bed time angina

[shoe56]

I am 60 years old. I had quad bypass in 1989 and due to not taking proper precausions, all four have closed, two to 100% and two to 90-95%. My heart has generated collateral arteries to take some  of the load.  The problem presented itself as mild angina over the last two months.  No indications on stress tests within the last two years.  My cardiologist has opened one of the the 90-95 % arteries through angioplasty and stent placement approximately 1.5 weeks ago.  He plans to do the other in approximately one month.  I am on  30mg of Imdur once per day for thirty days for post stent angina.  Also have nitroquik available.  I experience some level of angina as I am  slowly beginning  to excercise. This is not at all unexpected.  However, I usually experience angina as I get ready for bed at night or sometime if I get up during the night for any reason. It usually goes away in 5 mins or so with some deep breathing or relaxation techniques.  I have started moving my Imdur  dosage later in the day to see if this helps.  I now take  it about mid afternoon, but  no change yet.  Any thoughts?

[Cleveland Clinic]

Shoe,

thanks for the post.

Your body goes through natural cycles through the day. Blood pressure, heart rate and various hormones all change in a cyclic manner. it is not uncommon to have regular fluctuations in your symptoms. Sometimes, altering the timing of medication dosages helps. Also, another angioplasy may certainly help if there is a specific target.


good luck

[Al Dente]

Hi shoe,

Like the doc says, sometimes it makes a difference in the timing when you take your meds--and sometimes it takes some tinkering to get the dosages right.

I've been on Imdur for about 1.5 years now (had a stent placed).  I used to take in in the mornings, and like clockwork I'd start to get some angina in the evenings--around 9:30.  A had a few ER visits late at night with angina until we got things figured out.  

I take Imdur about 3pm (I don't take it with food).  I take Atenolol and Cozaar in the evenings with dinner, around 5.  Mornings, I take my other meds (Cardizem, Plavix, ASA).  This seems to have helped.

Keep an eye on your angina, especially if you have to augment it with sublingual tabs or spray--don't hesitate to get checked out if things don't calm down.

Good luck!

[save]

Have you ever heard of Ranexa?  I am on the nitro patch and Troprol XL.  He is trying to stop angina.  I have written to you before.  I had the open heart surgery 4 months ago.  They think that the LÅD is giving me trouble now.  I have 4 blockages that were not done.  There was 7 in all, but the valve was really bad.

[Al Dente]

Hi Save,

I'm sorry to hear you're having a rough time, plus recovering from the surgery.  I hope your docs can get you on a good regimen that helps.

I've read up on Ranexa....my cardiologists haven't suggested it as it's pretty new on the market, and if I remember right on the PI notes, there's a couple conflicts with some of the meds that I take.  Imdur (long acting nitro) seems to be working ok, but I think I need an adjustment in my beta blocker--I think my body has adjusted and I need a higher dose.

I hope you start feeling better and good luck!