Brand new diagnosis - and confused

Heart health and blood vessels
1

Hi everyone.

I'm 56, non smoker and obese.

Following an episode on Friday (tight chest and arm pain) I was taken to A&E. ECG & Bloods were clear but diagnosed as angina.

I was in a bit of shock at A&E (still am!) and didn't ask the questions I should have.

I've been given some meds and told that an appt will come through from the "chest clinic".

I have no knowledge of Angina and I don't even know what I should/shouldn't be doing prior to the gp visit. Walking up and down stairs gives me some tightness in my chest with an ache in my left arm all of which eases at rest - but happens often. Could this just be anxiety?

What is the standard process from here?

What sort of immediate adjustments should I be making and what questions should I be asking the GP (I've made an appt of my own back this week)

2

Hi,

Where you given any Medication?

I found that he majority of people have their symptoms managed quite well through mediciation (cardiac rehab group, social media groups etc) That said there are unfortunate souls on here also for whom, angina is a constant struggle.

To put things into context, I am 34, I was brought into a&e and long story short suffered a heart attack through a coronary artery spasm (vasospasric angina) - having recovered from the Heart attack (Its now been 10 weeks) in pretty much absolutely fine.

I am now on a few mediciations for my angina - namely, calcium channel blockers and GTN spray, depending on your angina - frequency and severity they may give you s combination or drugs.

As a rule of thump to answer your question if you're doing anything that causes pain, stop and sit down and relax. If prescribed nitrates (such as a GTN spray) you can take that before physical activity to stop the onset of angina.

First piece of advice would be to try to get the weight under control...that will keep the good pain away as you age as it will reduce the risks of cardiovascular disease, a culprit of stable angina.

Good luck and know that with a few healthy life style choices you can lead a normal life - keep positive!

The worst I found I was doing was worrying/over focusing on other's symptoms which was making me miserable. Listen to your body and follow your doc's advice

3

Thanks Nim.

Yes I've been given beta blockers and amlodipine (as well as aspirin and statins) and my wife is already ensuring that the weight is at least going to start to go in the right direction!

I haven't yet been given a gtn spray.

I realise that everyone will be different, and I assume that my treatment plan once it's in place will settle me down.

I just wonder at the moment if anxiety itself is causing me more anxiety than the illness!

Thanks for coming back to me so soon.

4

If I can throw another question into the mix (and yes I know I can ask my Dr in a few days) from what I'm reading, it seems Angina is diagnosed by process of elimination given certain presented symptoms rather than my any particular test.

Is that correct?

And if so, how do they decide what course of treatment would be more appropriate (meds, stent etc)?

Thanks again.

5

Hi, it's not anxiety, it's angina unfortunately. Pain in the left arm, chest and jaw are classic symptoms of heart disease, i was diagnosed last Summer and please do not allow any doctor to tell you otherwise, if it eases at rest , it is almost certainly angina. My condition is Cardiac X Syndrome caused by high BP so is inoperable, fatigue, breathless and pain is the order for the day. The medication they have given you should help to ease the symptoms. You may need an angiogram to check for blockages but try not to panic and take it easy, life in the slower lane unfortunately

6

Thanks Richard.

7

Your symptoms do sound like Angina.  In my case, I had jaw pain.  within 8 weeks I had had, all bloods, heart scan, ecocardiogramme, stress test, angiogramme and a stent as one artery was blocked 90pc. This was a complete shock to me. as I had not other pains or breathlessness.  Im currently doing 9 weeks rehab. I was a heart attack waiting to happen so consider myself very very lucky.  Your dr needs to get you to the chest clinic asap, so keep pushing for this.  Good luck

8

Hi Richard, it doesn't sound like anxiety to me... and the gold standard for finding out if you have narrowing/blockage of the coronary arteries would be an angiogram. The way they diagnose angina varies from country to country to doctor to doctor... not being a doctor I don't feel comfortable answering that question to be honest. That said, chest pain is often a cause of angina/cardiovascular disease or heartburn/anxiety... I guess they come to a conclusion based on your criteria/circumstances - such as age and weight and general fitness.

