prinzmetals angina

Hi Neale, i have both types of vasospasm - micro and macro not that high on D, but as my mircos "mostly" are overnight i am on a high night nitrate type drugonths of headaches to beging to aclimatise, now no longer thumping, just bad headaches... yes i am in the UK and exercise when i can which does seem to help a bit... or if i rest too much the chest pain goes up markedly as does frequency D does being kept as low as possible to allow for increasing doses as time goes on...

Hi. Andrew.  I get bad headaches and have done so for a long time now.  It does worry me that I am a high dose of D but have go my life back at the moment!  Stress is a big trigger, cold wind and constipation!!! I am treated by st G eorge's hospital in London, where are you treated in the uk and do the cardiologists understand !  

Hi Neale, read about Prof Kaski on here and emailed direct and got GP to refer... as i am in Cornwall its a long way... Otherwise its GP and local Cardio who is aware i will cheat and go to Prof if need be... i am treading water now - better than i was! but work retiring me at present and not sure what my next steps will be yet, one or two ideas but will finish this process first... stress indeed is a primary trigger then cold, then resting / reading which can also set my Arrhythmia off... then too big a meal... then - who knows.... trouble is the ME need rest the heart needs exercise...  the cardioogists have a loose grasp of the concept... GP is very good though lucky for me 

Hi Neale,

Funny you should ask that question about Diltiazem, I actually asked my GP this the other day what was the highest dose of it and he informed me that 360Mg was, When I was first put on it, it actually helped but I think my body has built up a kind of immunity to it, Now that I know it does come in higher doses I can put this back into the lap of my GP or Cardio, The Nicorandil helps me but doesn't last as long as it's suppose to, with me it only seems to last 3-6 hours instead of the 12 hours it's suppose to.

I'm in Australia

I was on diltiazam for a few years but have been put onto verapamil and nicorandil and monodur instead with better results, I get a lot of attacks but have been able to stay out of hospital longer using 4 lots of spray, I still can't do much and excercise is out of the question, and weight gain

Hi Lynnette, Neale and Samuel, Samuel and Lynnette first the Australian heart foundation has quite a good PDF document if you havent seen it, look it up via a good search engine (i use the G one...) perhaps they can offer support advice etc, i took my steps after a lot of research and them my wife checking my research and then forums like this and reading on British heart foundation, then emailed and went back toi GP with results, then onto speacilists some of whom were great and some.... I have bad days and today may be one.... but i often find if i have a good day (pain of 2 or 3 only) then i will within 3 days have a very bad day....  i have tried to rest and also be very active and am now trying various different levels of rest and activity on my good days but so far it doesnt seem to make any difference... however i do find exercise of any level better than prolonged rest there is the ME limit but... I also find i get the Arrhythmia no matter the level of PM until i hit around 8 out of 10 on a pain score then the arrhythmia seems to happenand i have to take medication and walk to solve it or  A&E i tend not ot A&E things until i hit 9 and no solution gtn etc doesnt work...  longer term stress hours rather than sudden shocks and going from warm to cold are my two biggist causers then resting,,, darn i love a good book too ah welll.... misty weather casues heart aches as do sudden drops in presssure which also set off my arrhythmia a bit more, thunderstorm do cause a change in heart sensations but... Lynnette, try a static cycle and see if that helps? going form there perhaps you could build up a routine of soemthing more? just a thought again ideally do this with testing involved to keep an eye on the heart but is an additional thing and could be social if there is a gym who would support you with this? walking with a camera is good too and being in sorting out the house is still activity stairs are very good!!! (er ....) if i think of anything else i will contibute again today but... i still think it is amazing that people in three different countries can club together and make a difference for each other!!

 

Hi Andrew, many thanks for that information,you don't know what a great thing it us for me to be able to share my experiences with other patients of pm it is it seems to me a whole lit of trial and error, I get tired easily and find I can only spend two hours tops at any one activity and nothing excertive at all, I have an appiontmentvwith my cardiologist tomorrow, she seems to very informed on my case, she seems quite concerned about the left bundle branch block. Do you have that too 

Good luck tomorrow!! I always take "my File" with me all my research and notes as well as pain diary (done as a graph) I am lucky my spasm may well close things down but the closure, if any, lasts as long as the spasm. My GP descibes it as like cramp but where we would stretch and rest the leg for example, the heart has to carry on, and that carrying on is the damaging bit - mind you not carrying on would also be bad!! I agree permanent blocks would be worse news, so i feel lucky today! hope tomorow goes well and you get more of a plan to go forward with!

