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Coronary Artery Spasms/Variant (Prinzmetal) Angina - scared! please hel...
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Coronary Artery Spasms/Variant (Prinzmetal) Angina - scared! please help!

I'm a 29yr old male, measure 5'9, and weighed 250lbs when I began having symptoms (I am currently at 240lbs)

I have a had a history of uncontrolled mild high blood pressure (which was first detected at about age 23) and recently quit smoking pot (I was a heavy consistent everyday pot smoker for the last 2 years or so). I've considered myself very inactive both at home and and work as my job requires sitting in front of a computer for most of the day for the last 4 or 5 years and my eating habbits were careless, as I did not watch what I ate (I actually had the tendency to eat out at fast foods alot, almost on a daily basis).

It started about 2 months ago when I started having different kind of pains in the left side of my chest approx an inch to the left side of the center of my chest (aligned with the nipple). The chest Pain comes as Dull, Achy, Shocking, Spasm, Sharp, Stinging, Tightness (sometimes Pressure in chest, usually about 15 minutes after commencing exercise or when I wake up in the morning). These chest pains can range anywhere from a pain scale of a 1 through 7 most of the time. Although on one occasion I did feel a “9" (which lasted about 10 seconds) and made me hunch over and almost fall to the floor. These chest pains are now going on 2 months “DAILY” (day and night) and continuing as of today. Not one day or night has gone by without the chest pain for the last 2 months. Some days lighter pain than others.
Chest Pain comes on spontaneously (for no apparent reason), sporadically (on and off) and usually lasts between 3 seconds to 4 minutes. Chest pain comes on both day and night, but most notably, more severe at night (while sleeping) and early mornings. MORE OFTEN THAN NOT, chest pain has woken me up at night from the severeness of it. Also, OCCASIONALLY, chest pain may come on with cold climate conditions ( i.e., air conditioner in car), emotional distress (i.e., such as getting spooked/scared unexpectedly), after having sexual relations or when taking a deep breath. OCCASIONALLY, I have also felt chest pain about 20 - 30 minutes after a meal.
- Pain that radiates to my Left Shoulder/Arm, Neck & Back - OCCASIONALLY, sharp, dull and achy pain can radiate to my left arm (under armpit) down to the inner part of my elbow. The pain can also radiate up to my left shoulder (between left shoulder blade) and up to my left side of neck. A few times, I have felt the pain radiate in my left side of back (almost as if aligned with the front part of the chest pain). The pain can radiate to these body parts with or without the chest pain, with the exception of the back, which seems to come on always with front chest pain.
- Heart Palpitations - MORE OFTEN THAN NOT, I will get heart palpitations that come on spontaneously and sporadically. Sometimes they come after a meal or simply by sitting up. They may also come with or without chest pain. However, most notably, they begin to come in groups about 15 minutes into my exercise and at times I may have to slow down or stop until the heart palpitations subside. (NOTE: On RARE OCCASIONS, They may come on with the pressure sensation in chest, as noted above, while exercising only).
- Dizziness/ Lightheaded, Fatigued/Sleepy and Nausea - OCCASIONALLY, I may begin to feel Dizzy, Fatigued or Nauseated for no apparent reason. OCCASIONALLY, the Dizziness can be accompanied by heart palpitations. The Dizziness, Fatigue and Nausea comes on spontaneously and sporadically,  but may not be necessarily associated with each other. Dizziness may come on with or without chest pain or heart palpitations, and may even occur when simply sitting down. OCCASIONALLY, I may also feel Nausea, but have never actually vomited to date. I also have the tendency to feel fatigued/sleepy (heavy eyes)/tired at times for no apperant reason.
- Shortness of Breath - Shortness of Breath tends to happen ONLY at night OCCASIONALLY. Shortness of breath is usually felt right before or after I am asleep. OCCASIONALLY, I will wake up gasping for air, as if I were not breathing while asleep. Shortness of breath does not occur every night, but I would estimate about 3 to 4 nights a week (varies), coming on various times on a single night.
- Slow/Fast Heartbeat  - This is my most deceiving symptom of all. Slow heartbeat is usually felt at night after I am asleep. After waking up to chest pains at night or simply changing my sleeping position, I tend to feel my heart beat slower than usual (seemingly also in an irregular rythum) when going back to sleep, at times prompting me to sit up to make sure my heart beats a bit faster. I cannot tell if this symptom is real or simply my mind playing tricks.
A Fast heartbeat is usually felt with strong thumping after getting up from laying down or sitting down for a prolonged period of time or after a meal. This symptom is for real.

For the first week of pain i brushed it off, in hopes that it would go away, possibly by excersising. I decided to start excersing after I quit smoking and also decided to change my diet. But after a week and a half, I woke up with heavyness in my chest for 2 days in a row, not to mention a continuance of "on and off" pain that had not gone away, I thought I better seek medical attention by making an appointment with my family doctor. They took me in right away as I complained of chest pains.

I have had the following tests done:

-Blood Test
-3 resting EKG's
-Chest X-ray
-Holtor Monitor (24 hrs)
-Stress Test

In which all have came back NORMAL (THANK GOD).

The only factor I can clearly point out is that the chest pains seem to be more severe at night (when sleeping) and early morning. Other than that, I cannot make out when the chest pains will come or what causes these chest pains.

My chest pain is focal. I can clearly point out where the chest pain is coming from (approx about an inch to the left of the center of my chest, aligned with the nipple).

I really don't feel any pain while excerising. I may have felt pain for a few seconds while excerising, but it tends to go away, despite my contiueance of excerise. I exercise (treadmill) about 5-6 times a week / 40 minutes a day. My speed consist of 6.5 MPH every 2 minutes, with 1 minute walking breaks of 3.2 MPH in between, until 30 minutes is completed, I tend to power walk the last 10 minutes at 4.0 MPH.


