just looking for some advice as very worried about my husband and we are in France. For the last 4 mornings he has had chest pain spreading to a tightness in arm/shoulder. Approx same time each day after standing up 6:30/7am. On the second morning I had the campsite call an ambulance and they took him in for ECG and bloods- all were clear.
We’ve obviously booked to come home to the UK asap which is ferry tonight. Have been reading up on variant/ prinzmetal angina. Could it be this? Hospital issued him a GTN spray which gets rid of attacks instantly. Prior to that they were lasting around 3 mins then subsiding. No breathing problems or sweating, just a tightness that he said made him want to push on chest. He is then fine when active for the rest of the day.
Will he be ok on the ferry? We obviously have GP appt scheduled for as soon as we are back.
any advice would be greatly appreciated as I’m trying to stay positive for him and our little daughter. Those of you who suffer from this- did it start with quite quick attackers like this?
Thank you in advance
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Zebra49
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I have lived with vasospastic angina, the term now more commonly used to describe coronary vasospasms, for many years.
Vasospastic angina is caused by transient constrictions of the coronary arteries which are usually eased by short acting GTN such as sub lingual GTN spray.
I was admitted to hospital in 2012 with a suspected heart attack, however I was told incorrectly that I couldn't have angina or a heart attack because my coronary arteries are unblocked.
My vasospastic angina was later confirmed by a specialised functional angiogram when a chemical, acetylcholine was injected into my coronary arteries to see how the arteries responded. I had lots of coronary vasospasms.
I tend to experience my episodes of chest pain during the night. My angina episodes will also be triggered by the cold, mental, emotional or physical stress.
I suggest your husband wraps up well and keeps out of the cold wind on the ferry.
Keeping a diary can help identify any possible triggers.
The BHF website has some useful information about how to use GTN spray
I suggest your husband sits down the first time he uses the spray. It can feel very odd at first, as it dilates the blood vessels in your brain too. It can make you feel light headed, nauseated and give you a headache.
Thank you so so much for your very quick and detailed reply. You seem to be an expert on it. Thank you for the links- I will have a look at the articles and reports.
Can I ask- do your episodes of chest pain that happen at night tend to happen when you suffer from stress etc or can they happen anytime? And do you know if people can have a mild form of this condition as his pains seem to not last very long?
Like any health condition there is a spectrum of how people are affected.
Some individuals have one or two episodes of coronary vasospasms, others intermittently, others are very severely affected requiring admission to hospital, to have their unstable vasospastic angina treated more aggressively.
Everyone seems to have their version of the condition.
I will have more symptoms including chest pain during the day, following exercise or in response to stress in the colder winter months.
The cold is one of main triggers for my angina or overdoing it.
Another resource is this group established by four patients who live with microvascular or vasospastic angina.
thank you so much- you’ve really helped. He is currently in A and E where the GP said to go so hopefully some useful tests will be done. Many thanks again and sorry to hear you had a such an awful journey with your condition. Glad it is under control. Thanks again
I am glad to hear that your husband is being seen in A&E, hopefully he will be referred to the Cardiology team or Rapid chest pain clinic.
I have had all my care through the NHS, including being reviewed by some of the world leading experts in caring for patients living with microvascular and vasospastic angina.
My vasospastic angina is unfortunately stubbornly resistant to treatment and I end up in hospital a couple of times a year with unstable vasospastic angina.
I have a very supportive and experienced Prof Cardiologist at my local hospital whom I see 3 times a year.
I had my angiogram with acetylcholine in 2014.
These types of angiograms are becoming more available however your husband will probably be offered the routine tests offered to people experiencing chest pain first, such as a CT angiogram, stress echo and cardiac perfusion MRI.
Vasospastic angina is rare and all the other possible causes of your husband's symptoms need to considered too.
I’m sorry to hear about your husband’s current situation, especially whilst abroad as I understand it can be a bit scary having been through something similar myself.
I had a MINOCA (myocardial infarction in non obstructed arteries) whilst on holiday in January 2022. It was later found that my myocardial bridge (an artery which tunnels through the heart muscle) spasmed and this is what triggered the heart attack. I have since lived with vasospastic angina, previously known as Prinzmetal angina.
Prior to the heart attack, I had similar chest pain to your husband. They would come on intermittently throughout the day for a couple of minutes and spread to my arm and upper back. Nothing significant as far as bloods and ECGs were found at the time and being 28 years old when my symptoms started, they did not expect or anticipate for someone my age to have heart problems.
From experience, do have his chest pain investigated. If nothing significant is found, it might be worthwhile seeing an INOCA specialist to rule out/in Vasospastic or even microvascular angina.
Stress is a major factor for me and does trigger my spasms. Stress was also thought to have contributed to my heart attack. Strong emotion is also another one that triggers my spasms, in addition to cold weather, very hot weather, and too much exertion.
There is a lovely supportive group on these conditions on Facebook which you might wish to join. You can ask questions and share you husbands experience/symptoms, as well as gain access to other useful resources.
Wishing you and your husband a safe journey home. Though I received great care when I was abroad during my heart attack, it is a relief being back home where you are familiar with the health service.
Thank you so much for your detailed reply and I’m so sorry to hear how you’ve suffered with it. That must have been so scary being on holiday and having a heart attack. I’m glad to hear you have it under control.
We got home safely and and my husband went straight to A and E and is currently waiting for more blood results but I’m thinking they won’t show anything and we may need to push for vasospastic angina testing etc.
Thank you so much for your advice. Can I just ask if you know how easy it is to find an INOCA specialist? Would we need to go private? And is it hard to get an Angiogram with acetylcholine or do most places do that these days? Just googled and it’s all a bit confusing. Thank you for mentioning the FB group- I requested to join a few days ago and am waiting.
I’m glad to hear you and your husband have both gotten back safely.
Where are you based and I can recommend you an INOCA specialist perhaps? The website below also has a list of specialists on it based on area/location.
I went private after having no luck on the NHS and difficulty getting the cardiologists and doctors to understand as it is an under diagnosed and poorly understood condition. However, I have now been referred to the NHS via my private specialist and I am now seeing some cardiologists based in London who are knowledgeable of INOCA/ANOCA conditions. I think the first step would be to see if your husband is referred to a cardiologist and discuss the plan and further testing with them first. Failing that, you can ask for a second opinion from a different doctor and cardio. If no luck like me, then I would recommend going private and then being transferred back onto the NHS and seeing the specialist that way.
A functional angiogram is not widely available, but it is not impossible to access under the care of a specialist who can refer you for one if they feel it suitable. I have not had one as my specialist advised against it, however, it is available as and when they feel I need it as they are satisfied with the medical evidence they have so far regarding my heart condition.
In regards to the Facebook group, do ensure you have answered all the membership questions as sometimes this can cause a delay in accepting you into the group. I had the same issue when I joined.
Thank you so much for your reply again. The website link is really useful and will help us find a specialist if needed. We are currently awaiting an appointment with the Rapid Cheat Pain clinic and then will hopefully know more.
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