34 years old... 6 weeks after heart attack (caused by Prinzmental Angina)... Fluvostatin = EXHAUSTIO

I know that is literally what everyone keeps telling me! I am still in denial I think . I had some dull schest pain for a while that used to come and go.. nothing to worry about (or so I thought) or moan to the doctors about. I used to smoke cigs but quit 3 or so years ago (only 3/4 a day and was pain free then!).

The heart attack was caused by a cornary artery spasm I'm told (eg the arteries are clean and unblocked blood pressure is normal, cholesterol WAS normal in hospital 4.6 and then 6.5 upon discharge for some reason - probably lack of exericse?!).

Thank you - and sorry to hear about your pain.. I have some lower back pain when I wake up but again nothing that lingers or that high to be worthy of a doctors trip.... other than that it is just the exhaustion.. and boy do I get tired early at night (I was/am nocturnal and I feel I can sleep for England come 10pm)

Interestingly enough I am on fluvostatin.... I have stopped taking the clopidogrel as I figured there was no need given no blockages... and the statin I plan on kickin in the rear as well as soon as I have my blood test end of Jan.

I guess the Calcium Channel Blocker needs to stay to avoid another event...funny thing is they discharge you but dont really explain how badly you damaged your heart/if you're going to be ok etc etc... so many unanswered questions here in the UK 

now I am worried, when they did my angiogram and then two weeks later the stent, they had one hell of a job, they cut the artery in my wrist ok but then my artery went into spasm and they had one hell of a job getting the tube in my artery,  I also had high bp and my cholesterol was 7,2 but down to 5.3 now having said that I am not on the statin so dare say it has gone up.  The bloody problem with these statins is there are many of them and they can work fine for one and bad for another.  You are so right about the nhs, they do tend to have little time to answer questions and send you on your way,anything heart related is bound to cause anxiety 

Well don't forget it also depends on your age... it is natural as we age for our cholesterol break down to slow down. So I wouldn't worry!!

Yea angiograms can be complicated and I have known them to go through the groin if the artery spasms too much - luckily I was not one of those.

What made you come off the the statin - the side effects? Or are you trying different ones because of the way the way they work as you say (side effects for one and not the other...)

Yea I was shocked - no guidance as to "don't do this.. dont do that... rest for this long etc etc" 

Just bye and a pat on the back! Crazy if you consider it is literally one of the most important things that can happen to you (heart attack that is)

 

Hi nima,

You will feel exhausted for around 4-6 weeks perhaps slightly longer after a heart attack, Statins main side effect is muscle cramping or wastage, joint  and muscle aches. Obviously there are many more side effects to any drug and people have different reactions, if it hasn't cleared up after around 4-6 weeks on them ,then you will know it's the medication and not the after feelings of a heart attack.

Now I am only guessing here, perhaps you just had an NSTEMI, even though these can be dangerous they are the lesser of the heart attacks and doesn't really concern cardiologists, that may explain why you weren't told all that much, although you should have been referred on to cardiac rehab after your event, that's procedure here where I am, well it was when I had my last heart attack, they are always changing the ways in heart attacks, something new is learnt all the time. The medication they have put you on is the gold standard treatment for angina,although I don't understand why they put you on cholesterol medication if yours was fine, oopps, hang on, I just saw 6.5 on discharge, that's why you was put on them, 6.5 is high.

There is a new medication out for cholesterol management if diet and exercise can't lower it, it's an injectable medication, only needs to be used once a week or fortnight, I can't rightly remember, the name of the medication is PCSK9 Inhibitor.

Hello Sir! bah... its been 7 weeks and still feel exhausted! although I have been sitting on my backside for nearly 2 months so....(that's my guess regadring the cholesterol being high, seeing as it was 4.6 in hospital). Funnily enough they put me on the statin (cardio) because they thought it would help the PMA but it was the doc who confirmed my chol levels which made me give in and start taking the stat... if you dont think its the stat causing the tiredness ill probably keep at it... see what happens when I return to work next week - that will be a shock to the system.

I guess I should try actually exercising before considering further medications-  as you say, they all have side effects!

Also I should have explained my upon discharge comment that was 2/3 weeks after discharge  

and yes it was a NSTEMI.. but would be nice to know how much of teh heart is damaged etc! 

so tell me about this cardiac rehab...perhaps they deemed it not suitable because of my age? (eventhough I would be curious in going)

Cardiac rehab is a program where they introduce you back into fitness (basic fitness) exercises, they tell you  the importance of exercise and  they look at your diet, medications and are generally there for you if you have concerns, it's more like a support group that runs for 6 weeks, it's run by our health system down here or our Government in public hospitals.

