Is this Angina?

Thanks for the reply? Samuels. I did have blood test for a DVT in November including a blood gas test & CT Scan. The CR Scan didn't find anything although the blood tests said possibly. I'll go back to my GP to have him check it out. I'm currently on 300mg of Ranitidine at nigh for the acid reflux and seem to be constantly taking peptac during the day as the reflux comes and goes.

Hi jamesk,

How coincidental this all is, Here we all were thinking I had pulled a muscle in my calf but an on the ball emergency doctor decided to run this blood test for clots, by the way I found out the name of the blood test, they call it D dimer. Now as I said they found a DVT and did the dye CT scan and found multiple blood clots in both lungs (pulmonary embolisms ), now after 3-4 days and being on the new medication (blood thinners ) I developed the exact same syptoms as you have explained in your original post. I asked the doctor if it could be the blood thinners causing these symptoms and she was of the opinion of No it wouldn't cause those symptoms ( I'm not real happy about that as I'm sensitive to a lot of medications ) I will ask my GP as soon as I can get in. I still don't feel right, still getting chest pain with troponins still up but higher than normal and still sitting in the negative range, however everytime I had to attend emergency my first troponins have been raised , way above  normal range (positive) but not enough to prick the cardiologists ears for cardiology intervention, last test was last night and it was still sitting on 14.

As I have mentioned I don't feel right and am experiencing some of your symtoms even after a diagnosis, one would of thought I would be getting better, the pains in my back I'm putting down to the blood clots in the lungs, as at times it hurts to breathe, the indigestion flare up I'm putting down to the new blood thinners medication, I now have unexplained heaviness to the left arm, down to the elbow and from the elbow down to the fingers it's all tingly, I get this with my usual angina attacks, but not all the time if you know what I mean. Since being diagnosed with having Pulmonary Embolism these symptoms you have mentioned have now hit me ? the heavy and tingly left arm has been the worst it has ever been for the last 2 days, not sure about this one, PE , angina or new medication related.

Wish you well and hope you get the answers you need in a timely fashion, look after yourself.

Hi Samuels just reading your comment and want to know what is classed as a height reading for troponins. I have got unstable angina and my last blood test in the ED for troponins was 19 but have never been told what it should be or what is to high

Hi joanne,

The troponin tests as you probably are aware are called "high sensitivity " and up until recently(maybe 2 years  ago ) here in Australia they changed to this high sensitivity, now depends who you talk to and what testing equipment (brand name ) is used, the cut off for where I am is 13, but some emergency doctors,  they say 14.

They yell me that cardiologist start to suspect heart attacks in the range from 50 -150 +. Troponins is pretty tricky to understand, well with me anyrate. they say that troponin is an enzyme only released by the heart and shouldn't be found in the body unless the heart isn't doing something right, but when you question a doctor about trops being detected in the blood they will tell you everyone has a "baseline" from 0 - 13, anything over they start to suspect other things. If I look at it the way the doctors have told me, my baseline is 8, lately it has been 32 on repeat down to 27 then disharged, last visit was 21 repeat was 21, then last week 14 on first test, repeat wasn't ordered.

Hey Samuels. Thanks for getting back to me. I have been told I have got unstable angina. I have very high Fisk factors, family history of heart disease and stroke I have high blood and cholesterol I am also over weight and have been a non smoker for 5 years. I have had an angiogram 4 months ago and was told that I have hearth disease. The last time I went to emergency with bad angina they did all the normal test and my second blood test my troponins were up at 19 which means nothing to me but they're have never been anything but 0. My angina pains have been more often in the last month and I'm not sure if I'm just meant to put up with them as when I was discharged I was told to just keep taking my meds. Any suggestions from anyone going through the same or similar would be good.

Hi joanne,

I suffer from coronary artery spasms, otherwise known as Prinzmetal Angina, (Unstable Angina ) I also have high risk factors, with high blood pressure, weird lipids profile, they call it familial hypercholesteroldemia amongst other names ( also herediatary ) type 2 diabetes and sleep apnea. I started off with " pristine " coronary arteries when my chest pains started 15- 18 years ago, I had an NSTEMI back in 2012 and an angiogram done, they found a 60 % occlussion in the RCA (right coronary artery ) with minimal damage to the heart from the NSTEMI, angina has been persistant all these years and still is bothersome and is affecting my lifestyle. I had another angiogram 2016 and they found a 50 % stenosis in the LAD and no improvement in the RCA. I average a trip to the emergency department at least once a week. Cold weather, extreme heat and emotional stress are major triggers for PM angina - unstable angina and up until recently due to high emotional stress I was visiting emergency department via ambulance up to 2 - 3 times a week.

What was the figure for your first troponin test, can you remember ?  If it was in the normal range or even higher than the cut off point, they obviously did the repeat and that came back at 19, what would interest me is your first number compared to your second number, if it was lower than your second test they should of done another (third ) test to see what your troponin was doing continuing up or going down or even staying steady

I forgot to add .......  if using your GTN spray under the tongue, do as instructed by your doctor or cardiologist, the usual treatment plan is 1 spray every 5 minutes, if angina / pain hasn't been reduced after 4 sprays (20 minutes ) to call for an ambulance. Most of the medications for coronary artery spasms anyrate, patients bodies tend to build up a tolerence therefore being less effective.

My first test was 0.01 and my second was 0.19. Have been using my GTN and go to emergancy if pain has not stopped after the 4th or 5th spray. I also have server sleep apnea and use a cpap machine. 

Hi joanne,

If that was the case I think a 3rd troponin test should of been in order, generally though in an event the numbers are usually quite high to start with and continue to rise reaching it's peak depending on what's happening with the heart in a quick amount of time, but, not always. That's a reasonable rise in a 3 hour period, assuming you had a repeat done at 3 hours ?  perhaps they left it at a repeat after 6 hours ? the second blood test.

Yes unfortunately I'm the same require a cpap machine.

Hi jamesk,

I have suffered reflux since ealry childhood and it could never be put down to anything. Well actually spicey food sets my reflux off, I'm in my early 50's now and reflux is controlled by medication for all those years, they still can't find anything or offer any explanation as to why I suffer reflux, If I forget to take my medication it flares up 12 + hours later.

My angina pain is heaviness radiating heaviness to left shoulder and arm, arm usually tingles rather than the heavy feeling, not sure if the heaviness is the pain or it's actually causing the pain, everyone is different but generally if angina is persistent in patients it can last up to 2 + hours on and off, depending on what type of angina you have.

Thanks for the reply Samuals, I wanted an idea and to compare my experiences before I visit my doctor.

I usually get either a heaviness or pressure in the left side of my chest and sometimes a burning sensation. Both of these do not last long usually under a minute, although occasionally it has lasted @10 minutes. Is there a test for Angina or is it diagnosed from your description to the doctor?

Depends on the cardiologist and how experienced he / she is . angiogram is the golden rule test for anything heart and artery wise, There are other tests that are also available and non invasive that will give your cardiologist a good idea on what may be going on.

See that's the difficult part as far to many doctors will pass those symptoms off as reflux / indigestion when they know that  angina presents itself in the same way. When I had my NSTEMI  I had the refluxy / burning sensation in the back.

Hi Jamesk my angina pain I'd heaviness on the left side of my chest and sometimes around to my back but not always. Also pain in my left shoulder and I pretty much always have hot flushes with it. Depending on how painful it is I will do my gtn spray and if it has not gone after 3 sprays within the hour I ring the ambulance. I had an angiogram a the end of last year and was then told it was unstable angina.