Angina & Exercise ?

  I am a 34 year old male with Familial Hypercholesterolaemia and I had a MI 3 years ago due to a complete block of my right coronary; I also have an occlusion of the left circumflex.
  I take no medication other than cholesterol lowering drugs (Atorvastatin and Cholestramine) and aspirin.
  I find that I am able to manage fairly strenuous exercise (push-ups, digging, mountain cycling) without any problems during the exercise. However sometime afterward, usually the following day, and for a period of a few days I find that I feel very tired with a heavy feeling/tightness in my chest. What may cause this condition since it doesn't seem to fit the text book description of angina. Incidentally I regularly undertake light exercise with no problems whatsoever. Any suggestions with a physical explanation would be appreciated. Thank you.

[CCF Cardio MD - MTR]

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Dear Simon, thank you for your question.  The symptoms you describe could be recurrent angina but are atypical because the chest tightness lasts for several days after exercise.  I doubt you are injuring your chest muscles with exercise to cause this problem.  I have no other ideas as to what could be causing your chest tightness, but you should alert your cardiologist who may want to perform a stress test.  Additionally, you should ask your cardiologist about treatment with a beta blocker which we know improves long-term survival after a heart attack.  I hope you find this information useful.
Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.