prinzmetal - diagnosis

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Could I have this? I have severe chest pain that comes on at night when Im sitting down or in bed. It spreads to my back arm and shoulder. I have very tender ribs under my left breast. I have chronic anaemia snd have suffered a lot of stress for 5 years now. Lots of fight or flight experiences. I have an xray tomorrow as my doc thinks it Tietze syndrome because of the rib tenderness but this wouldnt explain my deep heart pains, pins snd needles, numbness etc...will an xray show up anything?

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  • Posted

    Hi, It doesn't really correlate with Prinzmetal Angina, your symptoms, That's not to say you don't have any type of angina, but what you have described isn't really typical of any kind of angina. No an xray won't tell you if you have prinzmetal Angina,it will show an enlarged heart or chamber(s) , Depending where you are there is a test that can be performed to diagnose prinzmetal angina. 
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    • Posted

      Hi Samuels

      I would be interested in knowing which test doctors can perform in order to confirm the diagnosis of Prinzmental Angina? I am based in UK.

      Also, is this same as "micro vascular " angina?

      Many thanks

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    • Posted

      Hi seangeen,

      There is a guideline that your cardilogist will follow before he/she suspects Prinzmeal Angina.

      Symptoms of Prinzmetal’s angina: Located under the chest bone Described as squeezing, constricting, tightness, pressure, or crushing, which is usually severe and may radiate to the neck, jaw, shoulder, or arm Often occurs at rest May occur at the same time each day, usually between 12:00 midnight and 8:00 AM Lasts from 5 to 30 minutes Relieved by nitroglycerin(Not always) Can cause fainting or loss of consciousness

      The easiest test actually is the ECG providing you are having an attack at the time of the ECG, it will show up on that but not always and this is what makes it difficult to diagnose, the other test is via an angiogram and either of these drugs injected to provoke spasms acetylcholine or ergonovine , if they go into spasm (You are then diagnosed as having PM Angina )GTN can quickly reverse it, where I am it's a test not performed because of it's dangers to patients.

      As for micro vascular angina that was discussed with me as well, however my cardiologist at the time told me there was no cure for this and he didn't  consider it to be angina, but new studies seem to have proven him wrong. Hope this helps......

      There is a lot of information out there about prinzmetal angina , some investigations seem to conflict with each other, some say it effects women more than men then you read another research paper and it says it effects men more than women, also what drugs that help and then ther papers say that these drugs don't help...if you get what I'm trying to say smile

      I have recently been put on Perhexaline (Pexsig) and I tell you what it's made a world of difference with me, suffering some side effects but have agreed to continue on with the new medication.

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    • Posted

      Hi missmarmite,

      I forgot to mention as RubyRed pointed out pain radiating to left side, this is very common in Prinzmetal angina, you will experience tingling in your left arm if the pain is radiating to left shoulder and arm, for some reason the achy....heaviness changes at the shoulder and turns tingly down the left arm

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    • Posted

      Do you know what started your condition and is there anything that makes it worse? Mine comes on at the same time every evening which I find very odd. It has become more severe very recently - my chest, back and arm are all affected and now my stomach and centre of chest - it makes me feel quite sick. I have wondered if it also correlates with eating as I have usually had dinner a few hours before. But my heart rate is usually doubled for a time beforehand. I am getting severe pins and needles at night - starts off as complete numbness and then the p&n start as my blood starts to circulate. I often feel my blood fizzing through my veins like cocacola - day and night. I have a lot of pain in my feet which seems permanent now and my left hand is less coordinated. Ive been healthy until this - not been on any medication ever - just had a bad run in life in general over the last five years and just got on with things so didnt think it could have major effect on my health. I have had a lot of 'fight or flight' moments though - and wonder if I suffered from adrenal issues some time (a year) ago. I was living on adrenalin.
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    • Posted

      Hi ,

      Mine started as central crushing /heaviness central chest pain,  and radiating to left shoulder and arm,radiation also went to jaw, teeth, neck and back ,   this all occured at rest not on exertion, had all the possible tests done to rule out heart, all came back negative and was put down to panic / anxiety, in other words it was in my head according to some doctors, it took a mild heart attack for them to quickly change their minds and do another angiogram, that's when they found that I had mild heart disease, I have a 50- 60 % occlussion in the right coronary artery and 40 - 50 % stenosis in my LAD (this is what I read off my medical report, the word change from occlussion to stenosis )

      Heavy meals can set angina off and in some instances pain can be felt in the stomach, but these can occur in any kind of angina, well from what I have heard and read about.

      Have you ever considered a TIA or bought it up with your GP, TIA's are extremely serious, it's like a stroke but they actually call it a mini stroke or TIA. Also have you also thought about diabetes, I have foot neuropathy  - can't feel my toes and I was found to have type 2 diabetes) this may also explain the tingling and weakness.