- Zantac
- Aspirin (baby dose)
- Hydrochlorothiazide (Yesterday, 7/15/08, I was recently prescribed this medication for high blood pressure)


- High Blood Pressure (Diagnosed at the age of 23 - Untreated until now)
- Migranes (migraines) (untreated all this time - diagnosed since age 15)

My greatest concern is that my chest pain is related to Coronary Atery Spasms/ Variant (Prinzmetal) Angina/. Being that I had unctrolled high blood pressure smoked pot heavily, was inactive both at home and at work, Over-ate (Also due to Pot).......
My Doctors seem to tell me that I am ok and nothing is worng with my heart (especially because all test have came back negative). I was referred to a cardiologist and he did not seem to take time to listne to me. As a matter of fact he laughed when I told him about smoking pot (in which he apologized). Every article I;ve read seems to fit this description which freaks me out. The doctors don't seem to take this seriously. From what I;ve read it could be hard to detect variant angina as it is uncommon.

Could it be possible I have variant angina???? What test are needed to be done to dismiss Variant Angina??? Could this be heart related? Could I have somehow caused damage to my heart? Could I have heart disease?

I don't know what else to do....I fear I make get the "BIG ONE" at anytime now, especially without being treated.

Any help or suggestions would be appreicated

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4 Comments Post a Comment
554610 tn?1215905711
Certainly sounds like you are having some problems.
Could I just suggest that you get the following checked out:
Adrenal gland disorders and pericarditis.  Have you had an angiogram?
Having had the past twelve months being checked out myself for Printzmetals,
Coronary Artery Spasm, Adrenal and Myopericarditis your symptoms could
fit into these areas.
Mine were similar in some ways and I have been down a similar track.
Main thing is..don't stress any more than you have to but get firm about
asking questions.
Avatar m tn
Thanks for responding....

I have not had an angiogram. I am going to push for one as my doctor has told me I may ask for a second opinion with a different cardiologist.

I've suspected it may also be Myopericarditis, in fact, I tend to think it may be either Myopericarditis or Variant Angina. The reason I tend to think it could be Myopericarditis is because in the beggining of my symptoms I would actually sit up and the chest pressure and tightness would began to go away slowly, but that is not always the case with the sharp and stinging pains, which can occur even as i'm walking. Also, on very rare occasions I can feel the sharp pain or dull and achy pain with a certain movement, however, it throws me off because I tend to repeat the same movement and the pain will not be there.....then again, I don;t have to make any movement and the pain shoots in my chest.

The only reall difference I see in the symptoms of variant angina is the fact that in almost every article I've read it says the pain lasts from 5-10 minutes. I've never had the pain last that long. My pain is usually between 3 seconds to 4 minutes.

I never acutally thought about adrenal.

I am now on antidepressants, recently prescribed by my doctor yesterday.

What test did they use to rule out Variant Angina?

Also, what should I look for in a good caridologist? experience?
Avatar n tn
I just found your question posted here a year ago while searching for help for my husband who is experiencing sudden episodes of chest/shoulder pain very similar to yours for the past six weeks.  He's had a stress test, two CT angiograms and a regular angiogram.  So far the discovery is that he has more calcium plaque in his coronary arteries than he should have at his present age of 48.  There was a 20% blockage in one artery.  And frankly, given his pain over the past six weeks, we were glad to hear these findings.

I did some research and discovered Prinzmetal's, printed out an article and took it with us to the cardiologist for the angiogram follow-up appointment.  He at first completely dismissed Prinzmetal's saying that my husband's symptoms were nothing like Prinzmetal's.  But by the end of the appointment, he was asking us if we wanted to go ahead and be treated as if my husband already had a Prinzmetal's diagnosis.  Strange huh?

The cardiologist's prescription is for my husband to wear a holter monitor for a month (I think) and he's also to have an untrasound of his gallbladder to see if stones are present which might cause chest pain.

I think my husband's problems are more due to adrenal hypertensive issues.  He's a financial adviser who has received not one, but two audits from the IRS this year.  We have no fear about the outcome of those since our records are well-kept and our deductions have been very conservative.  However just putting all the documentation together and corresponding with the IRS is stressful enough!

I have been in poor health the past nine years and I'm sure this has added to my husband's stress.  In May of this year I took a turn for the better following a diet and taking just a few supplements recommended by a web site for candida overgrowth issues.  Thankfully, I've been well enough to be there for my husband who, like you, is pretty scared about all of this.  I am too.

So, please, would you tell us if you found anything since posting your original post last year?  I'm not really familiar with this forum and am not sure how or if you will receive this inquiry.  I hope you've found your answer and are feeling much better and that all this is ancient history by now.  If I can only get my husband to that same destination, all would be well in our world.

Thank you for any help you may be able to provide.  Take good care,
Avatar m tn
When I read your comments you were describing my life. I have been diagnosed with Prinzmetal and it is something that runs in my family. There is nothing they can do for us. I have looked into natural products and take several things that support artery strength. What happens is the arteries constrict all of the time. you never know when they will constrict for a longer period of time which causes heart attack. It can also cause your heart to race. I have had 2 heart attacks so far.
I take fish oil, magnesium, Arginine, Vitamin D3. But you should look into it and decide for your self. If you have a heart attack they will give you nitro to open your arteries and then morphine for the headache nitro gives you. They will also do a catherization going through your groin or neck to see if there is blockage. If you do have Prinzmetal then you will not have blockage. I carry nitro with me so if I have a major heart attack symptom I will take it and bypass going in to the ER and put through the routine. So far it has work. I hope this has helped.
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