Symptoms of 2nd MI

[nspower]

Will the symptoms of 2nd MI be the same as the first one OR can they be different?

[ed34]

"my assumption is that as I continue to walk, the BP gradually increases and more blood flows and oxygen demand is met without exerting heart. This relieves the throat discomfort"

Interesting idea. In normal circumstances of course, the heart would have to work harder to push blood into the system with a higher blood pressure. But your 110/70 is good anyway so the heart wouldn't have to work much harder at all and the higher velocity would be of benefit to the body muscles and coronary arteries. When your BP is only 105/70, perhaps your heart is working harder to try and compensate?

[nspower]

Again many thanks for your mail and valuable information you shared. It is interesting to know how closely you monitor your symptoms.

I do the same but not with so many details. My cardiologist is not in favor of keeping such a close watch. He feels that it creates anxity which is not good. I do it anyway, may be I am extra cautious by nature.

In my case I have noticed that BP has influence on my throat discomfort during walking. That is how I can explain myself that the pain goes away after 15-20 minutes into walk. On days when I have good BP (110/70) I have noticed that discomfort is minimum. When I start my walk with low BP <105/70, I have discomfort/throat pain. My assumption is that as I continue to walk, the BP gradually increases and more blood flows and oxygen demand is met without exerting heart. This relieves the throat discomfort. My low EF could also be influencing in some way, but I am not able to figure out.

The speed at which I walk, I do not have any difficulty breathing.

I have also noticed, when I have acidity/stomach gas, the throat pain invariably appears during the walk. This discomfort sensation starts from lower left part of sternum passing through my shoulders like a line and going through neck upto left side of my head, a streaching feeling. I suspect this could be due to some nerve getting effected. Just a guess. A small burp   during the walk helps reducing/disappearing the pain. This makes me believe that there is some gas trapped under left sternum which causes discomfort and walking helps releasing this gas giving relief.

So far my nuclear stress tests have not been able to point out any ischemia and intetestingly, this pain did not appear at any of my three stress tests for nuclear scans. This makes me believe that pattern of exertion also has influence on this pain/discomfort.

Could there be some small vessel causing this problem?

I have not noticed much influence of weather other than that it effects my BP. From now onwards I will keep track of weateher, as well.

During stenting following MI I had a serious infection which drained life out of me. It took 10 days to get control with heavy doses of antibiotics. With trauma of MI I had tough time recovering. I have a sense of fear for cath angion.

I will be looking for some support for a CT angio. If it does not come, I will have no option but to go for cath.

Regards

[ed34]

