Throat Spasms

I just found this while looking for some information for my GI appt. tomorrow and can't believe I didn't see this months ago although I had found another vague reference a while ago .... this ties in with the swallowing thread we have going but this is so important (to me!) and exciting (to me!) I had to post it separately.  This is my for-real eureka moment.
It comes from  emedicine.com/MED/topic743.htm

"Esophageal spasm can modify cardiac function and vice versa. Esophageal spasm and coronary artery disease may coexist. Mechanisms that cause esophageal spasm can feed back to cause coronary spasm, and coronary spasm may feed forward to cause further esophageal spasm."

So why am I still having to figure this out on my own... or does my cardiologist not know this? LOL

For those of you who don't know me, I had a heart attack caused by SPASM in January. This helps to explain all those tests that come back ok. My cardio just last week told me he didn't think I had to worry about having another cardiac event.  Since my MS diagnosis, both my husband and I, along with a good friend who is a nurse, have thought the MS was connected somehow with my MI - the esophageal spasms could very well be the link!!

The meds I am on for Angina DO help with esophageal spasms, especially the nitrates, according to other references I have found.

Thanks for indulging my excitement!
Lulu

[Sarahsmom46]

Stay the course, my dear, stay the course!  

You are definitely on to something and if you aren't careful, you just might find the connection that these genius doctors and scientists have not been able to put their finger on - and answer!  Heck, you mind end up writing a paper on it one day.  

I'll be watching what you learn and can maybe glean from your GI doctor tomorrow.  

Very interesting stuff indeed.  Thanks for sharing the information and link.

Julie

[Lulu54]

Julie,
This ties in with what I had already found -a case study in a medical journal of GP's that reported on an MS patient in the hospital with the MS hug syndrome who suffered a coronary attack while being treated for the MS spasms.  Then they found a second one with the same thing - hug/spasm turned into heart attack with no serious damage.  I really believe I am case #3, at least!

Friends accuse me of being in denial about having a heart attack - i admit I had one, it just doesn't make a lot of sense WHY....

Lulu

[Sailorsong]

   You are the only person I have ever known that had a heart attack from a spasm like myself. That is how I had my first MI (1995). My BP had always been on the very low side up until then. When they checked my cholesterol levels my HDL was 3. So when I had the spasm the walls of my arteries stuck together causing the MI. Ever since then my BP has been high and my HDL still remains on the low side (last test it was 35).  I had MS symptoms for almost 7 years before that MI, but I think it was more from stress than MS in my case.

Dennis

[Quixotic1]

Wow!  That is a Eureka moment.  Let us know what your cardio says.  I assume you will print out the eMedicine artcile for him.

Q

[Quixotic1]

It makes me wonder if my episodes of severe bilateral neck and jaw pain are Prinzmetal Angina and not esophageal spasm or are both....

Question for you.  Does coronary vasospasm show up on a stress (adenosine) test?

Quix

[Lulu54]

No to showing up on the stress test -  vasospasm is a diagnosis by exclusion UNLESS you happen to get "lucky" and actually have one while you are being catherized!  There is one test that can be done but has fallen out of favor to test for Prinzmetal  - the ergonovine test - you are injected with the medicine while undergoing the cardiac catherization and if the heart spasms then bingo! they know for sure but they also have to administer meds immediately to stop the spasm which is actually a heart attack.  I understand it is not only risky but also very painful... it was invented at the Cleveland Clinic.  

Jewish Hospital in Cincinnati is doing Prinzmetal research - it involves a genetic marker in your blood.  I have not done that yet - just involves having a sample sent in.  You can google that and read lots about their study going on if you are curious.  

I should go to bed now - early day tomorrow and lots to talk about at 7:30 AM with the GI doc.  Here's hoping I can get it all out in a coherent thought pattern.  Lu

[Lulu54]

here's where the study is   http://www.jewishhospitalcincinnati.com/cholesterol/Research/prinzmetals_angina.html

[doni54]

Hi Lulu,

This is very interesting and I can understand why you are so excited!!  It amazes me sometime how our own research answers our questions when we can't get the answers we need from the medical community.

That's why this forum is so important!!!  Knowledge is power!!!  We have to be our own advocates and search out the info that answers our questions.

Good luck today!!

doni

[tot_teacher]

Lulu -

I'll be thinking of you this morning and sharing in your excitement.  Please let us know what the cardio says.  Good Luck !

- Alisa

[Quixotic1]

The may also be monumental for me.  The articles out there are NUMEROUS that discuss the association between coronary vasopasm and esophagela spasms and Raynauds (which is another form of arterial spasm) and migraines.  All of these are associated with inflammatory diseases.  And now we see the association with MS.

I discussed this with an internist today and she recommended that I do see a cardiologist for my neck and jaw pain which sounds like atypical angina to every doctor I have described it too.  So that is in motion.

I know I have esophageal spasms.
I know I have Raynaud's
Now, is the severe neck pain and crushing jaw pain a form of vasospastic angina (Prinzmetals) or just a side effect of the esophageal spasms?  I'm actually a little concerned.  I only get this about once a year and it is very short - 10 to 20 seconds.

And I swore that I was not going to complain about another thing to a doctor@!!

This is soooo interesting!

Quix

[Lulu54]

Q- my fairly informed opinion is if this is only happening about once a year, it is probably not angina or Prinzmetal angina.  PA in particular appears to cycle but pretty much doesn't go away for that long.  It is one of those pains you learn to wait out and live with- funny but Prinzmetal is similar to MS in that it probably won't kill you but will make your life miserable.  And PA almost always occurs at rest, never under exertion.  

there is considerable evidence that like migraines for women, peak episodes of PA may correspond to menses.  Now those of us who are post-menopausal don't have a clue how it all fits with hormonal fluctuations.  

that said, I would still encourage you to see a cardiologist and have the jaw pain checked out - you do know jaw pain with women is a fairly classic heart problem indicator, right?  LOL
Hope this helps,
Lulu

[Quixotic1]

Well, mine always occurs while I am up and around.  This is likely another mountain from a molehill situation.  I'm turning into a hypochondriac!  I will be with my mom in a few weeks when she sees the cardiologist (whom I think is awesome).  I'll bounce it off him.

Yeah, I know that women often present with an MI atypically.  The first time I had this I was at the hospital making rounds, but I felt too crummy to tell anyone.  I just wanted to go home and go to bed.  It was during my 4 year battle with vertigo and fatigue.  My internist throttled me when he heard about it a week later.

But, I have ignored it because it was so infrequent and after two stress tests were pristine.

My new mantra "Me, too!  Me, too!!" (see my new post)  If Lulu has it, I want it!  (not!)

lol  Quix

[Lulu54]

Angina is a pain in the rump to get diagnosed - it does occur under activity and I don't mean to tell you that PA never does, but that's not the usual scenario.  You could have good old ordinary variant angina, not as s e xy as PA, but still a legitimate disease! LOL

Be careful what you wish for here 'cause angina is almost always treated with CCB's and nitrates.  The Nitro headaches are never ending - take a dose of meds and everyone i know gets the dreaded nitro headache within 60 minutes. Its a drug our bodies don't get accustomed to.  Sublingual Nitroglycerin tabs make it happen immediately.  Both lots of fun!!!

And if you have a new mantra I get one too - maybe I'll try out "pass it on. pass it on." or perhaps "pass me by."

my laughing best,
Lu

[sllowe]

OMG!  WOW! Totally sharing in your excitement w/finding this data...

This is so educational and interesting! I'm thrilled to have more knowledge on this topic!