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

Yea if it the spasm goes on for long enough, it constricts the coronary arteries to the point where reduced blood flow damages the heart muscle and s heart attack is the result. Or so I'm told at least by the cardiologists! And yes I have zero also. Curiously hey say beta blockers are counter productive for prinzmental angina (they put me on that initially when they suspected a heart attack as a result of a blockage then immediately took me off once the diagnosis was given - apparently it can cause the pain to increase. To be fair I've had no real pain since being out of hospital and didn't really have any before the incident.... maybe a dull chest as I mentioned but that's it.

Thank you for your kind words, at any age it must be difficult but at mine... well it's certainly got one thinking as to if there will be a future to speak of and what it will hold... I guess a few more months and healthy lifestyle from here on in, and this will be a distant memory.. until my old age.. at which point I'm sure it will be a challenging life ahead!

Actually PM angina itself doesn't cause a heart attack, we are all susceptable to heart attacks , you are right about reduced blood flow to the heart but it's generally not enough from PM angina to damage the heart, if it is damaged in this way , the NSTEMI I was telling you about earlier,  Cardiac Rehab and cardiologists have told me that the damage can repair itself, exactly like a liver can do, but to much damage then obviously it's not reversable

and may I ask if you have had any heart attacks since and whether your prinzmental angina was diagnosed to have been something you had afterwards or before your heart attack?

I don;t understand why they have you on beta blockers as that is supposed to make prinzmental angina worse - if you are still in pain might be worth raising..I guess they are learning more and more every day about this disease - calcium channel blocker is often the first line defence for Prinz I am told then Nitro (I have a GTN spray that I have not used since being discharged from hospital but is now my safety blanket!).

Thank you.... I needed to hear that Diana. I stil have a lot I want to do as you can imagine so the term Survivor is something I will remind myself of, thanks to you. Hope you're right, with the medicine, I am really hoping there will be no further heart attack as a result of this.

You say you dont let the spasms go on... sounds like you have them tamed and a secret trick - do tell 

I have to say, I have find myself at home on this forum... you are all a bunch of lovely people and if you were all nearby I would bring you flowers.

You are very sweet I was diagnosed with prinzmetal's about five years ago just out of nowhere I started having heart pains I take the beta blocker because I have PVCs a lot I had been much worse sometimes 148 Within 22 hours many times I had to take Nitro up to 6 and 9 times a day I forgot to mention that I take clonazepam for severe anxiety and it helps to calm me down and let this pass and relax I've been to the ER countless times just to find out they are spasms and painful but I had tests done catherization and the one that you have if you can't do a treadmill were they put something injected into your your veins that go into the heart and make it beat real hard for 6 minutes and see if the spasm comes it is like a cardiolite test and then have an MRI the next day of the heart but that is what proved I had prinzmetal's I have not had a heart attack since although it felt like it several times the reason I don't take a lot of other medicines like metoprolol or the other types is because they made me have a bad arrhythmia which I already have so these are the best ones and the only ones that have worked for me no they are not the right choice but it was a process of elimination so there you have it and so I go on and so will you much love a fellow Survivor

beta blockers aren't reccommended for people suffering from prinzmetal angina as you say they can make the condition worse, even calcium channel blockers don't work all the time for a lot of PM angina sufferers, our bodies get immune to all that kind of stuff and in the end when you have a bad attack they do nothing and it's a trip to the emergency department to make sure we haven't had a heart attack via a troponin test.

All my severe attacks are exactly the same as when I had my first heart attack, I can't tell the difference, I'm a rock in a hard place or I'm damned if I do or damned if I don't . when I get my bad attacks of spasms I can have up to 16 sprays in an hour or so, does help slightly but it keeps rearing it's head up every 3-5 minutes and in the end GTN is doing nothing. I also take Alprazolam for my agoraphobia, it was used for a condition that I had, Panic / Anxiety attacks, works wonderfully on them but unfortunately doesn't do a thing for the PM angina attacks.

I was told and from experience p.m. as you call it rears its ugly head at night and I've had several Spells at night with lots of nitro my Atenolol slash beta blocker is 4 arrhythmia that I had after my first heart attack that left me with left bundle branch block which is also first degree heart block widening of the QRS something I was told that you can get a tolerance even to Nitro but there's nothing else that you can do like you said damned-if-you-do damned-if-you-don't all you want is the pain to stop and the spasm to be over doctors become insensitive to the pain of this disease they told me in the beginning that it was very painful and very long lasting you have it indefinitely forever they told me mine was a severe case and put it on my paperwork sounds like you have the same diagnosis but without the arrhythmia like I have very hard to handle and to deal with this disease it makes me cry and it makes me afraid my children tell me that it's all in my head and that it's all anxiety it's easy to say if you don't have it but we know different my cardiologist is always happy to help me over the phone in between my yearly visits with adjusting my medicine are advising me about something because they know it's a true disease and not in our heads I am very empathetic with your problem I hate this disease but I fight it and I go on for the days that I feel good and I appreciate those days even though I know it will come back I pray a lot I have a very close friend that helps me that has a quadruple bypass and stents so understands the pain of heart pain keep going you will be ok I'm glad you are on this forum I will be here as long as I can be patient stay calm you will get through each of these attacks I have had some that were I have spent screaming and writhing in my bed and even in the doctor's office the pain was so horrible and in the hospital but I got better we are survivors I tear up talking about this with you because I know you are suffering and scared me too but we will make it and we will be ok alright? Much love from a fellow sufferer actually a woman of course hope you are better