In case if your symptoms improve with the medications you're on I suspect there won't be much of a follow up unless you have further complications. Know what you mean about the "giving you a pat on the back and discharging you" part - I was left clueless after my heart attack without much advice or direction. Luckily with a father who's a doctor a mother who's a dentist and considering myself of average intelligence I managed to do quite a bit of research online..

If you still have pain, push for an angiogram and definitely ask/request a GTN spray this is really a miracle drug for angina!

9

Thanks Nim.

Interestingly my diagnosis was in the UK while I was at work, but I live in France so I'm back here now for the GP visit.

It'll be interesting to see if the approach will be any different to the UK.

I'm realising that I've probably posted an impossible question given the variety of individual experiences.

Christine's reply has scared the pants off me! :-)

(But it's as appreciated as the rest)

Thanks again

10

Hi, no worries at all.

Keep us updated - and do ask about the GTN spray (nitrate) and angiogram.. hehe now you can see why my first response was structured the way it was! Everyone on here is a star but as a new comer (as I was) it's easy to read too much into things and a negative outlook is the worst you can have when first diagnosed, in my opinion smile. You can imagine you was going through my mind as a relatively (what I felt to be) fit, 34 year old and then to hear the "the worst of the worst"....was close to depression!

Luckily, managed to slap myself out of it and instantly started feeling better - but of course, as we've said everyone's different!

PS: Look out for severe muscle pain whilst on the statins as that can lead to complications later down the line and is easily adjusted...

ciao for now. N

11

It sounds like angina to me. It is artery spasms. You need an angiogram. It will tell if you have any blocked arteries maybe you might need some stents. If not there are heart meds that will help you most of us here on this forum are familiar with coronary artery spasms and have learned to deal with them and to be careful and to reach out to others a family and friends and this Forum too.we are here for too. It is very scary. Take care of yourself ask as many questions as you can to the doctor tell them you want your arteries checked for blockages hopefully they will give you some nitroglycerin. be careful taking it that is all for now. from someone who's very concerned Diana

12

Ok I was asked to update so settle in - here goes:

(I divide my time equally between France & UK where I work).

After my first post I was in a bit of a state and after discussion with my wife, my brother brought me home where I'm registered wth the French health service.

After I arrived home I called my French GP on Monday afternoon to make an appt to advise him of what had happened and register for continuing treatment here instead. I got an appt for Wednesday morning.

However In the early hours of Tuesday morning I suffered the same pain as I had in the UK and decided it was prudent to do the same thing and call an ambulance.

I was taken to A&E again

Again all the tests were clear but I was admitted anyway. As the Dr said to me "we will keep you until we know for certain what it is".

Over the next few days I was monitored and tested continuously.

On Wednesday After having echo radio Gram it appeared that my heart wasn't just ok - it was good. But still no diagnosis.

The next day I underwent a stress test which didn't go well.

So I was transferred by ambulance on Thursday to another hospital where an angiogram was carried out (on Friday). They discovered a severe restriction of the main Aorta. There and then they put in a permanent 3cm chromium-cobalt stent.

I am now still in hospital recovering until at least tomorrow (Monday) but I'm assured that they searched thoroughly, that was the only restriction, and with lifestyle changes and permanent meds I can now lead a perfectly healthy life.

However I was also told that the vein was so restricted that i could have suffered a heart attack at any time and it was vital that I had been admitted when I had (I'm hoping to get copies of the before & after images I was shown).

Today my uk address received a letter for the INITIAL appt at the cardiac clinic on 10th Feb.

This is for an ecg and blood tests - the same initial tests that I undertook here, with a notification that following them, I might need a follow up appts for EchoCardiogram and then later an angiogram.

(Obviously I've cancelled that).

Given that up until the stress test, nothing was highlighted, How long are people in that position routinely waiting for angiograms in the UK?

I have to learn to life with my stent now - and to learn the difference between the pains and twinges I'm getting - but I'm so grateful to be in the position where I can!

Thanks again to everyone on here for your help and advice.

13

Thanks very much for the update - sounds like you've been through an ordeal!

Curiously, were you ever told what caused the constriction of your aterty? (Plaque build up). I for one, waited 4 days given I had elevated troponin levels (indicating a small heart attack had occurred, even though the echo showed a healthy heart muscle and the MRI revealed a small mycardoial infraction aka heart attack but "minimal damage". So all in all, upon the pain and hospitalisation I didn't wait long at all. But then again....it was the blood test that showed some peculiarities that made them dig further and find the root cause.

