prinzmetals angina

I have had angina for five years since age 36, it is caused by ectactic segments in my right coronary artery,  in short these segnents are wider.

Like in a river where the segment is larger blood flow is slower, and is prone to clots forming which can lead to a heart attack (ive had two) and also pose a greater risk of stents further downstream becoming reblocked.

The segments are also prone to vasospasm which causes angina and some studies indicate that the application of GTN can also irritate the segments making vapospasms worse so angina will not be releived when GTN is used.

Unlike standard prinzmetal the attacks can happen any time of the day and can last for long periods of time.

Triggers for me can be tiredness, stress, family arguments, excercise, illness or simply happen when im sitting still.

I have very lttle help from my cardiologist or GP as there have been very few studies that have been done for treating the condition, those studies that have been done have always been small and always profess the need for more larger studies to be done.

The best advice I can give anyone is listen to what your body is trying to tell you; the times that my angina have been severe is when ive had a heart attack, have had a severe fever building which i was unaware of except for strong angina pain, and when a stent had reblocked.

Do not take no for an answer ask for a cardiac ct scan to be done, it is non invasive except for a single injection of contrast dye and picks up on a multitude of problems.

 

I echo your thoughts Hope.  I have the best family in the world, and I couldn't handle this as well as I do without them.

Stefan, I would imagine y=they have you on a statin.  What do they have you on for anticoagulation (blood thinner), and have you asked them if genetic would be a consideration for you?  All stents have the risk of re-occliding, but there are certain things that can make you ghigher risk for it to happen faster.  Anything that slows the rate of blood passing through the arteries increases the chances, as you mentioned.  Typically, they wouldn't do genetic testing, but given your situation, you might be able to find someone, and if you come up positive for any of them, they would usually put you on a regimen of aspirin and warfarin (Coumadin).  There are many genetic traits that can cause issues with clotting, one of them is called Factor V (five).  I'm not saying that I think you have a clotting disorder, but if I was in a position that put me at increased risk of having my stents occlude, I would ask to have it looked into, so that they can be proactive intreatment, instead of just reactive after things go wrong.  Just a thought.  They may very well say no, and to be honest I'm not sure that it is indicated for you withought knowing your full history, but like I said, if it was me, I would ask if it was something that should be looked into, given the other issue that you have.

Blessings,

Cathy

I am a 31 y/o female in the US. I love uppers and used meth for a year and half 10 years ago. After that I abused ephedrine. I would take up two 150 mg of it and then go pound out 1000 calories at the gym. I didn't like the aggressition that made me feel so I stopped that, then I quit smoking cigarrettes. I was working 4 jobs and was drinking at least two of the big cans of Rockstar a day. One night I woke up on my tummy with my arms under my chest and had this intense pain. I thought I had finally crystalized my lungs from all the years of smoking New Ports. Several episodes insued after that. We went to the ER. They said no heart attack, but maybe it was GERD. I didn't believe it was a heartburn pain and being that I hadn't eaten anything at 2 in the morning I didn't believe it. When it kept happening I assumed that's what it was. Episodes of this pain would happen day and night. I would have parasympathetic symptoms. Hot, cold, sweating.. freezing.. I had to sit against a heating pad or have my boyfriend pound on my back for me. At one point the only relief I found was from sitting in the shower.  I had polyps removed in March of this year. On April 3rd, I was omw to clean for this lady that had a little boy who was shy but liked me. All her gf's would come over and he'd shy away from them, but whenever I came to clean he'd talk my ear off. I was having chest pain on the way to clean for them, the pain wouldn't go away with tums, or ranitidine.. and it hurt so bad I was in tears. Then a strange thing happened. I started to hyperventilate. I was freaked out, thought I looked a mess and didn't want to scare the little boy so I decided to go to the ER. By the time I got there my lips, ear, and fingers were going numb. I went in, they tested my blood and my troponin was elevated. He came back and told me that I had had a heart attack. He said he needed to give me Aspirin. I am allergic to aspirin. I told him no and that I was allergic while wearing two wrist bands stating I was allergic. A nurse came in and tried to adminster 4 baby aspirin. I declided. The Dr. returned and I again declined. He told me that it was more important to treat my heart than to worry about my allergy and they had given me Benedryl in my iv. I finally agreed to take it. 10 minutes later I started sneezing and then wheezing. They treated me with two breathing treatments back to back. I felt this super intense pain in the middle of my chest and I told my boyfriend and mom that I felt like I was going to die. I thought they'd given me a pain killer and that I was going to sleep but I flatllined instead. They resuscitated me and did an emergency card cath. I was in the ICU for 3 days. I was put on Coreg, Diltiazem, Lipitor, and Effient. While I was recovering, my parents were present when I asked the Dr. what had caused it. He blantantly said,"The cocaine." Well that's a surprise because I hadn't done any in over 10 years.  Anyway, that was the start of it. I have asthma as well, and not all of the 7 trips to the ER were because of it, but half of the times my troponin has been elevated enough for them to keep me. This last stay a Dr. did another card cath and injected me with that stuff that makes vasospasms act up and it was like watching a branch blow in the wind. The cardiologists from the frist group that did my first card cath only told me, "Vasospasm. You're cholestrerol is too low. Quit the marijuana." and then didn't want to see me for another few months. I've been doing research on this condition now that I've seen it in action and came across this blog. It happens day and night, whether I smoke pot or not. I have noticed however that sometimes when I smoke marijuana (I have a red card and live in Denver) that I start to get chest pain. I am attempting edibles and vaping. However, so far it seems vaping makes chest pain happen. The new Dr. is concerned about me building a tolerance to the nitrates, They are the only thing that helps but lately it does seem like they aren't working. I have been put on Isosorbid 30mg and they took me off of the coreg, effient and lipitor. You are not alone and yes they happen day and night for me as well but usually more so at night. I have considered the possibility of a paranormal explaination for the pain since it was such a mystery at first. 