Hi,

Yes it's terrible, this is something you wouldn't wish on your worst enemy, I have been to our emergency department 4-5 times in the last 2 weeks and I asked for my usual pain relief so this doctor had to go speak with her boss, she came back and told me that I don't need pain relief, I'm like......what !! ....lets see the doctor put up with this pain , endone / morphine  gets rid of my pain if I can't keep it at bay early enough with the GTN, funnily enough my night time spasms have ceased due to a medication being introduced, however it's not working on the day time spasms.... I can't work it out, the medication I was put on is called Perhexiline (Pexsig ) I have only had around 3-4 night time / early hour morning spasms sending me into emergency since the perhexiline, I am in our emergency at least once a week, other factors also have been triggering mine off as well, going through some pretty emotional stressful stuff at the moment and during winter, glad it's summer here, not so bad unless we get a real scorcher of a day as to much heat can trigger it as well.

Thankyou for your kind words   it really is appreciated

Hi again I am in California USA where it is winter very cold here into the low 40s and 30s unusual for California and it does have an effect right now I'm fighting high blood pressure but I know where you are do you have something for anxiety I forgot we written so many letters or emails sometimes by the time you get to the ER and they give you oxygen and you feel safer they figure you don't need pain meds I know the morphine works because it always worked for me it relaxes the arteries in the heart please keep in touch I want you to get better so much I hate to see anybody going through this and we need friends please get better I'm sorry you had to go through this during the holidays I hope your doctor sees your plight and wants to help keep you out of the ER by giving you something that's going to help stop your spasms and pain I will stop for tonight let me know if you get some help that is good for you good night from your friend Diana

Hi I`m new to all this meaning patient forum. 

3 years ago I was diagnosed with varient angina (prinz metal) and was in Hospital for 9 days. The frequent episodes were nearly always at rest, I have lost count of the times I have been to A&E with chest,arm and jaw pain. The usual tests all negative including an angiogram. I`m on diltizem 60mg twice daily( originally was on 60mg 4 x a day) isosorbide mononitrate 60mg twice daily, ramipril, sol aspirin and gtn spray. now I`m told they think I`s not Varient angina, I am having a myocardial perfusion scan (stress test)in a few weeks. my angina occurs every 2-3 months lasting approximately 5-7days several times a day with more episodes occuring in January.I also have hypertension which appears to be now under control (by medication). I am not overwieght. and am active although not as active as I would like to be. The cold, heat, stress and hypertension I think play a large part in my problems but examinig my past I am sure stress was the trigger factor thereby giving me hypertension which is causing my blood vessels to spasm.

I would be interested to hear your vews.  

Hi Wendibles,

What you have described in your post are classic symptoms of Prinzmetal Angina, The only test that will confirm it is a provocative test which involves an angiogram and certain medications, a test which , so I have been informed, is not a routine procedure where I am because of the risks involved, yet I see quite a few people on these forums have had the test even though they are from a different country to me.

How is your cholesterol ? Cardiologists have told me that high cholesterol can cause coronary artery spasm, that's how I was diagnosed by 2 different cardiologists. All the "normal " heart tests won't show prinzmetal angina, sometimes an ECG/EKG will show spasms but not always. They say that prinzmetal doesn't cause a heart attack, I've had 2 NSTEMI's due to it , the firstone they did an angio and found that I have mild coronary heart disease , not stented as the blockages are big enough. 60% in RCA and 50% in LAD.

My medication consists of 120 Mg of Monodur once daily, 20 Mg of Nicorandil twice daily, 100 Mg aspirin once daily 360 Mg Cardizem (Diltiazem) in the morning and 240 Mg at night and 100 Mg of Perhexiline twice a day along with GTN as required. When I first started taking the Cardizem that helped for awhile but now I think my body is used to it as it is with the Perhaxiline, that helped heaps as well, it's a bit weird it stopped the night time spasms but for some reason I kept getting the daytime spasms. Now I'm starting to get night time spasms back after 12 months being on the Perhexiline. Just of late I have been visiting the emergency department up to 3 times a week.

I can tell you cold weather can trigger Prinzmetal angina, as with even a puff of wind to the face, extreme heat can also trigger it along with severe emotional stress, I am dealing with 2 teenage kids, one of them likes to push the boundaries and some of the things he has been getting up to is extremely stressful, perhaps that explains the amount of visits to emergency each week, Paramedics tell me that kind of stress will do it as some of the emergency doctors have said as well but there have been a couple of ER doctors say ..." No it wouldn't cause chest pain "...it's common knowledge that severe stress is a trigger for angina or even a heart attack for that matter.