They always said i was dizzy...

I was diagnosed with pretty severe arterial spasms.  I have had a large number of stress tests, echos, and 2 heart caths. I don't have any stints. During my last cath the cardiologist saw what she thought was a severe blockage, but she gave me nitro and it opened right up.  The pics are dramatic.  You didn't have to go to a million years of medical school to see that one. I have struggled with pretty heavy duty fatigue, breathlessness, and occasional angina for about three years. I take Renexa 1000 mg twice a day, Isosorbide 60 mg twice a day, Cartia 120 mg twice a day, Simvastatin 80 mg once a day, I wear a 4 mg nitro patch daily, sometimes if I need to, I wear two patches. I also take 60 mg of Cymbalta twice a day. I take 1200 mg of fish oil, 400 magnesium twice a day, glucosamine and MSM, and a multivitamin every day. And I have sub lingual nitro if needed. I don't let people see me take my meds because it's a little embarrassing. Occasionally, I have had bouts of dizzyness , but not often, and I blamed my sinuses draining into my ears. Over the last few weeks though it is almost constant.  Sometimes it feels like I am falling when I am not, sometimes the world is dipping. It only lasts a second or two when it happens. I would blame the large number of drugs that I take, but I have been taking them for a long time and this is new. I am a 50 year old woman, and both my mother and my sister have had several heart attacks and my mother had a stroke.  My sister had her first heart attack (of 9) at age 45, so when I started to show symptoms I wanted to treat it aggressively, and fortunately I stumbled onto a wonderful cardiologist who was willing to hear me and investigate. My question is is this something to run to the doctor (yet again) for?  Is it serious? My company was just bought out and I am trying not to take off work.  Thanks!

[ed34]

It could be the effects of the nitrates. Some people are more sensitive than others to this medication, in fact I used to wear the lowest dosage patch and had to give up after just 2 days. I couldn't even stand straight and got nasty headaches. They unfortunately don't just open the arteries around blockages, they open all your arteries and this lowers blood pressure. Your heart then has to compensate for this anyway by beating harder. I know patches are supposed to be slow release and easier to tolerate, but they just didn't work for me. I had a total blockage in my LAD, and the nitrates did nothing to relieve my chest pain.
I do have a question for you, if you don't mind. When they diagnosed you with severe artery spasm, how was this done? Was it observed during an angiogram? This is a very difficult thing to accurately diagnose. Oh, and why didn't they stent your blockage rather than keeping you on nitrates?  The blockage may have looked like it vanished, but it has not. All that happened was, the nitrates widened your artery temporarily so blood could get through more easily. The blockage is still there.

[Jboldt]

Hi!  Thanks for answering! Yes, I know what the nitrates do.  I've been on them for about 3 years, so I'm pretty sure they didn't suddenly start making me dizzy.  They diagnosed the spasms in my arteries in a heart catherization.  The dr saw the arteries spasm. They saw that in both caths.  But in the second cath, the artery was completely closed and narrow.  She gave me nitro and it completely opened.  Not just a little open, completely. It was very clear what was happening, it wasn't vague at all. They didn't do a stint because even if they put a stint where they saw the spasm, the artery could just spasm shut somewhere else. I don't really have plaque build up at all, and my cholesterol level is a healthy 138.  My triglycerides look pretty good too. Basically, for a fairly healthy 50 year old woman, I'm a mess. My sister teases me and says that she always knew I was a spaz. :o)

[ed34]

Cartia? this seems to have a variety of medications so I'm not sure if it's a company name?
Some drug sites seem to list it as aspirin, some as calcium channel blockers. Do you know which yours is?

Nitro works with some people and not others. I had induced spasm caused by the catheter in an angioplasty procedure. The tickling of the wire caused it to go nuts. I was put on a calcium channel blocker, diltiazem which stopped them. Nitro didn't work at all. The muscles in the artery wall use calcium for energy, which it takes from the blood through tiny openings called channels. Calcium channel blockers lower this ability and so the muscle has a much harder time generating energy and going into spasm. Strangely, after 3 months, my artery seemed to settle down and I've been off this med for nearly a year now.

[Jboldt]

The cartia is a calcium channel blocker.  I am feeling better with the new meds, I am not as breathless and fatigued. I was able to clean the whole house for the first time in a few years a few weeks ago.  I was so happy.  Well, I would have been happier if it was something like I was able to d something fun, but my floors were happy. :o) I just wondered if the dizzy was connected to the heart thing, but it probably is something stupid.  

The spasms are the first thing anyone said that made sense to m.  I have all the heart symptoms, angina that goes away with nitro, fatigue, breathlessness.  The first doctors I went to checked my cholesterol (which is fine)  and decided I was having panic attacks (despite the part about not feeling panicky), and wanted to give attavan. Which is always nice, but not helpful in my case. So I kind of threatened him into a doing a stress test, and, what a surprise, the EKG was bad. And I met my current dr, who listened, and scheduled my first heart cath.  They saw my little narrow arteries, two small blockages,  and the spasms. We started meds and the difference in how I looked and felt was astounding. Then over time, I started to get fatigued again, and started the breathlessness again.  We swapped meds around, and over time things got worse, so she scheduled another cath. This time they really saw the extreme spasms, and changed my meds, and watched everything much more closely.  

For me, nitro is my friend.  It really, dramatically, stops the spasms.

I'm so glad you are feeling better. Can I ask where you are from? Cute dog!!
Jackie

[ed34]

I'm from England, a county just outside London called Hertfordshire. The dog will be 16 this November but still thinks he's a young pup when he has a haircut :)

[ed34]

Oh and don't laugh :)  his name is barney, but that isn't my doing. He grew up with my 17 year old son who was into that monster purple dinosaur on tv at the time. We told him there are no purple dogs so we opted for white.