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Heart Disease (Expert Forum)
Re: Heart Spasms
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Re: Heart Spasms
by CCF CARDIO MD DLB, Jan 01, 1995 12:00AM
Posted By CCF CARDIO MD - DLB on September 22, 1998 at 18:17:27:
In Reply to: Heart Spasms posted by Lori on September 22, 1998 at 07:03:30:
I have recently had a "highly abnormal" stress test with signs of "Ischemic Episodes" according to my chart. I had an angiogram of the top left side of my heart and my coronary arteries yesterday which showed no evidence of blockage, however the ECG taken the day before the Angiogram showed "Lateral Q Waves". All of these tests were prompted by the chest and radiating pain, shortness of breath, pressure in the center of the chest and heaviness in the chest I have been feeling with increasing frequency and duration over the past three months.
Since Angiogram of the top left side of my heart and the coronary arteries was normal the cardio said I have "heart spasms" and that heart spasms have no known cause. I was previously on Lotensin and Verapamil. He has d/c'd the Lotensin but increased the Verapamil to two tablets of 180mg each a day. I have three questions: (1) Can you give my any information on heart spasms? On doing some preliminary research, I have found reference to magnesium/potassium deficiency as one possible cause of the spasms. I have muscles spasms every where already (all large muscle groups, neck etc.) which I take Klonopin for so I guess it is possible my heart may just be one more muscle affected. I have had muscles spasms since childhood (nocturnal leg spasms/cramps, my eyelids and the area just below the eye are constantly twitching as are my cheeks), the waking large muscle spasms hit within the last four years, (2) how serious can these heart spasms be? I blacked out last month when the pain and pressure where really severe. Can these spasms lead to heart attack? Is there anything that will get rid of them all together? and (3) Can there be any other causes for the symptoms I have been having? (and, no, I am not looking for a diagnoses, you may be aware of something to look for that my cardiologist may not be familiar with.) Symptoms: Shortness of breath upon exertion (sometimes when relaxed); pressure in center of chest; squeezing tightness in chest; pain radiating down left arm, up into jaw and cheeks; pain in left shoulder; pain sometimes radiating to right arm. For the past week, I have been awakened in early morning by horrible chest pressure which leaves me gasping for breath. It literally feels as if someone is deliberatly stepping on my diaphram and chest preventing me from breathing. Walking up a slight incline leaves my chest so tight and my breath so shallow that I have to stop and rest before I can continue.
A diagnoses of "heart spasm of unknown etiology" is frustrating and frightening because it is so unspecific. Is it possible that part of my heart that was not seen on the angiogram is damaged and therefore my heart is not functioning at optimal efficiency? What other possible causes can I look into?
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Dear Lori
This diagnosis of heart spasms in your case sounds shaky. Heart artery spasm is rare. It can cause serious symptoms like chest pain, heart attacks and fainting. Drugs like verapamil are useful at preventing it. It is even more rare to see patients on verapamil that have spasm. The proper way to make the diagnosis is by administering an intravenous chemical during a cardiac catheterization and seeing if the heart arteries spasm. This test is only done at specialized centers, as it can be somewhat risky.
Before embarking on such specialized testing, I would recommend a cardiac ultrasound (echo) to see if you have had a previous heart attack (as your EKG suggests). If not, it is unlikely there is anything wrong with your heart. If the echo is abnormal, then further cardiac workup would be indicated.
I hope this is useful. Feel free to write back. I wish you the best of luck.
If you would like to set up an appointment with one of our cardiologists here at the Cleveland Clinic please feel free to call 1-800-CCF-CARE.
Information provided in the Heart Forum is intended for general medical informational purposes only. Actual diagnosis and treatment of any particular medical condition can only be made by your physician(s).
In Reply to: Heart Spasms posted by Lori on September 22, 1998 at 07:03:30:
I have recently had a "highly abnormal" stress test with signs of "Ischemic Episodes" according to my chart. I had an angiogram of the top left side of my heart and my coronary arteries yesterday which showed no evidence of blockage, however the ECG taken the day before the Angiogram showed "Lateral Q Waves". All of these tests were prompted by the chest and radiating pain, shortness of breath, pressure in the center of the chest and heaviness in the chest I have been feeling with increasing frequency and duration over the past three months.
Since Angiogram of the top left side of my heart and the coronary arteries was normal the cardio said I have "heart spasms" and that heart spasms have no known cause. I was previously on Lotensin and Verapamil. He has d/c'd the Lotensin but increased the Verapamil to two tablets of 180mg each a day. I have three questions: (1) Can you give my any information on heart spasms? On doing some preliminary research, I have found reference to magnesium/potassium deficiency as one possible cause of the spasms. I have muscles spasms every where already (all large muscle groups, neck etc.) which I take Klonopin for so I guess it is possible my heart may just be one more muscle affected. I have had muscles spasms since childhood (nocturnal leg spasms/cramps, my eyelids and the area just below the eye are constantly twitching as are my cheeks), the waking large muscle spasms hit within the last four years, (2) how serious can these heart spasms be? I blacked out last month when the pain and pressure where really severe. Can these spasms lead to heart attack? Is there anything that will get rid of them all together? and (3) Can there be any other causes for the symptoms I have been having? (and, no, I am not looking for a diagnoses, you may be aware of something to look for that my cardiologist may not be familiar with.) Symptoms: Shortness of breath upon exertion (sometimes when relaxed); pressure in center of chest; squeezing tightness in chest; pain radiating down left arm, up into jaw and cheeks; pain in left shoulder; pain sometimes radiating to right arm. For the past week, I have been awakened in early morning by horrible chest pressure which leaves me gasping for breath. It literally feels as if someone is deliberatly stepping on my diaphram and chest preventing me from breathing. Walking up a slight incline leaves my chest so tight and my breath so shallow that I have to stop and rest before I can continue.
A diagnoses of "heart spasm of unknown etiology" is frustrating and frightening because it is so unspecific. Is it possible that part of my heart that was not seen on the angiogram is damaged and therefore my heart is not functioning at optimal efficiency? What other possible causes can I look into?
-------------------------------------------------------------------------------------------------------------
Dear Lori
This diagnosis of heart spasms in your case sounds shaky. Heart artery spasm is rare. It can cause serious symptoms like chest pain, heart attacks and fainting. Drugs like verapamil are useful at preventing it. It is even more rare to see patients on verapamil that have spasm. The proper way to make the diagnosis is by administering an intravenous chemical during a cardiac catheterization and seeing if the heart arteries spasm. This test is only done at specialized centers, as it can be somewhat risky.
Before embarking on such specialized testing, I would recommend a cardiac ultrasound (echo) to see if you have had a previous heart attack (as your EKG suggests). If not, it is unlikely there is anything wrong with your heart. If the echo is abnormal, then further cardiac workup would be indicated.
I hope this is useful. Feel free to write back. I wish you the best of luck.
If you would like to set up an appointment with one of our cardiologists here at the Cleveland Clinic please feel free to call 1-800-CCF-CARE.
Information provided in the Heart Forum is intended for general medical informational purposes only. Actual diagnosis and treatment of any particular medical condition can only be made by your physician(s).
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