership for £80. When the pain is bad, I re -do ‘The journey’ and the ‘Mind’ section is great.

I made friends with the man who developed. Sometimes it is a little clunky as he doesn’t have the money to take it much further and it is £20, 000 for a small nhs clinical trial. Nevertheless it’s a life saver for me.

You probably have your own app, but as you have been helping me, I thought I’d reciprocate.

Thank you so much

Xx