prinzmetals angina

Hi Daytona,

I dare say this page is pretty active especially if people haven't got their alerst on, It's a horrid condition, I have a lot of ER doctors sympathise with me but then again on the other hand I have just as many that think I'm crazy, it's amazing how the younger generation of doctors haven't even heard of Prinzmetal Angina, even though it's the same they only know it as Vaso spasms, Anti Angina medication helps to an extent but just like any drug you can get an immunity to it and that's when doctors sart scratching their heads for a work around, GTN helps me 9 times out of ten but there is always that one day a week where it helps but the spasms increase in their intensity and ohhh the pain.......Where I am the Paramedics seem to know more about Prinzmetal Angina than the doctors and how to get rid of the pain in a rather quick fashion.What I have been told is not to muck about when I get my Prinzmetal Angina I'm to use 4 sprays of GTN at 5 minute intervals (20 minutes) and if no relief to call an ambulance immedietely as 9/10 my ECG's (EKG's) are normal it's when the troponin blood test that tells them when Iv'e had a heart attack, Iv'e had 2 mild ones in 2 years and lots of chest pain before and after the mild heart attacks.

This is actually a good site as you can see others experiences and what has helped or not helped them in the past

Indeed true, reading around it is very much if you are lucky your local team knows abot the condition, if you are less lucky you see doctors arguing in front of you about the conditon (i know i have seen 2 for 2 against... luckily for me the for ones were very good...) to the appalling where they really dont know how or what to do... on here advice and support  always available. Thank you Samuel good to read about someone else at my point in life...good luck with all...

Hi Lynette, My consultant told me to exercise more to help slow /stop/ improve the spasms. It would be worth getting an exercise test done to see what you can do to help your heart and not do too much so as to cause pain / problems. recently i had gastric flu and was bed bound for 3 days and settee bound for 2 days. the next three days were very painful. An exercise test would allow you to learn what pace to do things at without casuing any harm. I have ME and Intermittant arythmia as well  so planning rest and exercise presents some challenges but doing both helps.  Of course i st knowing what else you have wrong, but is just a fellow sufferers thoughts    

Hi, Ouch! enjoy the hobbies!!, I find them a help, can you do things like static cycling?

Hi Lynette,

I find Nicorandil(Ikorel) the only thing that helps to a degree, I find all the other anti angina medication is useless towards Prinzmetal Angina. I enquired about if I could take a igher doe of Nicorandil as it does seem to help but unfortunately I can't as "apparently" I'm on the maximum dose of 20 Mg twice a day. Also I have noticed Nicorandil for me i only lasting 3 - 4 hours when it should be lasting up to 12 hours

For the time being i am stuck with Monomil and Diltiazem Nico would affect my intermittent Arrhythmia (atrial fib) but yes i can see it is useful, cant say i would enjoy the headachs, monomil is bad enough!! but well done on finding a help, i took ages to find my help point, but, like you could be better... 

Hi Andrew,

Headaches aren't an issue for me anymore as I'm use to all the medication, I'm currently on what I believe is the maximum doses for my anti angia medication.

360Mg Cardizem (Diltiazem)

120Mg Monodur (Duride)

20Mg Nicorandil (Ikorel) twice daily

GTN Pump Spray and on a bad day I can have up to 20 - 30 sprays

Was on Clopidegrel (Plavix) but was taken off them) for some unknown reason as my Cardiologist didn't put me on them yet he told me to stop them, Our stroke unit put me on them due to a TIA I suffered last December. The Cardiologist wants me to take amitriptyline but I won't take it because I have really bad unwanted side effects from all anti-depressant medication even though in this case it's not being used for depression but for pain management, it is suppose alter the way we feel pain....some mumbo jumbo like that (Altering our pain receptors)

Also am suppose to be on statins and I also have severe side effects from them and can't tolerate them.

This is the trouble, where do we draw the line between medication, way of life and health? Yes i find GTN works but only 80%ish of time. i have to admit i would rather be aware of pain so as t oknow when enough is enough and go and get A&E to check it out but... again where is theat levele, i usually leave it too late... and get told off accordingly... Good luck with it all!  i wish it wasnt quite such a challenge, but hey ho... its teaching me patience (well actually its not but i need to learn it)

Yes I can understand all that, mine sometimes comes in clusters .I.E one bad day a week on any given day of the week. I have had 2 AMI's ,one earlier on in the year and one back in 2012 and on both occassions I have had some emergency doctors tell me not t ignore the pain if it doesn''t go away after 4 sprays and to call an ambulance but as you can understand about this condition nothing usually happens unless it's picked up in the troponin test or there is an actual change in ECG.

I think with me the problem lies in me....As I'm in there at least once a week and a lot of the doctors are sick of the sight of me but there are some that are very understanding. Last 3 weeks alone I was in our Emergency Department 3 times a week because my cardiologist had fiddled around with my medication, he in fact halved them all because he is starting to think it's neuropathic pain, My old cardiologist did warn me about being taken over by a new cardio, it turns out that my old cardio never retired so I go see him when I think the other one is carrying on a bit

Last week my GP put me back on the full dosage rate again and now I've only had to visit the hospital once since then but I think stress bought on this attack. I'm at the stage where I'm to embarrassed to call for an ambulance but I always end up calling as the pain gets to much....