Hi Andrew,

Yes I have read the PDF from the Australian Heart Foundation  and I had to telephone them in regards of some settings off of my Prinzmetal Angina....I.E Cold weather and even just a simple puff of wind to the face, foor you see most doctors here think we are crazy when we mention that the cold weather set it off, I spent the afternoon in ED yesterday afternoon, everything returned negative then was discharged still in pain, the paramedics tried to get a line in but weren't succesfull.Just because it was Vaso Spasms (Prinzmetal Angina) I was shoved out into the waiting room.....

Sorry forgot half of my comment

The Australian Heart Foundation were  very surprised to hear that I have had experiences with doctors that didn't believe me about the cold weather ....They informed me that it was a text book symptom and was taught in medical school as a trigger to Prinzmetal....They suggested I print off their PDF and show the doctors that do not believe that cold weather sets it off

Well done Samuel, it is scary how few actually know about it and its three main causes, did you read a previous post from me about when i was calling one of our cats in? I have ben thinking about doing an information leaflet for A&E or for people with PM / Vasospasm (macro and micro) to take in with them when seeing medics....  makes me get so stressed i could, oh darn cant get stressed...  ah well at least we can smile i guess... have a good day, drifting to bedtime here in dark wet Cornwall ...

Andrew, Yes it is scary, they play with our lives , they think they know everything and yet they don't know what Prinzmetal Angina is

I'm a motor mechanic by trade and I tell you I'd love for one of these doctors to bring me their car for repairs, perhaps I could spin them a line that the "heart " of the motor is buggered knowing full well it was something else   let's see how they would feel in a mis diagnosis treatment or a diagnosis they have never heard of before ....How I'd like to put the boot on the other foot.

I understand completely, after my last visit to A&E i would now say i would like to apply the boot to a rear end... ah well, i work in local government (but now being retired due to health) my manager has the view that me being taken to A&E is upsetting my colleagues and me being off so much is messing with her targets so can i work harder when i am in to make up for it....i supplied info on PM and so on they said well if you are well enough to be in work ... if not dont bother... so much for help and support oh and help wirth stress management...hmmm I dont mind people not understanding, its the not learning that bugs me or worse the i am right and the evidence is rubbish and i am not going to try to understand approach of some doctors and bosses. Make a mistake learn from in and try ... perhaps i live in cloud cuckoo land, my other role in life (or one of them) is elite athletics coach, i expect my athletes to undertsand their programmes question me on them and for me to keep on learning more and new ideas and to adapt to what happens on the night. Like car engines athletes can be tempremental and do odd things for no reason but with a bit of patience and skill... ah well nuff grumbles on with the day today could be ... interesting ...hmmmm 

Yes stress is used far to easily for a lot of ailments, theres no denying that stress exists but I think there'sa lot of us out there that have learnt or been taught how to cope with it, there's definately no doubt we all suffer some kind of stress/anxiety when we get our chest pains, it's a natural thing to occur and that's another thing that bugs me with some doctors "ohh it's just stress" then they try to lumber more medications into us to treat what they "think" is stress / anxiety...I think they just want to make their day easier and less stressful for themselves, they have the attitude that if nothing shows up in any tests we have nothing wrong with us...

If I thought is was "pure" stress/anxiety I wouldn't present to our emergency department.last week I had 3 visits to our emergency department the second time I was taken in nothing was done for the pain, I had "know it all " paramedics that wouldn't administer pain relief then I was seen by the ED doctors and they wouldn't even offer any kind of pain relief, my test came back negative which was good news but I was discharged in pain and I didn't get any sleep that night and had to recall for an ambulance the next morning, yet again I get "know it all " /unsympathetic paramedics, arrived back into ED was seen promptly ECG and blood taken for trops and doctor ordered Endone X 2 and after around 35 minutes the endone started to kick in and the pain was diminishing and when blood test came back negative I was asked by the doctor if I would stay in for the night, the reason she asked that is because I said that I'm getting sick and tired of having to  call an ambulance all the time to come into emergency and that because the night before when I was discharged in pain (7/10) I told this doctor that my firearm locker keys looked so attractive and that I stared at them for sometime, she understood my frustration with the Prinzmetal Angina but was more concerned with my mental state because of what I had said to her, she didn't want me to leave but I assured her that all those thoughts had gone now that the pain was finally taken away and that I have 2 young children and that I didn't want to cause to much paper work her or the rest of the department..after a short conversation I convinced the doctor that I was fine now and had no more of those thoughts because the pain has gone now.