No they don't tell you much if it was only an NSTEMI because even though it was a heart attack those kinds of ones don't really concern them unless thay find something wrong with the heart itself , I have had 2 NSTEMI's  first one back in 2012, I was 46 then, they found a 60% occlusion in the right coronary, had the other NSTEMI nearly a year later ( 2013 ) no angiogram this time, just medication adjustments , I chose not to do cardiac rehab  because I had done it before. I had another angio done Feb this year and they found a 50 % stenosis in the LAD, more medication. To cut a long story short, they told me it was my cholesterol causing the spasms, one cardiologist doesn't seem to think I have PM angina but 2 other cardiologists say I do and that was their explanation, my cholesterol is causing it, what the cholesterol is doing is either eating up or absorbing the nitric oxide that is being produced in the endothelium which in turn causes coronary artery spasms due to the lack of or no nitric oxide, actually my cardiologist has started to come around to the others way of thinking but he doesn't like to use the term Prinzmetal Angina I don't think. My cholesterol is very weird, it has a lot of cardiologists stumped worldwide , well so I have been told by my old retired cardiologist, it's the hereditary type.

Yeah, I'm not saying it's not the statin causing it but you do have to remember you have been through a traumatic experience and that knocks everything for a 6, As I said NSTEMI's are considered baby heart attacks and generally aren't of concern if nothing is found but they can be dangerous.You know I thought 4 was a normal cholesterol level but I'm sure my doctor told me the other week 2 is the number to aim for ? See years ago when all my chest pain started is when they decided to check my cholesterol, my GP back then said 4 was an acceptable number, anything above 5 for a male is high and anything above 6.5 for a female, I don't know, I think they like to change the rules every couple of years

The first statin Atorvastatin made me bleed from my mouth, my tongue went large numb and black,it took ten days to get back to normal!! The pravastatin omg I was like an old woman of 90 walking about, full of aches and pains, I have been off them for 10 days and today is the first day I have been able to walk my dogs for three hours then walk round the shops for another three hours.  Mind you lets wait and see if I can get up tomorrow lols 

 

that sounds absolutely delightful - i dont really fancy that..... lol I can sympathise with your description feeling like an old woman! although I'm not in any great deal of pain... some back pain but nothing thats stopping me from moving....

I'm assuming you didn't have any damage to your heart - because there is no way I can manage being on my feet for 6 hours rushing around! 

Hope you don't feel destroyed today

I remember you having a stent but can't remember what else you were dianogsed with?

Hey Samuels, 

Hope you're keeping warm down under as we have -3 here in London.... was just reading up and saw something that made me think of you:

The selective alpha, blocker prazosin was used to abolish Prinzmetal's variant angina in six patients. All had had an acute transmural myocardial infarction, after which the anginal attacks with transient ST segment elevation developed, and three of them had already suffered from variant angina prior to the infarction. Therapeutic trials with high doses of nifedipine, verapamil, nitrates, beta blockers, and (in one case) phenoxybenzamine were ineffective in all six patients. Prazosin, 8 to 30 mg/day combined with low-dose nitrates or nifedipine completely abolished the attacks in four patients, markedly reduced their frequency and intensity in one patient, and had to be stopped in the sixth one because of hypotension and dizziness. Except for this last patient, the drug was well tolerated by all the others, and no changes in blood pressure were observed. In four patients discontinuation or reduction of prazosin resulted in exacerbation of symptoms, but its renewal was followed by disappearance of the attacks. Since the mean follow-up period in this study was 4 to 6 months, further evaluation appears necessary concerning the long-term effects of this drug in Prinzmetal's variant angina.

Yes you're right traumatic experience... I think I;m still in denial . Also from what I read it mentions people returning to work 2 weeks after their incidents etc which obviously makes one think...especially given my relatively young age!

Your assesment of the NSTEMI is correct I have a vauge memory of the cardiologist whose care I was under in hospital saying I had damaged 1% of my heart and that I would make a full recovery... I wonder if the heart feels itself so it is "as if it never happened" and good as gold haha. It sure was a wakeup call anyway - I have a lot of work related stress and bad sleeping routine and used to smoke when younger.

I am pretty sure 5 is the normal CHL level based on what they told me in hosital but perhaps that changes with age or yea I think they just want to keep us on our toes... good news is so far I haven't experienced any black tongues or muscle pain.... just heartburn (which must be from the clopidogrel or just the heart healing itself...)

Hi nima,

I have heard that mentioned and it hasn't been introduced into my cocktail of medications yet, the only new medication this year is perhexiline (Pexsig ) That has stopped my night / early hours of the morning spasms but for some weird odd reason I still get the attacks during the day, not every day, but I can generaly guarantee at least once a week, if I get the chest pain before my medication time of a morning or even before they are due at night they take care of the spasms after about 30-45 minutes but only lasts 4-5 hours and it all starts over again, so as you know have to hit the GTN if that doesn't help I have to call for an ambulance.

We are very warm down under, it's out summer time even extreme heat can trigger PM angina.

I was also told by a cardiologist a couple of years ago that they are waiting on a new drug for people with cholesterol problems, he also said that it is highly likely that this medication would stop the artery spasms, I did a bit of reading up on it and I saw in some paper, did this ages ago and can't find it but they say it could even reduce the severity or remove angina, now whether that is true  I couldn't tell you, I believethis new medication for cholesterol has been out in the USA for awhile now, it has only just been approved here and approved to be put on the PBS, there's a criteria to meet to be able to get it on the PBS here and unfortunately I dont qualify for whatever reason. The name of this new injectable medication is PCSK9