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Heart Disease (Expert Forum)
Angina--what to do next?
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve, Pacemaker, PAD, Stenosis, Stress Tests
Angina--what to do next?
by nurse12hr, Nov 03, 2003 12:00AM
Hello
I am a 46 y/o female, NS, ND, who is now at a healthy weight.
About 2 years ago-I had several episodes of what seemed to be classic angina. I had a stress test and echo done, and no cause was found. I was diagnosed with MILD hypertension, and treated with Lisinopril at that time. I was about 25# overweight then, and was advised to lose weight and begin an exercise program. The plan was to investigate the chest pain further if it recurred. I had no furthur problems until last week.
I (with my docs ok) came off the Lisinopril slowly last month, to see if my weight loss and exercise program would allow me to get by without it. I had a 5 hour episode of chest pain at work last week, characterized by an intense pressure/pain in my chest, radiating to my throat and lower jaw. This pain eased when I rested for a bit, only to resume when I would get back up and resume work. Maalox did'nt help. Saw my doc the next day, who did an EKG (just some LAH noted on that) has scheduled a stress test, and put me back on the Lisinopril (BP running about 140/mid 90's at this point again). and gave me some nitro to carry.
Once I began the Lisinopril again, no furthur problems. What would be your recommendations regarding furthur investigation, assuming the stress test will once again be negative? Could the Lisinopril be helping in some way? I don't obsess about my heart, in fact I rarely think about it at all. Just seems funny I don't have these pains while I am on it. Do you think a cath is indicated? Lipid profile pending, OK 2 years ago.
Thanks.
I am a 46 y/o female, NS, ND, who is now at a healthy weight.
About 2 years ago-I had several episodes of what seemed to be classic angina. I had a stress test and echo done, and no cause was found. I was diagnosed with MILD hypertension, and treated with Lisinopril at that time. I was about 25# overweight then, and was advised to lose weight and begin an exercise program. The plan was to investigate the chest pain further if it recurred. I had no furthur problems until last week.
I (with my docs ok) came off the Lisinopril slowly last month, to see if my weight loss and exercise program would allow me to get by without it. I had a 5 hour episode of chest pain at work last week, characterized by an intense pressure/pain in my chest, radiating to my throat and lower jaw. This pain eased when I rested for a bit, only to resume when I would get back up and resume work. Maalox did'nt help. Saw my doc the next day, who did an EKG (just some LAH noted on that) has scheduled a stress test, and put me back on the Lisinopril (BP running about 140/mid 90's at this point again). and gave me some nitro to carry.
Once I began the Lisinopril again, no furthur problems. What would be your recommendations regarding furthur investigation, assuming the stress test will once again be negative? Could the Lisinopril be helping in some way? I don't obsess about my heart, in fact I rarely think about it at all. Just seems funny I don't have these pains while I am on it. Do you think a cath is indicated? Lipid profile pending, OK 2 years ago.
Thanks.
Doctor's Answer
by CCF-M.D.-RCJ, Nov 03, 2003 12:00AM
Christie,
Interesting story.
Assuming that the stress test is again negative, your story is consistent with "Cardiac Syndrome X". This syndrome is characterized by normal-appearing coronary arteries, but evidence of ischemia based on symptoms or specialized testing.
Alternatively, and perhaps less likely, you could have run-of-the-mill coronary artery disease, simply undetected by the previous stress test.
There are reports of improved microvascular function in patients treated with ACE-inhibitors, but ACE-inhibitors are not generally considered anti-anginal medications. Although in your case, it certainly sounds like the lisinopril may be acting in this capacity.
Your decision to have or not have a cath is a judgement call. If you don't have symptoms on the lisinopril, then it is probably reasonable to not have a cath. A lot of this is determined by your comfort level.
Good luck.
Interesting story.
Assuming that the stress test is again negative, your story is consistent with "Cardiac Syndrome X". This syndrome is characterized by normal-appearing coronary arteries, but evidence of ischemia based on symptoms or specialized testing.
Alternatively, and perhaps less likely, you could have run-of-the-mill coronary artery disease, simply undetected by the previous stress test.
There are reports of improved microvascular function in patients treated with ACE-inhibitors, but ACE-inhibitors are not generally considered anti-anginal medications. Although in your case, it certainly sounds like the lisinopril may be acting in this capacity.
Your decision to have or not have a cath is a judgement call. If you don't have symptoms on the lisinopril, then it is probably reasonable to not have a cath. A lot of this is determined by your comfort level.
Good luck.
Hello, I'm 23/about 10 pounds overweight/normal blood pressure/no family history/general good health/no prior heart trouble. Recently during a fever exam a mild murmur was found. I was asked to return after the fever so they could monitor it and they found that there was no longer a murmur. A follow up exam a month later also found no murmur. I work out regularly and used to play professional soccer without any trouble in the past. Blood tests (twice in last 6 months) came out normal.
My problem is this : I occasionally feel a mild pain on the left side of my chest, its never so high as to be noticeable and does not radiate. The doctor dismissed it as a panic reaction. I am not too sure myself if I'm imagining it. I still play regularly (sometimes violently) without any shortness of breath or anything like that. But this pain keep lingering on my mind and the irritating part of it is I'm not sure if its there. Should I see another doctor about this ?