Prinzmetal angina

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I have Prinzmetal angina.  My first attack was when I was 44 but not diagnosed until I was 51.  I just recently found out i have eNOS T786C mutation which most likely is causing the vasospams.  I'm curious if anyone else has been diagnosed with this mutation.  A doctor that is doing research on Prinzmetal patients recommends taking L-arginine.  Anyone else take this supplement?  If so has it helped?  I have never had an EKG during an attack and was wondring if ST segment elevation is ALWAYS present on an EKG during spasm?

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  • Posted

    Hello Sheri,

    I have microvascular angina (MVA) which is spasms of the micro arteries. I'm not sure about the mutation, but I am currently taking a cardio cleanse which a naturopath has given me and are trialling it, which does include L-arginine and other amino acids.  I didn't take them last night and found my angina was worse today, but have not taken it long enough to test it out.  I am only half way thru the bottle, so will be interesting when I'm finished them.  Can get some more if I want, but I want to see what happens.  EKG's don't always show up anything, I normally have ST depression when I get a bad attack, but usually normal for milder ones.  I have had MVA for a year and am 50.

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    • Posted

      What is the diffence between MVA and Prinzmetal?  How can they tell the diffence?  What is the cardio cleanse?  Is it a prescription?  When you have an attack what do you do to stop it?  Nitro gylcerine does not help me. I was wondering if there is anything else that can help. 
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    • Posted

      I'm not really sure, but my angina only comes on with exercise.  I don't know what is in the cardio cleanse, only that it is a mixture of amino acids.  When I have an attack, I try 4 sprays of GTN, but usually know if it is going to work, then I have morphine liquid to take and take 10 mls, sometimes that doesn't work and end up at ED and all they give me is more morphine by IV, which is about 3x stronger.  Last time I had to have that they had to give me 30mls IV, which is about equal to 100mls liquid.  Mine does tend to come and go, have 'good' weeks, then bad weeks.  I do find that ginger is a trigger.  Even gingernut bisc.
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    • Posted

      Hi Sheri,

      Technically there is a difference but a lot of cariologists put them both in the same basket, Prinzmetal Angina and MVD as we call it here are the type of Angina that differs from the other Angina,Prinzmetal Angina and MVD comes on while at rest usually between the hours of 8pm through to 8am, it's unpredictable where as the other Angina is predictable ( exercise etc induced) ...I think for better words Stable Angina ...activity induced and predictable, in this case cardiologists recommend you take one spray before going out in the garden or mowing the lawns, etc etc then you have unstable Angina...Prinzmetal Angina, occurs at rest, can come on during activity but mainly while at rest and totally unpredictable. Depends on the cardiologist they use different terms, stable, unstable variant angina, maybe a couple of others that I have forgotten about. If GTN doesn't help  I dare say that it's not your heart acting up in the sense of having angina or MVD..unless you have like me built up a tolerance to it...after 16 sprays GTN only  works for me for 5-10 minutes if I have a bad attack, Nicorandil has helped my night time spasms so no more late night visits to our emergency departmentfor me since I've been on them, however I still get a bad attack once a week , usually the GTN clears up my Prinzmetal Angina after about 2-4 sprays, the only thing that settles down my big once a week attacks is morphine or endone, because it's summer time here where I am I'm expecting less attacks as warmer weather seems to help,I still will get the occassional attacks but the GTN clears it up unless it's a real stinking hot day as really hot days and cold days can trigger Prinzmetal Angina/Vasospasms.

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    • Posted

      Samuel, thank you for that! there i was thinking roll on summer and i will be ok again, now i have to worry about hot days too..... nooooooooo lol
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    • Posted

      Hey Andrew,

      I thought the same smile bt have been digging around lots about this Prinzmetal Angina and found that extreme heat could well trigger spasms as well, Australia is well know at times for getting exreme heat in the summers. I'm not to fussed about our summer I'll just sit inside and adjust air conditioning accordingly...not to cold though smile

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    • Posted

      FFirst thing is make sure the Doc is nto makign the mistake I see form way to many of them. They have to compare your ECG to a baseline ECG NOT NOT to the last ECG when you came in with Angina. It is hard to believe but soem docs forget that if you compare ECG from this ER visit to the ECG from your last ECG visit he may see no change just because they are both during a spasms. I just one trn bright red when he had the OH DAH moment when I explaiend that to him. Second as explained otme at Mayo Dr. Prasad and can be found in documents ther are times for reasons one is  opposing forces from multivessel spasm the ECG won't show a change. We reproduced me in cath lab and more then one vessel spasm and the ECG did not change but we could see spasm & flow deviation. The docotr I had explained oppositing forces to me then. Therre are alot of articles & research articles tht bear this out but many of the cardio & ER docs have not read them making gettign treatment when you do have those epsisodes hard. But you will run into way to many docotrs that flat refuse to believe what study's show is true which is at times due to things like multi vessel spasm , collateral vessel creation, etc there are tiems when Variant Angian is seen without ST elevation. In one study I read 12% of the patients in study showed this,
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    • Posted

      Hi cher,

      If  that 12% is worldwide I'd be in it , very rarely is ST elevation found in my Prinzmetal attacks, sometimes but not very often I have an ST elevation, sometimes ECG by paramedics have shown some PVC ( I can't remember what is meant by that ) also occassionally they have picked up bundle branching as well.