I fully understand where the doctors are coming from with pain relief and it's addictiveness but I'm not in there everyday asking for it because 9/10 the GTN spray takes care of my chest pain along with the Nicorandil if the pain occurs around the time I'm due to take it. I actually had one doctor accuse me of drug seeking and I spat it with him, I said look mate if I wanted pain relief everyday I wouldn't be here for it as it's readily available "elsewhere" he shut his mouth from then on. I'll be glad when summer finally hits as I don't have as many attacks during summer, we have about a month of spring left to go even though we have had well above average temperatures we still get the odd cold windy days and as you know that can set it all off. When I get the caring paramedics which is around the 99% they get a line in and get the morphene going and by the time I get to the hospital I'm pain free...in the last month I have had that 1% that doesn't do anything for me while transporting me into hospital, yesterday the best the could offer was what we call the "green whistle" because the paramedic couldn't get a line in after 2 attempts , they didn't want to keep jabbing me, I said I don't mind because the needles don't hurt as much as my chest pain, the "green whistle " actually worked for me this time but when I had used it all the spasms had started again about an hour later and yet again sent home in pain, Iv'e had spasms on and off all day today but nowhere near as bad as yesterday as in pain wise.

Thank you for reminding me how lucky i am really! sorry, wish i could do something constructive for you ...but... it does make me think more about some sort of leaflet for emergancy services... incororporating the world view on PM advice and notes all bullet pointed so they stop treating us like idiots sometimes

Hello samuels

I am dismayed for you at the number of prinzmetal attacks you are getting and yes I know how bad it is  as I had some bad ones in February causing heart  damage .  Have they tried diltizam at 480 and nicorandil to try and stop them!  Only asking as it worked for me?

Hi Neale,

Yes I am on Diltiazem but only at 360Mg's as they tel me that's the highest dosage rate for any kind of Angina, I enqured about a highr dose as when I first was put on them they did indeed help but my body seems to have built up a resistance to them, I am also "apparently" on te highest dose of Nicorandil as well 20Mg's twice daily, I find that they work as well but are now only lasting for around 3-4 hours a day instead of the 12 hours. If I et the spasms around the time I'm due to take my Nicorandil after about 30  or so minutes the spasming is decreasing and then disappears.

here's an example of one of my bad days... have the spasms early of the morning take my anti angina medications come around 10-11am the spasms and pain are back and GTN will help but only works every 5-10 minutes then the pain graduates back up and after having up to 16-20 sprays is when I decide to call the ambulance. I have been told to call after 4 sprays if pain is increasing but I know what it is and so do the ED doctors but I have had several ED doctors tell me off for leaving so long especially when I've had 2 AMI's and a TIA, because the ECG doesn't show the spasming, Iv'e had a couple of abnormal ECG's but they have corrected themselves, the only true way for them to know if I have had another AMI is by doing the blood test for Troponins.....

 

Hi Neale,

Yes I am on Diltiazem but only at 360Mg's as they tel me that's the highest dosage rate for any kind of Angina, I enqured about a highr dose as when I first was put on them they did indeed help but my body seems to have built up a resistance to them, I am also "apparently" on te highest dose of Nicorandil as well 20Mg's twice daily, I find that they work as well but are now only lasting for around 3-4 hours a day instead of the 12 hours. If I et the spasms around the time I'm due to take my Nicorandil after about 30  or so minutes the spasming is decreasing and then disappears.

here's an example of one of my bad days... have the spasms early of the morning take my anti angina medications come around 10-11am the spasms and pain are back and GTN will help but only works every 5-10 minutes then the pain graduates back up and after having up to 16-20 sprays is when I decide to call the ambulance. I have been told to call after 4 sprays if pain is increasing but I know what it is and so do the ED doctors but I have had several ED doctors tell me off for leaving so long especially when I've had 2 AMI's and a TIA, because the ECG doesn't show the spasming, Iv'e had a couple of abnormal ECG's but they have corrected themselves, the only true way for them to know if I have had another AMI is by doing the blood test for Troponins.....