You are always welcome. My Cardiologist always prefers the normal angiogram and when I asked why he said something about it not being too clear with certain vessels. I suppose it's best to let them use what they are used to and have lots of experience with.
With regards to putting a stent without requiring it, you have to sign a consent form. Last year I went for an exploratory procedure only, so I wrote "NO STENTING OR BALLOONING" on the consent form before signing. I also reminded the cardiologist when I was taken into the angio-suite.
The deciding if a discomfort is cardiac in origin can be difficult. I found many influences with mine but I knew it was always cardiac due to the fact my left artery had such a huge blockage. Perhaps if I share some of my findings with you, it may help.
When taking my daily walk, discomforts would vary very much. Some days there would be no discomfort, yet other days I was in a lot of pain. Other days the discomforts were somewhere between the two on a large scale.
I did the same route for my walk every day and made notes at specific points, so I could chart how I felt and see the results over time. I also made notes of the air quality, temperature and humidity, also if there was a light breeze, lots of wind or if the air was still. ALL made a huge difference.
Here's what I found with my blocked artery.....
Hot weather (>20C) and no breeze. Harder to breathe, but no discomforts.
Hot weather (>20C) and light breeze, easier to breathe, no discomforts.
Hot Weather(>20C) strong wind, very hard to breathe, no discomforts.
Warm weather (17-20C) no discomforts and still hard to breathe with strong winds.
This was the same all the way down to the temperature of 3C. With 3C and below, discomforts were bad. Throat discomfort and then chest pains. Shortness of breath was never apparent at lower temperatures.
Rain. Wet weather made a lot of difference. If it rained in hot weather then breathing was normal. If it rained in cold weather, it lessened the discomforts by around 20-30%.
Inclines made a huge difference in cold weather. If I walked up a hill of a very gentle incline, it was like trying to climb mount everest. However, as soon as I hit level ground, the discomforts would start to go away.
The shock of air temperature change was also obvious. If I was in my warm house and opened the front door to cold air, the shock used to bring on throat discomfort immediately. In the winter, if I had to put something outside in the refuse bin, I would hold my breath until I was back indoors. This prevented the discomforts. So, there are lots of influences on your heart with walking. If there was a lot of traffic, or a bus went past me, I would notice a drop in air quality. It's amazing how much healthy people take for granted without knowing it :). As a last note, I found that the time of day for my walk was also important. To ensure my body was in the best condition for the trauma, I would take my beta blocker at around 8am. I would then do light chores and then go onto the more demanding chores, such as vacuuming. I would then go for my walk at around 1pm. If I took my beta blocker at 9am and went for a walk at 10am, I would feel like collapsing before half way round the route. It was as though I had to do some gentle exertion to wake things up, get my heart going. Then build up the exertion very gradually.
One thing I hear asked often is should you PUSH through the pains. Work your heart hard and forget the pains. I always say no to this because the pain is telling you that there is not enough oxygen reaching the heart muscle. To push can cause damage. I tried this a couple of years ago with some gardening. I had throat discomfort and kept pushing. I suddenly felt nauseous and then very light headed. Suddenly I was laying on the grass, with very low blood pressure. I wouldn't recommend this to anyone.

I apologise this is such a long post, but I thought the more I typed, hopefully the more chance you might find something in common which may help.

[nspower]

Your explaination means a lot for me. Thanks for sharing your experience, it is valuable for someone like me.
My first MI could not be caught in a stress test held 15 days before MI. As a result, throat pain did not evoke urgency and when reached ER found that I was having severe MI. LCx 100% blocked, LAD stented, RCA good. Some smaller blockages in branches and 30% EF.

I get pain during exertions for past 3 years. Three nuclear stress tests each year during this period were negetive. Last one was six months back. Cardiologist says it is not cardiac.

My worry is that pain comes during exertions. On ocassions it is mild and sometimes it is severe (with streaching sensation) but generally goes away before I complete my walk. There are times I do not get this pain during the walk. But there are times when it gets severe and I have to stop my walk.

I am afraid that it should not happen that I ignore the pain and end up with 2nd MI.

I plan to go for CT angion but my cardiologist is not agreeing. He says if I want angio, it should be cath angio as it is more reliable. My concern is that during cath angio sometimes they will put stent even if it is not warrented. I also fear this invasive test.

I am trying to figure out if this pain of mine is really ischemic. Is there any way to differentiate it from ischemic pain?
What is your opinion about going for CT angio. Is it really so inaccurate as compared to cath?

Sorry for long mail.
Regds.

  

[ed34]

There is more chance that you will feel new symptoms before an MI. It doesn't have to get that far. If you start to feel more short of breath than usual, or get any other new symptoms, go to the Doctor. It can be lots of symptoms. Some examples are shortness of breath, episodes of light headedness and sweating, odd throat discomforts, jaw ache etc etc. You may feel symptoms after eating and no other time, this warrants examinations. Anything which causes your heart to work harder could bring them on, any exertion including digesting food. The sooner you report any changes, the more chance there is of avoiding MI. You get quite good at it over time, I caught my last 2 blockages at 90%, so I still had 10% flow.
Another thing to remember, don't feel embarrassed about going to the Dr with any symptoms. Even if they prove to be false, you've learned something new and important, that symptom is not heart related. The more you learn about the feelings in your body, the better you will become at predicting problems.
IF you have another MI, then symptoms can be very different from the first. It could be silent, it could be very mild and you ignore it. It could feel worse.  It probably depends on where the blockage is, and how much muscle it's affecting.