Chest pain and using the GTN spray

[tennis-guy]

Hello. I am now 5 weeks in after a heart attack which came completely out of the blue and then angioplasty with aortic stent. I have had chest pain ever since which is generally mild but can get stronger (it can come on at anytime whether I am exercising or not and can last for an hour or more). It feels like a stinging pain localised in the centre and/or left hand side of my chest. I put it down to my heart as I never had it before my heart attack. I was not automatically signed up for rehab (apparently there was an oversight) so I chased them up myself. I had to answer some questions before they would put me on rehab and the medic made much of the chest pain I was describing to her and said it would have to be investigated before I could start the rehab. Anyway she also made much of the use of the GTN spray. I explained I have not used it yet because I thought you just took it occasionally and if the pain was particularly strong. If I were to use it whenever I got pain I would be taking it every day and maybe several times a day. Can I ask others in the community what their experience is and whether they have similar pain and use the GTN spray as consequence and if so how often? I am very grateful for the support I have already had from lots of you.

[Tos92]

Hi tennis-guy,

I was initially hesitant on using my GTN spray as well. I believe most are and are never quite sure when to use it and how often. The purpose of the GTN spray is to dilate the blood vessels so that more oxygen reaches your heart. The angina that you feel is due to a lack of adequate blood flow to the heart.

The rule is to administer 1-2 puffs under the tongue. If the pain does not subside, you are to repeat it every 5 minutes. If the pain has not subsided/gotten worse after the third spray, it is usually a visit to A&E.

I tend to only use mine when I find that my spasms are quite unruly and intense. I have something called vasospastic angina and as a result, my coronary arteries go into spasm. Like yourself, I have daily angina, but due to the side effects that I get from the GTN, I’m sure I’d be on the verge of passing out if I used that often and there is a small risk of becoming tolerant to it as well.

Make sure when you are using the spray you are either sitting down or lying down as it can cause your BP to drop. You may also experience a fast heart rate as the blood vessels dilate and a headache. Some people also experience nausea and sweating. These usually subside fairly quickly.

It’s best to follow your cardiac’s teams’ advice on how and when to take it. It could be that if you are having daily angina, they give you an alternative such as a long-acting nitrate instead. This could be something to discuss with your rehab team or the person that has been assigned to you.

Good luck and I hope others can offer their experiences too.

Tos

[tennis-guy in reply to Tos92]

Hi Tos92. Thank you for your full and very helpful reply. Could you approximate how often you use the spray in numbers eg once a day, twice a week etc

[Tos92 in reply to tennis-guy]

My usage is low. I would probably estimate maybe around 9 sprays a month.

[Stentsandrun]

Good reply from Tos92 following your interesting post. I don't use mine much and every time I have it has made no difference so I assume it was probably indigestion or muscular, although this has only been half a dozen times in 6 years. However I do believe some people use it regularly before doing exercise, or even while doing it for example while walking. I think the advice has been to them to use it as often as you think you need it.

Often wondered if it would improve my Parkrun time lol.

[Beckster1964 in reply to Stentsandrun]

Yes, that how I use my GTN spray - just before I start my run and then after about 20-25 mins when I can begin to feel a little bit on Angina coming on - it kicks in really quickly and allows me to keep running for longer. I probably run about 3-4 times a week.

[tennis-guy in reply to Beckster1964]

That is interesting. Can I ask how old are you and how far do you run? Thanks

[Beckster1964 in reply to tennis-guy]

I have just turned 60. I had a couple of stents a year ago after struggling with Angina for some time. I typically run 5-6km per session - pretty gentle pace these days - normally stop after about 40 mins. Initially I was quite anxious about using the spray, but it now seems routine. I may be lucky in that I get almost no side effects - no headaches, feeling faint etc.

[Bluelobby]

Hi pal , you say exercising ? 5 weeks after . If you mean just walking then fine but I wouldnt be doing much more at this stage . Your pain could be stretch pain after having a stent fitted , I had the same which went away maybe after 8 weeks or so . Used to use my spray maybe 5/6 times per week , 20 months on I use it once per month if that .Gd luck

[Farmer63]

Hi, just to say, you will think ever ache or chest pain is your heart, especially such a short time after your HA . In my case it was acid reflux that was causing my chest pain.My rehab nurse told me that most people rarely need or use the. GNT spray. I used it only a few times the side effects where bit horrendous, as I have slightly low blood pressure it floored me, also I am prone to migraines and the headaches where something similar, but did not last as long. It's important to give yourself time to get back to normal after your HA, sometimes new medication can cause heartburn,acid reflux.

[30min-ambition]

hello - I had HA and stent in January of this year. I had similar pain and put it down to the stent settling in - I was told by the rehab team it can take up to a year for it to settle into your body. Also, I noticed that when I exercised (walking or rehab session) I was exhausted after and sometime my chest felt a little tight. I worked out this was because I was unfit. I have used the spray a few times, but now tend to rest when I feel like that and am ok after a few hours rest.

I probably have not helped, but to say, we can be hyper vigilant to everything and because of what’s happened over think stuff. But do as you have and go back to your hospital consultant for them to help/advise.