coronary artery dissection and coronary artery spasm

[nancy grace]

I am 43 low cholesterol normal blood pressure, moderate to better exercise (walk/jog) .healthy diet. I had heart symptoms 8 yrs ago, several spells of severe chest pain post partum (5th baby, since then I've had 6th) attributed to chostochondritis in emgcy room. Sent home.(I now thing definitely was heart spasms or healed dissections?)
Recenty I had a brief episode chest pain and next day had a heart attack in emgcy room turned out to be a coronary artery dissection. Had two stents placed. Two days later in hospital recovery, I had a coronorary artery spasm, not controlled by nitro, progresseed to heart attack. Two more stents placed.  In the prior year I had chest tightness and some arm numbness exercising, I had some brief abnormal herat rythms, racing or skipping, off and on, and some days of fatigue and feeling out of breath, but other days fine. Anyone else with similar symptoms. I'm taking aspirn coumadin plavix and norvasc. I still have some anginal tightness and elevated heart rate if I walk up hill.

[tanns]

When you had the heart symptoms 8 years ago did you go through the battery of cardiac testing?  I have been having chest discomfort for a year and a half.  I have seen 4 cardiologists and all my tests have been fine.  Yet I continue to have these symptoms.  I have left arm pain usually from elbow to shoulder, horrible unexplained heartburn, tightness in the chest, pain/discomfort in the left arm pit, left back, neck and jaw pain, abnormal rhythms and a generalized "blah" feeling.  

Although I am grateful that there hasn't been any abnormal cardiac findings, I wonder if this is a precursor to something.  I wouldn't think that cardiac discomfort could last for so long but your post makes me wonder.

I wish you well and hope you get the answers you need.

[nancy grace]

I did not go through full work-up 8 yrs ago just an EKG, no blood work. So I was sent away with ibuprofen. But since I did not go during a pain episode ekg showed nothing unusual. My cardiologist now says I may have had healed dissections.

He is wondering if a prolonged spasm could have lead to a dissection. The spasm I had in hospital (was my second MI) responded to nothing, not meds, not catheter, not even balloon angio- so he had to put stents in to stop it.  

I would suggest going to emgcy room DURING a pain episide and have troponin levels checked (unless your cardiologist will do this).  If they are elevated it signals ischemia and need for follow up, maybe catheterization to look for blockage.

I still have some chest tightness walking,  and there is an area of the artery adjacent to the stent that may be weak or affected somehow? So the cardiologist does not think chest tightness is benign, in other words don't assume your chest tightness is nothing. Best wishes