You needs to get off the drugs.

I am a 29-year-old male, and I was first diagnosed with Prinzmetal Angina six years ago, when I was 23-years-old and had a heart attack.  I was diagnosed, and placed on both blood thinners and vasodialators, with quick-dissolve nitro tabs in case of emergency.  I was later hospitalized two more times for severe spasms leading to cardiac episodes.

I have since come off the medications, because I've found that I can control the spasms with regular sleep, healthy behaviors (including good diet, exercise, and quitting smoking), and generally avoiding too much stress.

You're right, though.  While my heart attack occured at approximately 3am, the spasms never seem to occur by the clock, happening instead at any given hour of the day.  Sometimes, it can even cause debilitating migraines, which I assume is from a vaso-spasms affecting the blood vessels in my head.  I'm curious if anyone else has ever experienced this.  Also, has anyone else ever experienced vasovagal symptoms, such as light-headedness or extreme lethargy?

Boy, reading this makes me feel really lucky. I had my first attack at 64 and went to the ER. After a stress test that was "almost" normal I was sent home with nitro, which had worked , and a referral to a cardiologist. At my first visit he reviewed my labs and history an told me since I had nothing to indicate a cardiac risk he was sure I had GERD. I agreed to have a gastric exam and they placed a monitor in my esophagus. I partially agreed to the test because I'd been having some symptoms I thought might be a hiatal hernia - two for one test!  When I got the results there was no GERD but I had had several esophageal spasms. I was finally able to get in to the cardiologist who treats my 99 year old mother - he doesn't take many new patients. The first time I saw him I had all my tests and went through my history only to have him tell me that I had prinzmetal angina - no question - since my mother has it too. He then said that it's related to the migraines I've had since puberty and the esophageal spasms. It only took a few months and so far it's not too frequent and the nitro works. My attacks have never been at night. Sometimes, I'm active and often I'm sitting watching tv or reading. I can't find a pattern. 

I just found out I had this. I still can't believe it. I am an active 39 yo female. I am vegetarian and have never smoked. I have read your post and many other's on here. I am glad I am not alone but can't seem to shake this feeling of confusion. 

I feel the pain whether I'm resting or active but not constant. It comes out of nowhere. It doesn't matter what time it is either. Have you had any palpitations too? I just had an angiogram and it seems that I have more frequent episodes of the pain. I have nitro that I take as needed but I went from taking one every few days to 2-3 in one day. 

Since you have dealt with this for 7 years, has it gotten better? Do you have these pains with total exhaustion, loss of appetite, and not being able to sleep?

I know everyone has different experiences and I am interested in knowing as much as I can. Thank you in advance for sharing.

i been in hospital alot and in icu a few times ,a lot of med people dont really understand this,yes i get a lot of palations my stress test dont be great either .we where on holidays 1 time and we went in to a shop between the cold in the shop and the heat out side it brought on v bad chest pain so yes heat and cold will bring on pains ,i get them at rest or doing stuff make no diff really

Hi interesting and perhaps amusing, i was calling one of our cast in though the kitchen window (open) inside was warm and toasty outside was cold, i got chest pain on each inbreath, i had to stand in kitchen breath and go to window... Sadly work have taken a dim view of my recent record and are now looking at dismissing me due to poor health... I am only 9 months into the condition meds are ok but not stopping pains all the time, also having intermittant arrhythmia doesnt help i guess. The additional stress from work hasnt been great today either i can see their point but really? finding myself at best retired with ill health or dismissed as they want is not a fun place to be.finding it hard to find the positve spaces today. However being positive about htings does help and i find the concepts of mindfullness a help to managing stress.