EKG normal--- angina persists--- anxiety?

[sinnequan]

i am 29.  i posted here once, and on your advice i visited a cardiologist.  i had a full work up around 4 years ago-- ekg, sonogram of heart, halter monitor (24 hrs) all normal)-- for angina.  well, this new one-- he did an ekg and said it was normal.  i have a prescription for inderal--- and have been given one for Atenolol-- 25 mg -- once daily. i cannot afford to buy it until march 3.  

the pain may go away for months--- and then if i start a new med-- usually a tri-cyclic--- the pain cranks back up though my ekgs are normal.  i have had around 5 ekgs this year b/t the ER and cardiologist.  i don't know why the tri-cyclics would prompt this.  DO YOU??? ANY IDEAS????

THIS IS THE LAST DRUG I HAVE TO TRY--- PAMELOR.  i am not exaggerating--- i have been on everything else. SSRIS cause hyper manic episodes.... so they are OUT.

they think this is anxiety.  how can anxiety cause your chest, arm and hand to hurt?  no one has explained this to me.

i know you are busy, BUT I JUST CANNOT CALL ANOTHER DOCTOR right now.

thanks.
fairydust.


p.s.-- happy valentines day.

[CCF-M.D.-CRC]

Dear fairydust,
I'm not sure that changing from inderal to atenolol will make a difference but I suppose it can't hurt to try.  I don't know why tri-cyclics would cause chest pain.  Anxiety can cause chest pain through increased sympathetic activity, increased gastric acid and reflux as well as increased concern over the whole episode.  

If cardiac causes have been excluded and the doctors think this is anxiety related I would consider consulting a psychiatrist.  They are the ones with the most experience using anti-anxety drugs (there are a lot of different combinations)  and may also be able to help with medical alternatives.  I understand your reluctance to see yet another doctor but this would probably be your best solution.  Also don't forget things like eating right, getting the amount of sleep  you need each night, exercise and prayer or meditation.  

Wishing you a happy valentines day as well.

[ponytail321]

A related discussion, Coronary Artery Spasms or Esophageal Spasms? was started.

[pikamom]

The anxiety and cardiac stuff seem intertwined. I'd been going to therapy for severe depression and my psychiatrist had me on remeron and nuerontin when I started getting what I thought was panic attacks. The first attack of racing heart, chest pain, short of breath sent me to the ER where they said I had a heart rate of 200 and it wasn't a panic attack. The cardiologist started a work up, my EKG showed changes of not getting enough oxygen but I didn't have the catherization he suggested. Just took the nitro all last year telling myself it was panic. But then like Lynn I ended up in the ER last month with severe symptoms. This time I had an emergency catheterization and the cardiologist started me on cardizem for angina and tachycardia, he said if I continued to let my heart run at a rate of 120--140 like it had been, I'd risk a weakened heart. Anyway, since starting the med, my anxiety has gone away. My therapist is suggesting the panic feeling was probably coming from a constantly racing heart. So the two are tied together somehow. I agree with what the doctor said about sleep, eating, exercize and prayer.

[cardiacurt]

i experienced a myocardial infarction last nov. that required angioplasty with two stents.  the following morning after i was released from hospital care, i thought i was either feeling anxious or that i was having an episode of angina or maybe even another cardiac failure.  when i reported it to my doctor, he prescribed nitro tabs that he said would help determine the source of that strange sensation.  so far i haven't taken them even though a vague insecurity persists because it hasn't become obvious enough to explain clearly (or to react so urgently to the sluggish performance of what i've accepted as a repaired but damaged heart).  i'm convinced my confusion is due to anxiety at a very emotionally sensitive time of the a.m. for me and it does seem to be relieved when i'm distracted by the progression of my day. i faithfully keep my nitro tabs handy, and that seems to give me confidence until my doctor can help me identify the cause of this subtle annoyance. however, i believe that our natural intuition regarding the mind's effect on the body often fails us especially with the cardiac system which deals so much with anxiety (as well as another important function).

[Richard]

I had a similar problem.  I was depressed, had anxiety, couldn't eat, couldn't sleep, and developed chest pains.  My heart tests were all normal.  Celexa for depression made me hyper.  Nexium for reflux didn't help.  Finally my new doctor prescribed Remeron and all my symptoms were relieved.

[itsa48]

dear fairdust: happy valentines to you too!

let me tell you my story...i was having angina pains for over a couple years my regular dr. put me on anxity pills which seem to help for awhile, then i started getting events of papatations, tarcardia and a resting heart rate of 100-110 so she put me on inderal, then i would get the angina while my husband and i was laying around relaxing watching tv and they would last for hours.  I would call the next day and she said it was anxiety and upped my inderal, i refused and asked for a cardologist and was told to get one so i did!  and i never went back to her.  My new cardologist is woderful, put me on toperal xl and that helped make the papls go away.  but then after almost a year i had a terrible angina attack at work and ended up at the er by ambulance my cardologist was called in the next morning i had a heart cath and i have a little blockage in my artery and the same artery has coronary artery spasm.  so that is where my angina is coming from, i spent 4 days in the hospital getting straightened out with nitro meds etc. that was month ago ...oh i forgot to mention i had all the tests they were all negative, stress test, echo, ekg's so....maybe you need to get a new cardologist talk to people and get there advise for a good one. One that will listen to you...my dr. says that the patient is always right.  And that is what my other dr. was missing.
good luck hope this helps you. heart cath is the only way to check for coronary artery spasm. but it was well worth it.
Lynn