how much does gtn do?

[Spedyrecovry50]

hi. I was wondering how much gtn widens the arteries by? if any one would know.the reason is I had a ct angiogram. they gave me two sprays of gtn. this opens up the arteries. they then said that I had two arteries with 25% restriction and one with 49%. if I hadn't of had the gtn would it be more?

I ask because my symptoms haven't changed. I still get angina when I exercise. I am still majorly out of breath when I exercise and dizzy etc. but the only help I have had is double up on the statins.

also if I was exercising would that effect the blood flow. wouldn't it be more difficult for blood to get around quickly through a 49% restriction?

I might be over thinking things but I am just trying to work things out.

any ideas would be great.

thanks for you're time.

[Milkfairy Heart Star]

You can have a lack of blood supply to the heart due the small blood vessels of the heart not working properly, microvascular dysfunction which causes microvascular angina.

Microvascular angina is a type of angina/ischaemia non obstructive coronary arteries ANOCA/INOCA.

I suggest you ask your Cardiology team to consider whether microvascular angina could be causing your symptoms.

The BHF has this information about microvascular angina.

bhf.org.uk/informationsuppo...

[Spedyrecovry50 in reply to Milkfairy]

thanks. so far I have an appointment to talk to my cardiologist in November.

[Etblue in reply to Milkfairy]

Dear milkfairy, I am sorry to bother you but would love your input re angina and recent hot weather. Recently, I have been hospitalised overnight due to fainting outside after using gtn spray. My Doctor has halved the amlodipine due to orthostatic hypotension and I have to monitor any rise in in chest pain. Is it best to remain at home during this recent hot weather? Regards and thankyou

[Milkfairy Heart Star in reply to Etblue]

Hello,

The recent hot weather can be a mixed blessing for us heart patients.

The BHF website has some information about how to cope during the hot weather as a heart patient.

bhf.org.uk/informationsuppo...

Drinking plenty of water and staying in the coolest part of your home as well as avoiding going out in the hottest part of the day is recommended.

[Etblue in reply to Milkfairy]

Thank-you. It's difficult -when most of your life....like mine.. has been healthy and fit...climbing Munro's and running 6 miles etc. - to come to terms with new limitations due to health reasons. Thank-you. Hope you have a peaceful & happy weekend. Take care

[Milkfairy Heart Star in reply to Etblue]

I acknowledge your feelings. I too was very fit, I loved walking in the Lake District. I used to cycle 8 miles to work and back.

Have a lovely weekend and take care too.

[Happyrosie]

the website of British Heart Foundation explains about restrictions to blood flow. If you read about this on the website, and if you’ve additional questions you can ring the cardiac nurses.

[Etblue in reply to Happyrosie]

Thank-you & regards

[Spedyrecovry50]

I saw this article that said the gtn can increase the size of an artery by 10-20% if that's true then what would a 25% blockage be without the 10% widening. this is what I am trying to figure out. I have one artery at 49% with gtn and 2 at 25% with gtn. I think a normal angiogram would sort this out. I am a bit boggled. the reason I ask is my symptoms are not good. I used to be able to walk, cycle, run and weight without issue. now I get majorly out of breath going down the stairs.

[oldwhisky in reply to Spedyrecovry50]

I have microvascular angina. Each morning I take 2 prolonged release tablets each containing 60mg isosorbide mononitrate which claims to open up the blood vessels. I also have a gnt spray for when I am walking uphill etc.

[sandandkev]

If you get angina I can't see why you can't have a gtn spray?? I had an ache in my chest- wasn't severe pain but got admitted overnight and have angina- was sent home with gtn spray which had to use when walking my dogs,or after hoovering etc, this still impacted my life so now on tildiem- a slow release gtn tablet which has changed my life,I have mild coronary heart disease,and for my age(67) its common to have some plaque

[Milkfairy Heart Star in reply to sandandkev]

Tildiem retard is a calcium channel blocker rather than a nitrate tablet.Isosorbide mononitrate nitrate tablets are usually prescribed as a slow release form of nitrate.

Another option is nicorandil.

Some people cannot tolerate the side effects of taking GTN. GTN can suddenly drop a person's blood pressure, cause a severe headache and lightheadedness.

Nitrates seem not to work as well for some people living with microvascular angina.

I personally don't use GTN spray, it works briefly, I then experience worse rebound coronary vasospasms which makes my vasospastic angina more unstable.

[Shabana1974]

This is a very difficult one to answer as we are human and we all have unique body reactions. So how my body would respond will be very different yo how yours respond. So this is best conversation to have with Cardiologist as they know your unique body. Sorry I can't be more help

[Qualipop]

Those are not bad blockages. I have two blockages of over 64% which were not stented because blood was flowing freely. I take statins to help prevent bits from breaking off. Two bigger blockages were stented after a heart attack but these two were left alone. I don't get any pain so I suggest you ask for more investigations. It could be smaller blood vessels that are causing it.

[Spedyrecovry50 in reply to Qualipop]

thanks. I am going to see if I can have an angiogram. that might help

[Qualipop in reply to Spedyrecovry50]

They will probably be reluctant to do an invasive angiogram on the basis of just the small blockages but in view of your symptoms you should possibly ask specifically for tests for microvascular angina. Take Milkfairy's advice; she's the expert on it. Good luck.

[fishonabike]

I think you will have trouble getting an answer in terms of precise percentages - the figure vary according to the degree of flexibility of the vessels as well as the amount of built up deposits - also the vessels vary in diameter in different places so any percentages will be averages, given as a range

so the simple answer is that GTN stimulates enough opening up to improve the flow of blood for long enough for it to be helpful for a short while - if is a short action medication and that's why other meds and measures are also important for maintaining good blood flow

[Jedi14]

Without the GTN, probably slightly less. The spray expands the vessels temporarily. The other blockages are due to other problems which are being addressed with meds, initially with statin for cholesterol control. But I think they will give you other meds as well.

[Spedyrecovry50]

thanks everyone. I am on asprin, bisoprolol and statins. but I am having problems with the statins.