Is Isosorbate Mononitrate 60mg necessary?

[Thisishappening]

What I've got is very mild angina symptoms brought on by emotional stress. I'm 63, male. It's like a slight stitch, almost trivial. They've doubled my atorvastatin to 80mg pd. And "added in" Isosorbide Mononitrate 60mg pd to "alleviate symptoms". I'm happy with the statin, but the nitrate tablets seem way over the top. I'm concerned that I'm being over-medicated and very unhappy about the side-effects. The GTN spray I have already gives me a splitting headache on the rare occasions I use it.

Question: is the (quite high dose) mononitrate medication simply to relieve the (slight) angina symptoms, or does it have a therapeutic effect on the heart which might prevent a serious cardiac event in future? If the latter, I'll give it a go. But if simply to quell symptoms which don't bother me, is there any good reason to put myself through the inevitable headaches and nausea that nitrates give me (provoking further mental ill-being)?

Any advice really appreciated. I feel like I'm going out of my mind without any clear guidance, much less reassurance from the medics.

The diagnosis has all come as a horrible shock. Last week received cc'd letter from Cardiology to my GP saying I'd got Triple Vessel Disease with severe coronary calcification, lots of scary medical jargon, urgent increase in medication and an appointment with the intervention team in two weeks. No sugaring the pill there! Given I had no inkling that I had any serious problems, am fit and healthy, swim two miles a week, don't smoke or drink, and have ok BMI, this diagnosis has knocked me off my feet. Also, I'm just left floundering with a thousand questions and no guidance as to exercise and rest guidelines. So I'm quite annoyed, as well as worried and depressed. I know I emotionally overreact (being ADHD) but just left to muddle on, not knowing what to do or what the prognosis is, seems really brutal (and stressful!!).

Things were picked up because I told the GP in passing that I had very slight pain around my heart when I got agitated. I was asking her if this was to do with the heart murmur she'd identified (now diagnosed as a mild aortic regurgitation). GP said no this was angina and needed urgently checking out. Weeks later, slightly offhand and sceptical telephone conv with local cardio nurse who eventually sent me for a CT tomography scan. Months later, appointment came through, scan done, another six weeks go by. Then the letter, now in panic stations mode.

ps "severe coronary calcification": does this imply arterial graft surgery (triple bypass) or might stents be an option?

pps second post of this as I misspelt the title!

[Manhattan1]

i’d maybe give the BHF nurses a wee call on

0808 802 1234..i’m sure they’ll be able to give information and advice.. they’re really nice

[Lowerfield_no_more]

Frustrating though it may be for you if you have concerns about your medication or treatment you should discuss with the GP or consultant who is responsible for your prescription and care. No one on here has access to your medical records, and the vast majority are not qualified to answer any detailed medical questions, and can only offer well meaning opinions based on their own experience or something they have read or been told, which very often can be conflicting. Otherwise, as Manhattan1 has suggested, a chat with the BHF nurse might at least provide a professional view on your circumstances

[cocobearbhf]

hard to bed sure of course, but ….

I had severe problems with 2 arteries and mild in another. Stents were used to fix the two (3 stents plus a balloon in total). Trying to manage the other artery for now with meds. So don’t assume a bypass.

I take 60mg a day aswell … recently increased from 40.. Still get symptoms, but it has helped. I stopped getting the headaches after a couple of weeks on 40. It was increased to 60 about a month ago and I am still getting headaches again. Hopefully they will subside eventually.

The drug is in theory designed to relax the walls of the arteries to make pumping easier on the heart.

BTW I was (it thought I was) fit-ish. Dog walking twice a day and football and tennis. Still managed to build up that calcification, and before I could get an NHS cardio appointment after being referred I had a mild heart attack. Age 56.

[jgd15]

Hi ..Similarily to you I.am newly Angina diagnosed with extensive calcification on 3 arteries and given 60mg IM which made me feel not too good so was reduced to half tab for a few weeks which was ok then put back up to 60mg which is now ok. Also statins were doubled to 80mg. So your treatment seems fairly standard to me. I still get some heart pressure, mainly meal related, as I walk slower now, so will be discussing with view to angioplasty which seems to be the next step. Keep asking questions of the medics/research to feel better is my approach!. All the best to you.

[Qualipop]

Just to say that the nitrate spray gives me the banging headache but the tablets never did although my dose was lower.