Well done sounds like you have a good grasp of your situation. Never be embarassed at calling for help, more problamatic to discover that you should have... though in A&E i find docs either know about vasospasm or dont... and are happy to argue about it with each other in front of you wife and i didnt enjoy that one... raised trops but not enough to confirm heart attack but showing damage on every visit. so each bad time is doing harm, not a good thought... however the heart does have some healing ability... better news... make a list of reasons why and keep that for discusion with  new cardio and keep the old one firmly near by - good move! i tend to keep notes now and have my own file, if one starts to become a bit... carrying on, i present file and all data so far, usually works and easy to keep some peace... Good luck and keep laughing, i like that and when i figure out how to get them in i will use them! ah that easy, ah well that my new thing learnt today.... 

Hi Andrew,

I actually did keep a diary of chest pain at the request from an emergency doctor, they found it very helpful.

I haven't had that problem with doctors arguing in front of me however I have had young doctors that have never heard of Prinzmetal Angina and have asked me what it is or have exscused themselves half way through a discussion so that they can go and ask a senior doctor all about it , usually the senior doctor comes back or sends someone back that does know about the condition in some cases the doctor that doesn't know anything about the condition sits in and listens .

I find the triggers for my spasms are cold weather, stress or comes on out of the blue,sometimes it can grab me when I'm pottering around with the odd jobs I do around the place.I've actually got mild chest pain as I type it's spring here but it feels like winter this morning and it's a bit windy, I let our dog out this morning to go to the loo and a puff of wind caught me and sure enough half an hour later if that the spasms started but is under control for now

Usually my troponins come back flat out 0.000 but there has been many times that it has come back 0.01-0.03 which they class as negative here so I take their word for it even though I feel like a truck has run over me. An emergency nurse told me about my Trops she said I have had quite a few come back in the range mentioned above ....0.01 - 0.03 so with out her honesty I wouldn't of known this today, I realise it may be nothing but to me I personally think that having the slightest Trop rise must tell them something is going on ....what's your thoughts on slighty raised Trops ?

Hi Samuel, I too gave that rouble, when I go to hospital you gave to tell your story over and over again, I also have a left bundle branch block and 1st deg heart block, prinz metals angina, stress is the worst cold and excretion, I don't excercise at all as if I do I okay for it 

Hi Andrew, it was good to read your post, I'm so glad I am not alone with my prinz metals angina, I live in Australia, there isn't anything here of help with my condition, I once went to a cardiologist who when I told him I had been diagnosed with prinz metals he replied oh no you wouldn't have that, thas only in America, I was so angry at him didn't go back, now I have a good one and I also have a left bundle branch block and a 1st degree heart block,do you know anyone else with that as well as prinz metals angina, my cardiologist has also put me on Larginine powder, she says it will be a big help,mi googled it and there are good reports of it 

Hi Andrew, I haven't tried that, I'm scared to do any form of excercise as the attacks come on at rest, I walk around the house a lot, hope that counts, I take verapamil twice a day was put on that instead of the diltiazam that I had been on for a few years, also nicorandil has been remarkably helpful I feel, 

Hi Lynette,

I fully understand your situation in regards to some emergency doctors, I raised the diagnosis of Prinzmetal Angina to my current Cardio and he said basically the same I corrected him but he is still not convinced that I have it and he tells me that there is no routine testing for it....I corrected him yet again....then he goes onto say that they don't ordinarily test for Prinzmetal Angina in Australia because of "possible dangers"from the drug they use to see if the arteries spasm ?

I went back to my old professor of cardio and he explained everything to me, he told me what was going on and that there is no cure for it and I would have to somehow learn to live with it but of course if the pain becomes to bad is to do the obvious and call an ambulance , but that's Ok for him to say because I'm a regular in our emergency department and very well known and it's becoming increasingly embarassing.

I've had 2 AMI's and have a baby blockage in one of my coronaries it's only 50 - 60% blockage(that was a couple of years ago) and there is nothing they can do because that is considered as non flow restriction and stents aren't made that big. Some emergency doctors are sympathetic because they know that the condition does exist but they can't do anything unless of course I'm having a heart attack or the blood work comes back positive in the Troponin test. Some paramedics will admister morphene for the pain and that really helps, some doctors will also give morphene or endone in emergency but they are reluctant to give it because of addiction, I had this discussion with both paramedics and emergency doctors that I wouldn't be here just for pain relief as it's readily available elsewhere....There would be no need for me to call an ambulance if that's all I was after, Some of our health workers like to think the worst for people like us.... They must know that all these anti angina medications don't always work for all patients

Yes I know what you mean Samuel, I was told by one very rude doctor in the ER that he said he would not admit me thought I was mad and needed to see a psychiatrist I was devastated and embarrassed it was in front of a group of student doctors, after it got home a day or two later I rang the director of medicine to inform him what happened and the effect it had on nod, he was terrific apologised and said that if ever I came to hi spiral with chest pain in future I will always be admitted and taken care of, he said he would deal with that doctor as I should never of been treated like that,MIT was so good to feel validated for what happened and now I don't worry if I gave to call the ambulance to go to hospital, we don't need that kind of stress, my traponans are always normal but they always say to come in if GTN hasn't settled it, the ambulance always give me morphine