How Much Angina is Too Much

Question

I am on beta blockers & nitrates for angina & SOB and still have some feelings of tightness or pressure in the mid chest region at least once a week-how much angina should be tolerated before I give in & have an angiogram-my nuclear stress test showed mild ischemia in the inferior apical region-should I be concerned?

Ellen1953 · Answer

Thanks for the info,Ken-I saw the cardiologist today & he has started me on dyazide as I am retaining fluid-my BP is very good-100/64 and heart rate is 63 & reg-I'm feeling much better on nitrates & headache & dizziness after starting nitrates has improved-chol is under control with diet, exercise & lipitor-thanks for the encouragement-has been a bit spooky trying to get this stuff under control-I have been in medicine for more than 30yrs but am better at being diagnostician than patient but am working on that one-stay well & hopefully 2009 will be a good year

kenkeith · Answer

Keep your cholesterol level normal or below as well cardiac rehab, and there may not be any progression (I've been told there can be regression!).  Stents can be problematic and once there is a stent implant medication is ineffective for that lesion...requires another stent or worse open heart surgery.  Take care.

Ellen1953 · Answer

Ken, you are a wealth of information-I really appreciate your input-I started cardiac rehab 2 wks ago and am hoping this combined with the medications I am on will control the problem-I have read the recent study that came out saying that the long term results of stent versus medical treatment are the same (after 3 years the morbidity rate and health status were equal) & I am hoping I can avoid angiogram if possible-sometimes I think it would be better to just have the angiogram & possible stent & get on with a better quality of life-thanks again for your help

kenkeith · Answer

You should not tolerate any angina.  If medication does not open the coronary valves sufficiently (angina remains), then there should be intervention (stent or bypass) to prevent heart cell damage.  Angina is a warning that the heart cells are not receiving enough blood/oxygen.  

Years ago, the treatment for angina (heart disease) was to not increase the demand for blood/oxygen that exertion does for the system.  But the lack of exercise/exertion is now recommended. Ideally, medication for angina (if controlled) and exercise is considered the appropriate treatment as well as medication to dilate system vessels to help reduce the heart's workload, etc.

Encephalomalcia · Answer

If I were you, I would have the angiogram to find out exactly what is going on and get it fixed.  Nitrates are so bad for your liver and being on them for years can lead to cirrohous of the liver which happened to both my uncle and grandmother.  There is so much that they can do now through a cath angiogram for the heart.