Angina vs Esophageal Spasm

[cheetoh15]

43 yom had cardiac cath 12 mos ago resulting in 5 stint placements. Another cath 6 months ago after reporting additional symptoms w/ no stints but additional narrowing of several cardiac arteries. Doc said it could be esophageal spasms but ordered stress test and follow-up every six months for two years. Stress test scheduled for next Weds with follow up appt in early December. Problem: Following last stress test, began walking 1.5 - 3 miles a day, 3-5 times/wk until early September, when I put it on hold due to other issues, although I maintained high level of activity. Last Sunday afternoon, I returned to walking track for first time, and in less than a quarter mile had to sit down and take a nitro because of chest pn. Returned home, but had additional attack later that evening. Following morning (Monday) had mild attack and that afternoon several minor-moderate. Tuesday morning had severe attack while showering that subsided after two nitro. One minor that evening. Several minor on Weds afternoon, as well as Thurs morning, all subsided after one nitro. Last night (Thursday again) very severe attack that did not clear up until after 3 nitro, with lingering pain in both hands, even after chest pain subsided. Symptoms are burning pressure that begins in center of chest and quickly radiates throughout the chest and down both arms. Cannot determine precipitating factor - it is occurring with and without strenuous activity, but since I haven't had any problems for more than 6 months, I am unsure of how concerned I should be, especially with a stress test with my Cardiologist's ARNP next Weds. Any advice?

[joanincarolina]

Esophageal spasms can mimic angina BUT with your history I'd get back to your doctor asap. Angina from heart can cause chest tightness, chest pain, down the left arm pain, and SHORTNESS of BREATH. Forget the activity. I have angina from non-obstructive big coronaries but have lots of problems with the microvessels of my heart. Go back to doctor before you have a heart attack. Joan.

[ireneo]

Can either of you describe the difference between esophageal spasms and angina (how they feel)? Or does angina always have SOB with it? From the little I've read about esophageal spasms, they seem to occur when eating, not from exertion. Or do they happen any old time?

[cheetoh15]

Ireneo, that's exactly the question I'm trying to answer with my posting: is there a specific symptom that I am experiencing that will not occur with either the spasm or angina? I don't want to call 911 when I only need a Zantac, nor do I want to mask a greater problem by treating the symptoms.

Joan, thanks for the advice. I haven't experienced anything today, but have a call into the physician's office.

[joanincarolina]

Hi again ireneo! I have never had an esophageal spasm but I do know by my own experiences (both as a nurse and a patient) that SOB occurs with angina and stays until the the pain from the tightened heart muscle ( blockage or spasms) is relieved by stopping an exertion or taking a vasodiolator like nitro. Cheetoh,take a zantac if you think it's from the digestive track. Zantac will not stop heart angina pain, but nitro COULD relieve the digestive discomfort. My friend, who has since died, had esophageal cancer and experienced discomfort from her tumor with spasms but not with SOB. I can easily get digestive discomfort from my angina-fullness, wanting to burp, but as soon as my SOB is relieved with the added nitro, then my breathing capability and pattern ( no splinting)improves greatly.You know when you can breathe better after an attack. Angina is brought on by an exertion or response for the heart to pump more blood so even stress can bring it on. Cheetoh15, I think the call to your doctor was warranted.Keep your nitro at hand as you state relief which is both from the chest pain and SOB.  

[cheetoh15]

Thanks again for your help. Since my appointment is so close, advice was to monitor myself closely and try not to over-exert. Any more severe attacks and 911 myself to the ER.