Angina after angioplasty

Posted by Mick on April 28, 1999 at 12:03:21
I experienced neck pain after three minutes into brisk walking on a treadmill and had an abnormal stess test result after seeing my doctor.  A heart cath was performed and then angioplasty to open two 50-70% blockages which was succesful.  After one week I started to walk for excercise and would experience the angina (neck pain) quicker and more intense than before.  I was very disappointed and reported this to my doctor who put me on Imdur and gave me Nitrostat.  Since then I have increased my excercise to a pretty intense level with only a little sensation of angina in my neck.  I even went on a mountain climb a little over two weeks after the angioplasty and really exerted with no pain.  I missed two doses of Imdur in three days and yesterday, April 27 (angioplasty was performed April 5) I missed the 2nd dose which I take in the morning.  After leaving for work I experienced the worst angina that have to this point.  It scared me and I returned home for the dose of Imdur.  I have yet to use the Nitrostat.
What could be causing this if I had a successful opening of these blockages?  Does the soreness that I've read about last this long?  Do patients ever get off the Imdur? It gives me headaches.
Thank you for your response.
Mick

Posted by CCF CARDIO MD - DLB on April 29, 1999 at 18:18:03
Dear Mick
There are two basic possibilities. Either the angioplasty was unsuccessful or the pains were never due to the blockages in the heart arteries in the first place. A less likely possibility is that you have coronary artery spasm, for which medicines like Imdur are excellent. You should discuss the situation further with your doctor.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please cPosted by Mick on April 29, 1999 at 21:30:48
Dear DLB,
Thank you for the response.  A follow-up question would be is it possible that by missing the two doses of Imdur (I failed to take a 60mg dose one day, took the dose the next day, then did not take it the third day) that I made the spasm possible?  During my stress test I was over eight minutes into it before I began feeling the neck pain.  After the angioplasty, just a short walk would start the sensation--much quicker and with much less exertion than before the procedure.  This is what is confusing me.  I have an appointment with my doctor next week.  
Thank you again.
Mick
Posted by CCF CARDIO MD - DLB on April 30, 1999 at 10:29:09
Dear Mick
When there really is spasm, 90% of the time nitroglycerin prevents or treats it. Thus, missing the Imdur could have allowed the spasm to occur.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.