      I'm not a medical professional so I can only give you similar symptoms that I have experienced over the years, I would highly suggest you see your GP or if the pain should come back bad go to your local accident and emergency department.

      Now I don't want to sound like the doctors smile but is it at all possible that you are experiencing some kind of panic / anxiety dis-order ?

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  • Posted

    Hi missmarmite

    I have Prinzmetal's Angina and find the attacks happen mostly during the night, but not always. I started with Stable Angina, so I would become breathless, chest pressure, and pain on exertion (going up stairs, up hill, carrying shopping, exercising, that type of thing) then had Unstable Angina as the attacks use to come on at rest.

    I was sent to the Papworth Hospital where I was diagnosed with heart disease. I also have coronary artery spasms with Prinzmetal's which are largely controlled through medication, or when meds fail I sometimes have a GTN infusion which is given at my local hospital.

    In my personal experiences, I have terrible pressure and a dull pain in the centre of my chest which radiates across my left side and round to my back, shoulder, and sometimes up both sides of my neck. I also have a dull ache on the underneath of my left arm to the elbow. I can also become breathless and slightly disorientated, even though I am sitting/lying down.

    I always have an xray when I've been admitted to hospital with an attack, but I believe this is to rule out other causes, it won't show/diagnose Angina. Please let us know how you get on.

    All the Best, RR

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  • Posted

    I have had angina for approx 33 years and until very recently without any problems. However the cardiologist consultant I saw at GWH Swindon,

    a Dr McCrea took me off the medication  I have used for 30 years.

    Varapamil 80mg 3 times a day. Since then I have had a few angina attacks and it is worrying. Thay hade only occurred since hr the specialist stopped the medication.  Before that I was 32 years with only one attack.

    Now I get a pain in my left side, just above elbow height, also a lot of wind (Flatulence) and indigestion. Never had these before.

    I am now not sure if I am getting Angina Attacks or chronic heartburn/indigestion  NT doesnt seem to work.

    I am now due to go to Oxford for some special procedure wherein they put a radio active substance into the blood and then scan you to see what happens.   Doest sound very good to me!!!!!!

    All in all it will apparently take some 5 hours

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    • Posted

      Hi DaveC,

      Just out of curiousty with your current status, "a lot of wind"  "heartburn / indigestion. Are you suffering any chest pain or chest discomfort at all during the heart burn/ indigestion periods, the reason I ask is because I have had that happened to me on one occassion and it turned out to be a mild heart attack, what they call NSTEMI, I have also experienced the wind side of things as well but I can't remember if that was there on my second heart attack, depends where you research , flatulence can indeed be a symptom of a heart attack, but like I said, depends where you look. If yo are getting hearburn or indigestion GTN spray will help, a lot of people don't know that GTN is also a medicine used to treat those conditions as well as Esophageal spasms.

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    • Posted

      I've just had a look at the consumer medication sheet for this drug and what you have described  are side effects from this drug but to experience them what 30 years after seems a tad strange, perhaps it's because your doctor has taken you off them. It also states on the consumer sheet that if you stop taking them the high blood pressure or angina will return, I hope your doctor had a good reason for taking you off them , My cardiologist did the same to me several years ago with even more severe angina returning after being taken off the medication so I had to be put straight back onto them....I don't know what he was thinking, the only thing I can think of was that he may of thought I didn't have angina, that's the only plausable thing I can think of  unless I'm missing something else.


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    • Posted

      This self same Dr  also didnt tell me that the manufacturers of the medication state that you should stop taking them over a period of time not, repeat not a sudden stop .

      At the moment I dont know where I am as they seem to close ranks if you quetstion anything they tell you.

      I dont have any medical qualification at all

      But I do have a lot of common sense.

      Something that seems lacking in some of the medical profession.

      Once again thank you for your valued imput

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  • Posted

    Thank you for your comments . Greatly appreciated.

    This Consultant appears to be a bit of a maveric.

    Goes on television and into magazines telling of the benefits of 

    two glasses of red wine every day to help wardoff heart attacks and strokes.

    Personally I believe he is a bit of a Chalatan and is more interested in his reputation than in his patient welare

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  • Posted

    I have now been setb up for a visity to the John Radcliffe hospital in Oxford for further tests.

    These entail having a radio active injection and then going into a scanner for some time to see exactly wahts is happening.

    Sounds a bit uncomfortable to me as I have to allow some 4 or 5 hours for this set..

    Let us sincerely hope that they come to some p[ositive conclusions from these test because so far its been all smoke and mirrors.

    Never commit themselves do they.

    Poor old patient doesnt have a clue what is happening.

    Are they working on it or just experimenting.

    It does make one wonder.


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