 

I think from on here and British Heart Fondation that dose is the highest i have seen (daily does) i have seen higher individual doses. I havent seen anything higher for nico - i can only suggest using G to search for more info on it. Also a lot of work has been done on natural nitrates recently shown on UK tv and a clear good result from using Beetroot and Garlic these have been shown to lower blood pressure by a few points and they do it by the effect of nitrate action however you would need to discuss and perhaps test with doc on hand or some medical kit around as it may do too much in combination with current meds?. My GP is trying to keep my doses as low as possible ot extend their life span of usefullnes. ideally i guess we needto take medication holidays to desensitise our systems, but i for one am very reluctant to try that, though i guess a planned admission to hospital for that might work, is that a thought? are any of you seeng someone soon? would a week in hospital on monoitored non nitrate meds give the body a chance to desensitise and improve the medicines effectiveness for a while? warm room, lots of fliuds and kept sedated, boring yes but would it work? I was told 4 sprays and equally told of for not doing so, i tend to give up at 10 to 12 though... chicken i know  but... 

My Cardio halved all my angina medication just to see what happens , I asked him why do it by halves and stop i completely, I also asked him if it would do any harm if I did stop completely and his reply was "No" the reason I asked about stopping completely is because the medications I'm on tend to add up over the months or end of the year even though our medications are subsidised down under.

I tried his way first by only taking the half doses and after 2 days I was getting chest pain / spasm's everyday, to start off with they were only minor ad weren't worrying but after the third day the duration of the pain was lasting longer soI gave it another week but it was just getting worse and I had 3 - 4 trips that week to our emergency department via ambulance, after being given the all clear I couldn't get in to get in to see my GP, I had to see another doctor at his surgery and the female doctor I saw  increased it back up to my full dose and after a day or two everything was settling down but I was still having that one "bad" day a week which required me to call an ambulance.I then decided to cease the medication to see if  it could get any worse than being on half dosages, it sure did,I was finally able to get into to see my own GP because as you know we get sick of going into emergency, he actually read my cardio's letter and decided to stick with the half dosage rate again why I agreed to it I don't know but I did, chest pain / spasm's returned more frequently and yet again back into emergency 3 times a week because the pain was to much, I was able to get back into my GP again and he said it looks like we will have to increase it back up to max dose again, things settled down again but I still have that one trip a week via ambulance....

I'm allergic to Garlic , I seem to be sensitive to a lot of things more so medications but Garlic causes breathing difficulties with me and Beetroot ....Yuk

Hi Andrew,I had my echocardiograph yesterday haven't got the results yet, my cardiologist seems more concerned about my left bundle branch block than my pm but I have been getting breatheless lately at the slightest excertion and so the report said worsening symptoms, I wish the doctors could be more understanding of prinz metals than they are, I know there is no cure but it's grad to live with and life debilitating  for us, there must be a lot of folk out there with no support at all, I hope to get the results of the echo soon, and also last post my computer does word predict and instead of excercise it said excretion makes me look like a fool lol I must read before sending 

INteresting and well done, i dont think i would voluntarily try it... i have accidentally forggoten a morning or and afternoon dose twice... i have no intention of forgetting a third time..... not fun at all... but i can see the sense to reduced or none for a recovery spell, i would have ot go for hospital and sedation i think to attempt it... Shame about the garlic but beetroot chuck it into a blender, mash to a liquid two gulps (or three) and its gone... then a good spoonfull of honey or ... and all over... i am going to try and do this soup /drink/ smoothie oh i dont know  but with garlic and brussels and cabbage and brocoli and cauliflower mix a batch and drink over the week  liquidised it cant be too bad surely... hmmm i will let you know just wish they wouold find a cure or treatment that works without side effects, in the meantime good luck with all will be watching for more news....

sorry to read that, i agree thats why i wonder if a patient leaflete we could take in with us would help, well referenced of course... good luck with the results though, hope is it safer news and something that can be worked on easily!  i have to check all i write as the computer writes what i tap in not always what i want... uh oh!!  

