Am I OK

[kathy426]

I am 40 years old and recently had a heart attack. I have two DES. One in August, the other in October. In the beginning of november I experienced chest pain and went to the hospital. A third catheterization was done and showed my 2 stents were fine as is the rest of my heart. No constricted vessels or blockages. They tested me for stomach and esophagus problems. Checked my gall bladder and pancreas and was told that I have a little GERD. I was sent home on a nitro patch. Was already taking plavix and lopressor since august (1st stent). I asked the doctor why the nitro patch if my heart is good. He said it also was to help my chest pains from my GERD. Tried going without it yesterday and experienced pain. I take nexium and mylanta every day to keep the heartburn down. I didn't think nitro helped anything other than heart problems. Can you explain more about the use of nitro patch for other causes and also are my chances of living to an old age less now because of having a heart attack at age 40 and being female. I have good cholesterol, am not overweight. I used to smoke a pack a day. I am not smoking now. I do not drink and I get a fair amount of exercise. My mom is the only family member to have a heart attack. She was 66 when she had hers. Doctor says no damage was done to my heart and my heart is very strong. Except for side effects from plavix (flu symptoms,headache) I feel ok as long as I wear the patch (no chest pain) Thank you for listening to me.

[CCF-M.D.-MJM]

Hello Kathy,

I am sorry to hear about your recent bout with chest pain.

1. Can you explain more about the use of nitro patch for other causes?

Nitro can help some forms of esophageal spasm.  Nitro also helps many forms of cardiac chest pain -- believe it or not, all chests pains are not created equally.  The stents you have were placed to treat blockages in major epicardial vessels.  There can also be blockages in smaller vessels, including microscopic vessels that are not detected on cardiac caths.  The treatment for this last form of chest pain is nitrates and calcium channel blockers.  The fact that nitro works despite no major epicardial vessels blockages suggests that your chest pain might be from a microvascular source.  

and also are my chances of living to an old age less now because of having a heart attack at age 40 and being female.

Your prognosis is still overall very good.  You should make sure that you stay active and take your medications like a statin and aspirin.  You should continue your plavix since you have DES.

I hope this answers your questions.  Good luck and thanks for posting.

[momto3girls]

Hi there,

I just wanted to let you know what my gastro. dr. told me...I was having esophageal spasms and he put me on this medication that is very similar to nitroglycerin.  He said it basically works the same by relaxing the esophagus muscle, similar to the relaxing and dilating of nitroglycerin.  

I hope you feel better. At least the doctor told you that your heart attack didn't cause any damage and is still strong and healthy.  There's your silver lining I guess (:  Take care and best wishes!

[anacyde]

I have non-traditional GERD.  I feel the burning sensation maybe 5% of the time.  I experience esophageal spasm and shortness of breath as my primary symptoms, so I suspected my heart.  I went into the ER and was given a nitro for the pain after a GI cocktail did nothing.  Bingo, it worked.  Long story of icky tests aside, it turned out I was having esophageal spasm.  The nitro works on it really well, nevermind that horrid headache...I think I forgot any other pain, lol.  

The experience was scary because I also believed nitro only helped cardiac pain.  When it helped my pain, I was sure it meant I was having a heart attack!  Turns out I wasn't though.  Esophageal pain can really trick you, right down to what eases it.

[Mels22]

Mels22
11/08/2006
C15  Al Dente Hi Al,
So sorry to hear about your rough time with health issues! How old are you if you don't mind my asking? It started in your 20s??? Thats crazy, do you have lots of family history? I have a question for you if you don't mind (you seem to be really smart)...
I am 25 - female - had a baby 6 months ago. Since beginning of September, I have had chest pains, shoulder/arm pains, even some in my jaw. I have been to 2 regular MDs, 2 cardiologists, a neurologist and have had chest x-rays, CT scan, MRI, 8 EKGs, blood work, thallium stress test, echo and all came back normal. I still continue to battle my pains and have terrible indigestion/burping/bloating. I also get lots of headaches and feel horribly fatigued all the time. I've had anxiety in the past - on prozac since I was 15. I've had panic attacks but never for this long! My docs say anxiety, GERD, and fibromyalgia but I'm just not convinced. The prilosec seems to be helping some and they just put me on elavil which seems to make me more tired. I don't know what to do! IT is disrupting my life. I have no family history, my HDL and LDL are good, my BP is good. THe only thing thats come back abnormal is my liver enzymes so we are retesting. I need to be back to normal for my husband and baby. My question is, do you think it could be cardiac? All my family and doctors think its just acid reflux and anxiety. What do you think? The cardiologist says there are no more tests he can do except for cath and he doesn't want to do that with my family history and age and risk factors. Let me know and I would appreciate any suggestions!
Thanks and good luck with your health!
  Also, for the past couple days, I have had jaw/teeth pain sometimes going up my ear and my nose. Does this sound cardiac? I'm so worried. I do grind my teeth and I suppose it could be TMJ or stress. What do you think? Many things I read online say to go to ER for jaw pain. My question is, if I've been having the jaw pain for several days, if it were cardiac, I would be dead now right? Doesn't jaw pain just start when having the heart attack. I had a regular EKG on Tuesday - good BP and pulse. Do you htink I should have it evaluated? I've had normal stress test, echo, EKGs, blood work, etc. Please just tell me, do you think its cardiac or anxiety or what? I see my regular MD on Tuesday, should I wait til then or go to ER? I would appreciate anyone's input!!!!!!!!!!!! Also still have left arm shooting pains and shoulder pain.

ps - I'm now on 60 of prozac and 1 mg of ativan. but why the teeth pains?

THANKS!!

[woodruff]

Heh-heh, mels,

You know what I would say to you, so I'm gonna let Al field this one.

[woodruff]

Oh, heck; this is actually relevant to the relationship of fear to physical symptoms:

http://www.cnn.com/2006/HEALTH/11/13/anxiety.health.reut/index.html

[anacyde]

Chest and shoulder pain is likely from toting your baby around.  Same thing happened to me when my first came along.  When it happened again after my second was born, I knew what it was.  I even had numbness and tingling.  It was musculoskeletal.

It really, really, really sounds like you just have GERD, anxiety and new mommy back woes.  Really.  Enjoy your baby.  I spent so much time worrying about my health after my first was born that I don't really remember much of her first 1/2 year.  And that is something she and I will never get back.  Don't let anxiety ruin what you have, and believe me, it can.

Hang in there.

[ktatum]

I feel so bad for you.  I have had a recent pulmonary embolism, and have increased right sided heart pressure.  I am 34, have 2 children (3 adn 6).  Now I am so worried about my heart that I notice every little part of my body. I would say, you know your body.  Deep down, you have to have some sort of feeling of whether this is anxiety or true health problems.  Maybe talk with a therapist, you have had a lot of new stress added to your life.

[kathy426]

Thank you to everyone for your response regarding the use of nitro patches for conditions other than cardiac. Also to momto3girls, do you remember the name of the medication the doctor gave you in place of nitro patches?