prinzmetals angina

Hi mlafitte,

​No throat pain in my case, I do get the pain in the jaw or sometimes the teeth, like a toothache has just come on out of the blue, I definately know cold weather triggers mine off, our last day of winter today (if we go by the quarterly seasons and not the Solstice this winter it has been recorded as the coldest in 50 years here  and boy did I know about it, frequent visits to emergency via ambulance.

​I have noticed over the years that stress does bring the attacks on, kids playing up, things like that, my pain is nearly always the same, radiating into the left shoulder and down left arm, sometimes shoots up into the neck/jaw, always short of breath with it, sometimes a clammy sweat, nausea but not every attack, sometimes I get an indigestion feeling but I feel it in the back more (middle of the back) I have noticed lately that I can get it after eating a heavy meal, I never use to but that has only developed this year, dizziness and weakness also comes with mine, I have collapsed a couple of times from feeling funny, but I don't think it had anything to do with the PM Angina, I was told I may of had a TIA when that had happened.

They should be treatign you with calcium channel blockers. when you ave angian on top of that you should have nephedipine 10 mg I have to crack under tongue they let me do it 2x 15 min apart as long as BP is over 105. Wiht three shots nitro spary. YThe physician needs to write a letter for you to carry & to be submitted into yoru medical records with instructions. Coroanary Spasm cause heart attack, death , heart damage. My cousin died at 50 with a compelte occlusion, I have stage 2 heart failure from repeated attackes. Many on the board have had multiple MI's. If the ER you go to is nto takign this serious you need to file a complaint to the board at hospital thru patient services. I jsut had an encounter where they left me in ER taking my own nitro spary and nephidipien without use of a BP cuff and I field the complaint and they physician & the charge nurse are up for disiplinary charges due to the exterme danger they put me. My physicial is the head of Cardiology at the serious of hospitals I go to as well as esclated to National Jewish. They take it very seriously. My sister went into complete heart block with an attack as well. I am at ER several tiems a month soemtiems a few tiems a week. I am in ICU alot. I have Trachealbronchomalacia on top of it and the hypoxia is settign me off bad. L-argine supplement shoudl be in your regime as well. DO  NOT take beta blockers they make it way worse. All the of them warn against use on prinzmetal or Coronary Artery Spasm (CAS) patients. The even made me try BYSTOLIC® (nebivolol)‎ saying it acted differently and it threw me into a horrible crisis as did Metropolol. So avaoid them like a plague. I have several friends with 5+ MI's with this DO NOT let them mess with you.

Hi Wannabwell,, arteries with such a small blockage(s) are considered small blockages and there's nothing they can do about them other than hope you can tolerate the statins, I have a 60% blockage in my right coronary artery and they were trying to treat it medically but I can't tolerate any of the statins avaialble. I'm a bit luckier than you in the understanding and compassionate department with the nurses where I am, they are aware of the condition and treat me with great respect, sure there's the ocassional one or 2 nurses that can be  off putting but I've put that down to me being in there very regularly, now up to 3 times a week, I have problems with the younger doctors, some have never heard of Prinzmetal angina and they end up putting it down to stress or a panic attack, the doctors that do know my condition treat me fabulously, however because it is so painful they get very reluctant in giving narcotic pain releif all the time as it's addictive and over time loses it's efficiency, it's like the anti angina drugs, they also lose their efficiency over time as well, I can have 25 sprays of gtn and my blood pressure is still sitting on 140/80-160/90.

I've had 3 NSTEMI's heart attacks (mild) they say prinzmetal can be detected by an ECG, a cardiologist told me that was incorrect, they cannot always pick up coroanry artery spasms on an ECG. GTN will help with the prinzmetal angina but if you have to use it a lot you will develop a kind of immunity to it and it won't last as long  or work at all, the drug of choice for prinzmetal angina is Cardizem and Nicorandil and at very high doses, I'm on 480mg a day of Cardizem ( Diltiazem) in the last 3 months my attacks have been more severe than ever and because the troponins come back negative and the ECG looks good to them there's not really much more they can do . There is a new drug coming out, I believe it has been approved for use in the USA but it's going up infront of our drugs board soon I hope, it's mainly for cholesterol but they have found that it also works in unstable angina, have a bit of a read on the drug PCS K9.

If you are being treated unfairly or refused pain relief and general rudeness lodge a complaint to your hospitals compliments and complaints department, if they work the same way as ours does they do a full investigation, talk to the doctor(s) in concern and find a common ground in treating your condition, the nurses will be disciplined for their actions if it's severe but more than likely they will be asked to show compassion towards all patients as they were trained to do.

