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Heart Disease (Expert Forum)
prinzmental's angina
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.
prinzmental's angina
by itsa48, Feb 10, 2002 12:00AM
thank you for taking my question
after over two years of having chest tightness and being out of breath (this was once in a while). I had an eposide at work where I knew I was in trouble, just didn't feel good had the squeezing bad, was nauseated, pale. Work called the amublance, anyway they admitted me I have an excellect cardologist now. He did the heart cath. the next morning and I had one artery on the right side that was a little blocked but not enough to do anything about and then he tested the heart for they spasms three times the same artery did it. I came home on 30 mgs this was jan 10 (ps iam 42 year old female) and I keep having them at home, i also had my nitro spary so he keeps changing meds now its 120 imdur 2x daily and norvasc 2.5 mgs 2 x daily and i take toperal 50mg 1 x daily. Now of course we are still trying to figure out why this happened and I go back feb 13th. I understand that with the spasam the artery closes that is why i need the nitro, but if he would have fixed that artery, do you think that could have fixed me (i don't like taking this meds daily for the rest of my life) how could it close if they would have put a stent in there? now iam also having other little pains i didn't have before that go in my shoulder, went in both sides of neck and one time in my left jaw. and i get alot of a little pain next to my left breast, when i have these i don't have the pressure. but that is when i notice them seems like they travel to the shoulder and now the jaw. Do they check your caroted artery during heart cath. Thanks for your time. Lynn
after over two years of having chest tightness and being out of breath (this was once in a while). I had an eposide at work where I knew I was in trouble, just didn't feel good had the squeezing bad, was nauseated, pale. Work called the amublance, anyway they admitted me I have an excellect cardologist now. He did the heart cath. the next morning and I had one artery on the right side that was a little blocked but not enough to do anything about and then he tested the heart for they spasms three times the same artery did it. I came home on 30 mgs this was jan 10 (ps iam 42 year old female) and I keep having them at home, i also had my nitro spary so he keeps changing meds now its 120 imdur 2x daily and norvasc 2.5 mgs 2 x daily and i take toperal 50mg 1 x daily. Now of course we are still trying to figure out why this happened and I go back feb 13th. I understand that with the spasam the artery closes that is why i need the nitro, but if he would have fixed that artery, do you think that could have fixed me (i don't like taking this meds daily for the rest of my life) how could it close if they would have put a stent in there? now iam also having other little pains i didn't have before that go in my shoulder, went in both sides of neck and one time in my left jaw. and i get alot of a little pain next to my left breast, when i have these i don't have the pressure. but that is when i notice them seems like they travel to the shoulder and now the jaw. Do they check your caroted artery during heart cath. Thanks for your time. Lynn
Doctor's Answer
by CCF-M.D.-CRC, Feb 10, 2002 12:00AM
Dear Lynn,
This is an interesting question and one for which the right answer is not clear. Coronary artery spasm is usually seen in middle aged women with minimal coronary artery disease. It can be precipitated in the cath lab with a drug called ergotovine and reversed in the lab with intracoronary nitroglycerine.
The treatment is usually medical and calcium channel blockers (e.g. Norvasc - amlodopine, verampamil and diltiazem) usually relieve the spasms. Does stenting the area of spasm help? It may but no one knows for sure. One thing for sure is that a stented artery has a chance of getting "in-stent restenosis" so it is not without risks.
In your case before stenting I would first make sure the pain is coming from the spasm and not something else. Next I would try a different calcium channel blocker (e.g verampamil) at higher doses. Lastly, if it did come to stenting I would wait until the "coated stents" are released as there is a much lower rate of restenosis with these stents.
Carotids are not checked during a heart cath.
This is an interesting question and one for which the right answer is not clear. Coronary artery spasm is usually seen in middle aged women with minimal coronary artery disease. It can be precipitated in the cath lab with a drug called ergotovine and reversed in the lab with intracoronary nitroglycerine.
The treatment is usually medical and calcium channel blockers (e.g. Norvasc - amlodopine, verampamil and diltiazem) usually relieve the spasms. Does stenting the area of spasm help? It may but no one knows for sure. One thing for sure is that a stented artery has a chance of getting "in-stent restenosis" so it is not without risks.
In your case before stenting I would first make sure the pain is coming from the spasm and not something else. Next I would try a different calcium channel blocker (e.g verampamil) at higher doses. Lastly, if it did come to stenting I would wait until the "coated stents" are released as there is a much lower rate of restenosis with these stents.
Carotids are not checked during a heart cath.
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This is an interesting question and one for which the right answer is not clear. Coronary artery spasm is usually seen in middle aged women with minimal coronary artery disease. It can be precipitated in the cath lab with a drug called ergotovine and reversed in the lab with intracoronary nitroglycerine.
this was like a really strange answer to my question! i had already mentioned that i had the ergotivine challenge test and then he went on and mention the following, In your case before stenting I would first make sure the pain is coming from the spasm and not something else.
I don't think i would second guess my heart dr. when he preformed the heart cath. and did this above study? did he not read what i wrote. I don't know what he considers middle age? i gave him my age and my history of minimal cad.
what kind of answer did i get? besides the stenting.
IF, I ever need a stent, I would want the newly coated ones that hopefully will be out in the very near future. My sister has had 2 stents in 4 months time as scar tissue builds up around it.
I really appreciate this site and the CC Doctors who take the time to help us all.
Good Luck to you.