      My cardiologist told me that you may  not  ever see any ECG changes at all during an attack.

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    • Posted

      I am so Glad your cardio is not one of those stamping thier feetign insisting no mater what research shows that it cant be VA without ST changes. I run into o many that just will not read or accept the research and proof of this when seen during recreation in cath lab. I have talked to so many patients at Mayo that are fighting this all over the US.
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    • Posted

      Hi cher,

      Mind you this is only 2 cardiologists, some  ER doctors and other Cardiologists seem to think  ST elevations need to be seen to make a diagnosis.

      I had a run in with an emergency doctor here about 2 momnths ago, he carried on like a pork chop and was going to send me straight back home as soon as I was bought in by ambulance, He also said there's no need to do a blood test, my reply to him was I think you better check my records before you go sending me home without having a look at me, he looked at my records, a blood test was ordered. Cardiology has put a note in my file that one blood test must be carried out before giving me the all clear to go home.....I swear some of them only read what they want to read on our files.

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    • Posted

      So true many ER doctors do not even bother to read the file at all. And I have written instructiosn to do the IV nitro adn that Mayo has confirmed with Cath and they still argue with me. I pray for those that do that they thaey get the diseases so they can see how we all feel .
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    • Posted

      I was in Emergency early hours of Saturday morning and the male nurse that was taking care of me had a can of energy drink sitting on my tray at the foot of the bed with my paper work, he was writing notes when he was called away to tend to another patient....Well a senior doctor walked past and I happened to look up at the same time and the look on her face...haha...she yelled out my name and asked why I was drinking an energy drink, she was ready to tear me to shreds,luckily the nurse heard her and said it's not his it's mine I wondered where I put it...lol...If that nurse didn't hear what was going on world war 3 would of broken out between the doctor and me.
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    • Posted

      You mentioned in the above post that if you have multiple spasms that it wont show up on an ecg and there is documentation that explains this. Could you please tell me where I coud find these article? I had 3 attacks that did not show up on an ECG and I am desperate to find information on why this happens. My cardio dr has never heard of this and I would like to show him. I also have what feels like cerebral spams as well and he finds this hard to believe. Feeling so frustrated.
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    • Posted

      Funny how these Docs never seem to know anything about anything, like they're always amazed rolleyes neutral 
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    • Posted

      Hi Sheri,

      Dr Google is your friend smile One of my cardiologists has told me the same thing as well, Prinzmetal Angina will not always show up on an ECG, usually,  according to studies you get ST elevations in a Prinzmetal Angina attack but I have since learnt this is not always the case, if they can't pick up an NSTEMI on an ECG how can they pick up Prinzmetal Angina on an ECG.....that's my train of thought anyrate smile  Don't always rely on an ECG especially when it comes to Prinzmetal Angina.

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    • Posted

      16 sprays of GTN?? How come your hed doesn't blow off your neck with the headache that would bring on in the majority of people Samuel?  You must be highly tolerant to it! sad

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    • Posted

      Unfortunately I am, most prinzmetal angina sufferers are tolerant to GTN if they have regular and severe attacks of spasms.
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    • Posted

      how true that is... i had the advice from an A&E consultant that if three pairs of sprays in 20 minutes doesnt work then to come in..... i said if tha twere the case i would bein every day virtually and certainly would be a regular... he took a while to think about it and said well... er.... maybe you should cos you can be doing heart damage by not having it checked... another one was cross and said why od i keep coming in when i know whats going on... i said well i dont really know and so when it is bad enough that the lack or blood is making me faint....  the grumpy one didnt know what to say and just waved his hands... so i go even less frequently now i phone and try and sneak a few momenst of cardilogist time on the phone...... he is, luckily for me, very good.... but it is a challeneg to know what and when is enough and yer should go get more help...

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    • Posted

      A doctor at the hospital explained to me that the reason nothing shows up on a ECG or Scan is because the arterie's randomly spasm causing pain/discomfort etc, but this doesnt last very long and usually by the time you get to hospital to have an ECG the spasm's and symptoms have stopped because the arteries are no longer spasming therefore they look completly normal and healthy. The doctors did about 10 ECG's and scans over about 1-2 month's of being in and out of hospital and they all came back completly normal. but then they one day the spasm's and symptoms started while already in hospital and they managed to do an ECG while it was happening and they could clearly see that it was Prinzmental Angina 

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    • Posted

      Hello there. I think I may be experiencing the same thing. How and where were u diagnosed? I'm from California. And I've had a bunch of cardio work up. All within normal range. I'm also 19 years old 

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