I'm interested to know why they went the stent route with you, as my prinzmental angina/chest pain at rest is pretty much gone since now (3 months after hospitalisation) but during the angiogram (not sure what a stress test is exactly, that you mention?) they "tested my heart" and that's what lead them to administer the nitrate spray which opened Up my arteries immediately. For now at least I am pain free simply on the calcium channel blocker and I have read many medical journals dating back to 1987 to say it simply goes away with time for some patients, lays dormant in others and is constant and regular with others - time will tell which camp I fall into.

All said and done, when they initially discovered the narrowing artery during the angiogram they were going to fly me over to Frimley hospital to put in a stent - then the clever cardiologist administers he nitrate/GTN spray and vola....

That's why I'm so curious why you had to have a stent

14

Hi Nima

The stress test followed completely clear repeated ECG's, blood tests and an EchoCardioGram. No diagnosis at that stage so the Stress Test was next on the list and involved me wired up on a lay-back exercise bike and monitoring any pain increase/decrease.

Didn't take long on that to decide it was classic angina.

In relation to "why a stent" that's something I can't answer. I was told that I was to have an angiogram and was asked permission to fit the stent of anything was found - tbh I didn't even think to ask about any alternative option. At that stage it was presented as a "fait accompli".

My understanding in the U.K. Was that medication might be an option but I didn't get as far as to discuss when the crossover might take place or what the criteria would be.

I'm today being transferred to my original hospital where I'll be speaking to my original cardiologist and I assume my many questions will be answered.

15

It sounds like angina to me. I have no idea about the cause but you should get it checked out. It is a signal that something is wrong you will be able to deal with it though. We are all dealing with this on this forum. But not knowing is the worst thing of all. Go and get the test taken and get a diagnosis and some medicine you will feel much better and begin to live with this problem and disease.

16

Thanks Diana

I think you probably missed my follow up reply yesterday, and I suspect misread the original one. (I think I've maybe posted them in a confusing way).

It has been dealt with and a stent fitted.

I'm due to be released from hospital tomorrow and now have a course of rehabilitation.

3 days a week for 8 weeks of sessions designed to help me to adapt to life with my stent - including physical exercise, diet, relaxation techniques and the psychological impacts.

I don't know if there's a similar post-procedure programme in the uk, but the thought of it has certainly eased some of the concerns that I had.

17

Hi there this sounds like typical angina, have you been given a GTN spray and advised to take Asprin 75mgs daily.  You should ask you GP if are planning angiography to look at your coronary arteries, if not ask him/her to refer you. I'm a nurse but awaiting cardiology investigations myself.  Try to limit strenuous exercise/any activity that brings on the rightness.

i wish you well and please ask your GP about the above.

18

Hi Vivienne

Thanks for your reply, but if you're able to read my updates you'll see that I've actually been lucky enough to have been dealt with incredibly well by the French health service. Had a stent fitted into what was a badly blocked artery and I'm undergoing rehab.

Thanks again.

Bob

19

I've been reading all the emails on this Angina Forum & am very confused as everyone appears to have different symptoms.  In December 2016 I was diagnosed with Angina after an ecg & then Angiogram.  I was allergic to the dye & my heartbeat went down to 10 & there was a panic when several nurses tried to bring the beats up, however, I recovered & was told I needed a by-pass as 3 arteries were blocked. I heard nothing further until February when I was asked to come back for an assessment & told stents would be inserted.  I had one stent fitted in March I had a heart attack two hours after & fortunately was resucitated & kept in overnight. Told that I would be called back in May for maybe one or two stents.  I get more breathless now than I was, I'm taking Beta Blockers 1.25mg, Aspirin & Clopidogrel, does anyone know if this is normal? After a 20 minute walk I get a pain in my chest & find it hard to speak until I rest yet I was told to get exercise by walking & going up the stairs.

20

Hi Cecily.

My symptoms (and experience) have been different to yours.

I'd urge you to make an appt with your GP and get information direct from them.

It might be that if you post a new question on the wider forum rather this as a reply as you've done here, more people would see it?

That said, whilst this forum is great for support, you have clinical questions to be answered and only your doctor can do that.

Good luck!