Ohhh by the way I'm in the land down under

FYI Samuels my physician has written in her letter to ER's that I do indeed have Coroanry Spasm and at tiems can hae no EKG shanged this has been proven via heart cath with reproduction of Coronary spams and NO EKG change. Her isntructiosn are that ER MUST alwasy assume that when I arrive with Angian symptoms I have ischemia and shoudl proceed with notro Drip sicen by the tiem I get there I have already doen Nephedpine 10 mg cracked under tongue 2x and three nitro sprays. SO no it is false that the EKG will show the spams. Mine are very bad spasm and at tiem becasue of reciprocation force conter act the EKG change with multipe vessel spasms

I don't understand what you are trying to say cher ? From what I can understand from your comment in regards to coronary artery spasms you are saying they don't show up on ECG's, is that correct ? I actually agree, they have rarely caught any spasming on my ECG's , however depending on the qualifications of the attending ER doctor and consultants they disagree, they try to tell me that any kind of coronary artery spasm(s) will always show up on an ECG, my reply to them is, I think you need to it the research books again and then come back and tell me spasms are always present on prinzmetal angina sufferers ECG's, they don't like it they also try to tell me that cold weather doesn't set it off, this is from a select few ER doctors ,winter time and stress are the biggest triggers for mine.

Those that say things like this are so poorly trained and do not understand this disease. Tus the need for the letters from Mayo, Natioanl Jewish & University to enlighten those poorly trined physicians. I also have a CD I carry with reserach artices that Mayo gave me to give out that I hand a copy of to these doctors in the hope thaqt they learn soemthign adn do not harm or kill oher patients.

Hi Amy, There is a difference I think between arterial spasms and coronary artery spasms, not sure on the workings of what causes arterial spasms but in coroanary artery spasms, lack of or no Nitric Oxide being produced in the endothelium is the cause for prinzmetal angina /coronary artery spasm (CAS)... Sorry If I have mis-read your comment if you referred to artery spasms as coronary artery spasm ?

In regards to veins hurting in your forearms are you taken to emergency a lot and cannulated all the time or are you speaking as in conjunction with your artery spasm with forearm vein pain ?

I did mean coronary artery spasms. Sorry to be vague.  I do believe, though, that there are more causes of coronary artery spasms (I was told that high cholesterol, high blood pressure, arthersclerosis can cause it, However, I have none of those) Not sure, perhaps those are the same as a lack of Nitric Oxide. 

The pain in my veins happens randomly. I have had them since I was little, and they have no association with a cardiac episode.  I don't go to the emergency room much. Only when the chest pain is unbearable. (I live in California and when we have an earthquake, the first response is to sit still for a moment and see if it is going to get worse. I tend to do that with my episodes. Has to be pretty debilitating for me to head to the ER.)  Doctor says that's silly, but that's the way I am

Hi amy,

That's ok , Yes you are correct about other causes for Prinzmetal Angina, Cholesterol is blamed for mine, what happens is the cholesterol isn't or can't be broken down naturally and therefore it enters the endothelium which in turn ,now this is the bit I can't quite remember, but it still amounts to the same thing, the cholesterol eats or absorbs the Nitric Oxide therefore causing coronary artery and small blood vessel spasms in the heart and that even though the medication we are on are the main stay of treatment,  they don't always work for prinzmetal angina, especially in people with the cholesterol problem but they believe they have a "cure" as such, it's been released in the USA and it's aimed at high cholesterol and unstable angina (prinzmetal angina) I was told we should have it made availlable by November this year by my cardiologist as it was beeing put forward to our drug panel to get approved ,however when I looked it up to see how it was going they are now saying another 2 years here in Australia, it's an injectable medication and depending on your situation administered once to twice a month, it comes at a high cost roughly $2200 a shot in the USA and could cost patients between $12,000 - $20,000 USD, so obviously more expensive for us down under, I was assured that I wouldn't have to pay full price because of my condition and the need for it to prevent any further attacks, cardiologists a very excited about this new drug. If you would like to look it up the new drug available in the USA is PCS K9.

As for the vein pain I have never encountered it with my prinzmetal angina and I've had it for over 15 years.

Thank you for the informaion on PCS K9. I had heard a little about it, but am not versed in it. I'm going to do some research. Seeing my cardiologist this week. Hope my insurance will cover it. 

Hi amy, Yes I've been waiting on this drug for ages now, for some reason it's been held up here, down here you have to meet a guidline for it to be able to be prescribed to you, funny thing  is, the cardiologists know all about the rules and guidelines and what it treats  this drug, yet the discussion paper say's it's another 2 years away.... I wonder how that works....lol...

Omg Amy how annoying is it that know one believes you the amount of doctors iv been to that have told me and spoke to me like im having some kind of panic attack is unreal the last doctor i seen said he didn't know what was causing me the pain but put me on beta blockers thinking it might just be my anxiety raising my heartbeat and telling me to do breathing exercises cuz he though it was panic attacks , iv just been told by another doctor to come off them straight away, yes i always get shooting pains down my vines xx

Stick with the Doc that's taken you off the beta blockers. If it is Prinzmetals he knows what he's doing.

I find this site difficult for communicating.!

Just been prescribed Ranexa , anyone else tried this ?