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Heart Attack and MS - I found the probable link

Aug 03, 2008 - 5 comments
Tags:

Angina

,

hearts

,

MI

,

Migraines

,

prinzmetal angina

,

variant angina

,

Heart Attack



If you read anything about me you know I had a Heart Attack in January and been trying to figure out why for the past six months. I have an official diagnosis of microvascular angina (of which prinzmetal angina fits into the larger category).

I just now found the article that ties this rare phenomena together. Tomorrow I have the three spinal MRIs in the afternoon and I am willing to bet that there will be a lesion on my spine to complete this puzzle.


The full article reprint is here at

http://www.jabfm.org/cgi/reprint/17/1/71

"A search of the literature reveals a single case report describing a 53-year-old woman diagnosed with multiple sclerosis during a hospital admission for severe angina at rest that was consistent with Prinzmetal angina.4 In their patient, Lalouschek et al4 found ST-segment depression in leads V2 through V6, resolution of pain and electrocardiographic abnormalities with administration of intravenous nitroglycerin, and normal coronary arteries on coronary angiography. Evaluation of lower extremity paresthesias led Lalouschek et al4 to a diagnosis of multiple sclerosis; multiple white matter lesions of the head and thoracic spinal cord were evident on MRI. Because sympathetic preganglionic nerve fibers serving the heart originate in the thoracic spinal cord, Lalouschek et al4 implicated the spinal cord lesion found in their patient as the cause of coronary vasoconstriction. Our 38-year-old patient’s multiple sclerosis relapse may have contributed to coronary vasospasm in a similar fashion. Although her spinal cord was not imaged, head MRI revealed multiple white matter lesions; at least 2 lesions were acute.

The exact mechanisms responsible for coronary artery vasospasm have not been determined, and causes may vary from patient to patient. Willerson et al5 considered the possibilities of changes in autonomic neural control, changes in contractile function, and locally released vasoactive mediators in contact with dysfunctional endothelium. Additional potential contributing factors to our patient’s coronary vasospasm include her history of cigarette smoking,6–8 mental stress,9 and oral contraceptive use"





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335728_tn?1331418012
by Rena705, Aug 03, 2008
I really hope that they don't find anything on the MRI but then if there is a connection between MS and the heart attack at least then you will have some answers!  Did you have any other contributing factors when you had your heart attack such as smoking or high stress?

This is a very interesting case and I hope you will get back to us with the results of your MRI's...this could someday prove helpful for someone else as well and it's always very fulfilling if one can help someone else with the knowledge they have gained throughout their own illness!  Good luck with the MRI's tomorrow and we will be looking forward to hearing how it went ok?

Lots of Hugs,

Rena

572651_tn?1333939396
by Lulu54, Aug 03, 2008
Rena,
I'm chuckling at the stress question because my answer would be - of course I have stress- I'm a 53 year old woman, I have a husband with health issues, I work full-time outside the home and my husband and I have a business that is based in our spare bedroom.  Stress?  Who me?  But actually  I am a pretty laid back person, so stress should not be an unusual issue with me.  And my MI (myocardial infarction , aka heart attack) occured on a holiday when I didn't have to work.

Yes, I was a smoker for 35 years - quit the night I went to the ER for my MI.  Also a regular beer drinker - which I also basically gave up the night of my HA/MI. I went 4 months without having one, and lost 40 pounds so far in the past 6 months.  I miss them both and will let myself have an ocassional beer, but not like I used to.  So yes, there were factors that I take full responsibilty for.  And smoking and alcohol both are vasoconstrictors as well.

BUT my MI just never made complete sense - it just didn't feel right.  I have low blood pressure, my arteries are all clear, my heart damage resolved itself quickly, my ekg and ecg are both normal.  Nothing shows on the nuclear stresstest I did last month.  I didn't quite fit the textbook case of heart attack.  I will be taking a copy of this journal article to the cardioligists office tomorrow - I know he will be amazed as well.  (I do like my cardio, and I'm not mad at any of my doctors).

Now that I'm looking at MS symptoms I would guess this disease has been quietly in my body for a good 5 years or so.  It was in January that it truly flared.  At least that is now my theory.  

Yes, tomorrows MRI's will complete the story perhaps and I will let everyone know.  

Strange how this has made me smile, even though MS is not what I want to have.  

My best,
Laura

572651_tn?1333939396
by Lulu54, Aug 03, 2008
Rena,
I think the wishful stage about test results is past for me, considering my brain MRI was riddled with enhancing lesions and a couple blackholes thrown in for good measure.  Something with my CNS is definitely not right.

Laura

335728_tn?1331418012
by Rena705, Aug 03, 2008
Hey Laura...I understand how you feel about the "wishful stage" but this could also help in that it could show them the reason for the MI right...and if it is connected to MS?  I am grasping at straws sure but I am still interested if there is an actual connection between the two.  

Just something to note...as a rule and MI happens AFTER a stressful or heavily physical activity, not during it.  That is why it is so hard for people to understand why people have an MI in the morning after they have played football the night before, not during the game.  My Father had an MI while playing cards at the senior's centre AFTER he mowed the lawn on his corner lot of his house earlier in the day...totally unexpected and unfortunately it was fatal.

I quit smoking a year ago July 17th and gave up drinking long before that due to the symptoms of MS and the meds I was on...I don't really feel any better because of it but I certainly don't miss having a hangover and I do smell good! he he

Like I said before, I hope you get some answers with these MRI's and you will be able to get on with your life and be healthy and happy!  I will be waiting to hear the results and I wish you good luck anyway!  he he

Lots of Hugs,

Rena

572651_tn?1333939396
by Lulu54, Aug 03, 2008
The connection would be great if  it can be made it would explain lots of things like my ejection factor is now at 65% which is excellent (should be 50-70%) and I was at 45% right after the MI.  That 20 point increase is virtually unheard of....

I'm sorry to hear you father's attack was fatal.  The statistics are so grim - and for women only 1 in 3 on average survive.  That is why I was so happy to be here and then boom, got run over by the MS freight train when I wasn't looking.  SO being able to connect the two really helps my mental status, in a strange sort of way.

My husband keeps joking that I wasn't sick when I smoked and drank and maybe I should look into that! :-)

It will be Wednesday or so before I get MRI results probably, but I will definitely let you know what I hear.

Be well,
Laura

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