Hi There,

I had an intereting discussion with another Cadiologist the other day as I was admitted for my Prnzmetal, I had asked him about high Cholestrol and if here as any links with the chest pains

I don't know what happened there ....sorry..Anyrate he said that high cholestrol is known for making artery and vessel spasms  and that there is a new medication on it's way out, well here in Australia, it's probably already available somewhere else in the world , it is going to take the place of statins and have "hopefully" no severe side effects like the statins do, he did reel the name off of the drug, I can't remember it but it sounded like the name of a police dog squad ....something like K9CHP...something like that and it's an injection and our cardio's are quite excited about this new drug. I put this high cholestrol and chest pain to my original cardio years ago and he had no answer to it so after asking this week and getting the reply above ^^ I feel as though I have hope and something maybe achieved in reducing the number of Prinzmetal Attacks....*fingers crossed*

Just to add to my previous comment as I didn't go into it to much but basically the answer  I got to my question about high cholestrol and chest pain,  the answer was, it  can cause spasming of the coronary arteries and the small blood vessels as it's cutting off the nitric oxide supply (something to that effect ) this Nitric , I think it's called that, has a lot to do with Prinzmetal Angina or the lack of it for better words causing the spasms, it was all above my head his explanation but he tried to explain it in laymans terms it also has something to do with the myocardum (myocardium ? ) causing the spasming as well.

So with this explanation given to me has any of you high cholestrol ? I do it was extremely high but have managed to get it down via diet and exercise when I can, it is still considered to high my cholestrol, mine is down to 7 from 20 but for some reason my trigylcerides have doubled it's sitting at 10. I don't know if those numbers would be the same as your countries pathology testing ..I know these numbers above would mean nothing to someone from the USA as they some how use different numbers..... same tests but they must use a different technique ..perhaps like in measurement I.E ... Imperial and Metric ?

Really interesting Samuel! i dont suppose you could get your cardiologist to do a report could you? if it could then be emailed to us (when i work out how to add in my email icon) I dont have high cholesterol but would be interested in trying the drug to see if even though i am lowish if i was lower would it help. if you can get its name  i / we can ask our GP's to keep an eye out etc. Yes i can see how it could compete with and block the effect of Nitric's and hence over;loading with GTN and the others works then. There are other effects that cause PM and micro vessel spasms to do with inflamation and histamine cascades and those sort of reactions that are stress related. There is also a direct nervous effect which may be part of the inflamation process. However removing one factor may well be enough to give our bodies the chance to regain control... The myocardium causing would probably be due to it being inflamed and pressing on the heart and the heart going,"stop doing that" and "flinching" away (two areas of mebrane in contact would rub and produce a sore spot and we know how the heart feels when sore so...) very interesting indeed. Thank you for sharing that and will be watching for more news!    

Hi

it is very exciting about the new cholesterol medication.  I do know the importance of keeping cholesterol low to stop prinz metal.  Also vitamin d3 ,and oestrogen for us ladies .  The main think is exercise I bbelieve too but when you have microvascular angina too, it is a balance!  Off to see prof Kaski in a couple of weeks, so will let you know if this drug is available in the uk. 

Hi I got good results from the echo so that was good, I really am confused as to activity because any exertion seems to give me chest pain so exercising is out of the question, my cardiologist said its trial and error what I find helps and so to pretty much manage it on my own it's impossible to get fit, such a frustrating thing I am sure the niccorandil has been the best help so far

Hi there the new cholesterol drug sounds very good will look forwRd to hearing about it, I currently take Crestor with no side effects but lack of activity leads to weight gain I have found or is it one of my medications causing it, it's a learning journey that's for sure 

Lynette, just a wondering point here... sorry! but if your GP or Cardilogy team could do it would it be worth a go with a static bicycle set on no resistance, reason being it is lower impact than walking and running and can be done very gently, this could be built up over weeks to a resistance based cycling effort to a point where it wa below heart pain but allowed some enhance activity. this could be done while wired up and would improve blood flow but at very very gentle levels. only a thought but would perhaps also give some confidence? I do undertsand though it isnt easy to push on when the heart pain starts, that worry cant be easily allayed. but good that the echo is good and clear!

 

Hi Andrew,

all my records seemed to have grown legs on my last admission last November  as I was suppose to have a follow up with Cardiology and have an increase in Cardizem but my GP didn't have any letters from Cardiology stating that my Cardizem needed to be increased from 360 Mg a day to 480 Mg (240 Mg tablet taken twice a day) My GP had to chase everything up and now everything is back in order, I see Cardiology next month so I will ask again what this injection is for cholestrol and what other conditions it would be used for.

