chest pains

[tregonyboy]

I had a stent in my LDA 4 years ago. Over the last 2 years I have had intermittent chest discomfort symptoms which tie up with unstable angina, although nitro spray doesn't help. 2 years ago had a myocardial perfusion scan which showed good blood flow to the heart. Still getting the discomfort, though. Recently started getting the discomfort at night, too. Visit to A and E last night showed no signs of heart attack, with everything looking normal. Does this ring bells with anyone? I have reflux problems and have taken PPI for years. Any comments welcome!

[Tos92]

Hi tregonyboy

I have a type of angina which causes chest pain primarily on rest. My arteries go into spasm which restricts blood flow to the heart. This is also known as vasospastic angina.

My arteries are also clear.

The typical pattern of the pain starts early to late hours of the evening and can last up until the early hours of the morning.

ECG changes are not always seen during a coronary artery spasm which can make it difficult to diagnose. Generally, it is under-diagnosed as it is not understood very well by cardiologists and doctors.

There is some more information about this on the links below.

bhf.org.uk/informationsuppo....

inocainternational.com/what...

A confirmed diagnosis is important to getting the right treatment for yourself. Has your unstable angina been confirmed?

I also have chronic indigestion and have been taking PPI’s for over 3 years now. However, I can differentiate between indigestion and my angina but I appreciate it is difficult for some to do this as indigestion/heartburn can mimic symptoms of angina or a cardiac problem.

I would keep a diary of your symptoms and note any noticeable triggers. In the meantime, I would push for more testing to rule in/out if it is unstable angina or something else is causing the chest pain.

All the best.

Tos

[tregonyboy in reply to Tos92]

thanks very much for your commentsTos92. The links are very useful. Onwards and upwards!

[Milkfairy Heart Star in reply to tregonyboy]

I have lived with vasospastic angina for over 11 years.I experience most of my chest pain at rest especially at night which is a classic symptom of vasospastic angina. I have dynamic ECG changes when I am in hospital with unstable vasospastic angina.

My coronary vasospasms were confirmed by a specialised functional angiogram using a chemical, acetylcholine to induce my coronary vasospasms in 2014.

These types of angiograms are not as yet widely offered as a result many patients have a presumed diagnosis which can be wrong.

I was presumed to have microvascular angina until my vasospastic angina was confirmed by testing. The treatment for microvascular and vasospastic angina is different.

You may find this patient story from the BHF website helpful.

bhf.org.uk/informationsuppo...

This recent article about vasospastic angina was published with the input of an expert patient by experience working with leading Cardiologists and researchers.

journals.sagepub.com/doi/10...

Microvascular angina is more common than vasospastic angina and can also cause chest pain at rest too.

However, another thing to consider is that you may have another blockage in your coronary arteries as you already have had a stent.

My husband had his first stent inserted into an almost completely blocked LAD in 2011. Last autumn I noticed he was slightly breathless. I sent him to his doctor who ordered a stress echo which showed he had a lack of blood supply to his heart again. He had a second stent inserted in January, his coronary artery was again nearly completely blocked next to his original stent.

I suggest you go and see your GP and asked to be referred back to be reviewed by a Cardiologist.

[Blackknight57]

I get cheat pains due to possibly a trapped nerve in my back.

It’s similar to fibromyalgia pain.

If it isn’t your heart there is another cause.

Only treatment is pain killer, paracetamol.

Also ppi play havoc with my system. I’m now off anti platlet meds (aspirin)so I don’t need the ppi.

I am male with old man’s prostrate problems, and diverticular disease . So you can imagine what ppi does for my intestines.