Angina and Blood Pressure

[Cody]

Dear CCF,
Almost two years ago I had an angioplasty procedure performed on my LAD.  Since then I have had yearly nuclear stress tests and regular stress tests each at six month intervals.  All these stress tests show normal and similar results.  My present daily medication consists of atenolol, imdur, diuretic, vasotec, and aspirin.  I have been jogging daily, for the past two years, approximately 30 minutes.  On occassion I have experienced mild chest discomfort that my cardiologist attributes to atypical angina or musculoskeletal because of the normal test results.  The two questions I pose are nuclear stress tests and regular stress yearly at six month intervals each sufficient to diagnose any restenosis?  Also, is there any correlation between angina episodes and blood pressure or pulse rate; i.e., would there be an elevation in blood pressure or pulse rate during cardiac related angina episodes?
Thanks - Tim

[CCF CARDIO MD JMF]

Dear Greg,

You are absolutely correct, microvascular changes in the heart are essential and under recognized.  You may want to check this web site out for further details.

www.vbwg.org.

[CCF CARDIO MD JMF]

Glad to help.  Let us know if we can be of further assistance.

[Gregory Gomez]

Hi Tim!

I read your post with interest!

You might read the post I just made about
microvascular angina.

I had two angiograms that were essentially
normal. In fact one cardiologist went so far
as to say that there was nothing wrong with
my heart. However, in the past four months
I have had some very serious bouts of angina.
Once, I passed out and the second time I nearly
lost consciousness as well.

Despite my medication (Norvasc and isosorbide
mononitrate) I am still having attacks; last
week I had three, but this week none. Why?
I stopped using my NordicTrack ski machine
and switched to walking for an hour at a
normal pace.

I am no doctor, but it sounds like you are
placing too many demands on your heart as a
result of your exercising. You may have to
reduce the intensity of your workouts so
that you do not feel any chest pain or
chest tightness.

Best of luck,

Greg

[Tim]

Dear JMF at CCF,
Thanks for the information.
Tim

[CCF CARDIO MD JMF]

Dear Tim,

These are adequate test to assess significant progression of your lesion.  The demands that you place on your heart are a function of blood pressure and heart rate.  As you might imagine if you ask your heart to pump harder ( against more pressure) and quicker, it has to do more work, demands more energy and may cause angina.

I hope this information is helpful.  Please write back with further questions if you need further assistance.