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Heart Attack from VasoConstriction
I had a heart attack in the beginning of October of this year (confirmed by elevated cardiac enzymes) and in the angiogram (sp) they did not find a blockage but were able to see where the damage was and said that one of my small arteries "clamped down" but had re-opened.  They diagnosed me with unstable angina.

I already have severe labile blood pressure (it will vary between 95/45 and 235/140, and can drop or raise by 40+ points in minutes and has happened under general anesthesia leading to severe complications when treated), mild LVH, sinus tach, v-tach (EKG confirmed) and severe exercise intolerance (just getting dressed or trying to brush my hair can trigger it, with tach and SOB) and "improper" positional hypertension (will soar when I stand still, stand up and plummet when I lay down).

I am using my nitro way too often (in my opinion) and do not even use it for every chest pain I get, only when the pain is unrelenting. (at least 5 a week, usually more).

I also have other conditions that are caused by vagus nerve issues (Gastroparesis) and am thinking that this is also autonomic in nature and possibly Mitochondrial.

I had no insurance when I had the heart attack (husband was out of work and just got a new job) and there is a 9 month waiting period for anything pre-existing...

My question is... since I have already had a heart attack from vasoconstriction am I more likely to have another from it?
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I guess that since you do not report any medication for the artery spams, your chances to have another one are the same that you had before.

Are you diabetic? I ask because this is a common cause of Gastroparesis and spams in small vessels. In case that you are not, you can  try to low the glucose levels in your blood.

Have you been tested for POTS? This could explain almost all your symptoms.

Have your adrenal glands been tested? This will explain the big peeks in blood pressure.

Jesus
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I am on 75 mg clopidogrel, 2.5 mg Norvasc daily and 50mg metoprolol twice a day. (and 0.4 mg nitrostat as needed) But they have had no impact at all on the frequency of chest pains or exercise intolerance.

I am not Diabetic... my Gastroparesis is believed to be from either Autonomic Neuropathy or Mitochondrial Disease.

I have been tested in the past many times for adrenal issues (including pheochromocytoma) as well as cushings, carciniods, zollinger ellison....

Orthostatic Hypertension (not hypo) has been considered since my positional blood pressure and heart rate are almost exact opposite of the norm for POTS, but we were not able to investigate that before losing insurance.

I can tell you that I discovered (on a trip from the coast to the Mountains in November to visit family) that altitude changes also triggered the angina. (Not something you want to discover halfway through a trip with no clue where the nearest hospital is when the nitro did not want to 'take')

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