Now as I had a different Cardiologist on my last admission to hospital I'm not guaranteed in getting to see him at my next appointment but he has improved my spasms greatly with one simple adjustment of my Cardizem, my regular cardiologist was taking me backwards, he actually halved all my medications with the exception of the Nicorandel, big mistake that was, Anyrate on my increased dose of Cardizem and wowsers what an improvement, I haven't had  severe spasms since the 5 of January this year, (this episode was bought on by a stressful/ angry event ) only 1 visit to our emergency department to date. this time last year I would of beenat least 5 times. since the Cardizem increase I can do more around the place, I seem to be tolerating the drug well and has bought my blood pressure down to normal as well I'm now sitting on 127/80 where as before i was fluctiating around the 170/90 and 160/90. things are looking up for me this summer just have to wait and see what winter has in store for me, with a bit of luck the Higher dose of Cardizem will keep  my Prinzmetal Angina in check

Fantastic news even if the gremlins have been at you records, good luck with getting the right cardilogist next time!! winter has been ........interesting! but so far so good. i use my "alivcor" a lot to check and that helps... my blood pressure is good but like you it only takes a bit of extra stress and......... ah well well done and i look forward to seeing more good news!! and yes i will be twisting an arm or two to try out cardizem

Yes that damned stress, one of the biggest pre-cursors for a trigger and that cold weather, I made mention to this cardiologist about an increase of Cardizem because I  was told by my GP that 360 Mg's was the biggest dose allowable but I remember seeing someone comment that they were on 420 Mg's a day somewhere on this site, the Cardiologist that was looking after me at the time said that increasing it may be just what I needed so he wrote it up but his records as I said grew legs and no-one could find them for awhile. My GP informed me that as a GP they are restricted by drug guidlines and 360 Mg's was their prescribing limit but a specialist can prescribe higher doses if required. I've been told what to keep an eye out for with this increase ..side effects...Constipation and fluid retentiion, I am suffering a bit of constipation but that is easily correctable and *touch wood* no fluid retention ....I started the increased dose on the 31st of Dec just gone and one visit to ED so far is record breaking for me....lol....I do still get small bouts of spasms but a spray or 2 and all over and done with so it's doing it's job (Cardizem)

All the best and if put on to it I'm sure you will notice the difference with Cardizem and Prinzmetal Angina, Cardizem is a calcium channel blocker and I was also told to ask the Cardiologist about being put on a Beta blocker as well to reduce the chances of having anymore NSTEMI'S but I think I'm popping enough pills as it is now.

 

great, thank you very much!....interesting.....

 

Hi  Andrew,

Had Cardiology follow up , I saw my normal Cardiologist and I asked him about this new drug (injectable) he didn't seem to know as much about it as the other Cardiologist that I was speaking to, he didn't even know the name of it , all he could tell me is that it was only for high cholestrol and that he in his opinion couldn't see it working on vasospasms, All he could tell me is that it is an expensive drug and may take up to a year or longer to come out but I am a prime candidate for a subsidy for it when it does come out as I "apparently " have a rare lipids profile...

I'm going with the third cardiologist because what he explained to me made a lot of sense....they all play a part with each other, to me if cholestrol either depletes or eats the nitric oxide well what would be the next thing to occurr ? Vasospasms I believe ? which is Prinzmetal Angina..... So as I said I think they all tie in.....

Hi Neale,

See my responce to Andrew, that's all I could find out about this new cholestrol drug, my normal cardiologist didn't seem to know to much about it other than it only being used to treat high cholestrol....he couldn't even remember the name of the new drug, all he could tell me is that it will be very expensive

third time lucky... interesting though and interesting that still the top team doesnt really know what is going on or indeed how to treat... the brief clearing of muddy waters... however interesting that he had some construcive input rather than the usual , ah well back to fingers crossed again... i am seeing my GP this week and will have a goo with him or him asking the cardilogist.... will let you (and all) know good luck...

Hi, neale,

​I was put on 480Mg's of Diltiazem, works wonders, no emergency visits for awhile, a couple but nowhere neare as many, well we got our cold weather earlier than expected this year and have been in to emergency at least 3 times a week, we are back into spring again now, prinzmetal settled down again but then for some funny reason it flared back up againand the pain is really getting up there, the worst I have experienced....on a pain scale out of 10 mines been getting up to 8 lately. I have also now been told even warm weather can trigger prinzmetal angina off ...well any angina off now,we just can't win.....lol... although I'm starting to slowly come right again, we have had a real warm spring, the hottest spring I can ever remember, already got bushfires going all over the place.

Hi Neale, wish I could contact St George's hospital as I'm in Italy so they just assume the language issue has me confused. I m not I have prinzmetals angina. So difficult to explain to those without a clue.