Aa
Angina at night
A comment from someone about my last post prompted me to post again. 'Healthyself' commented about pushing yourself to the point of angina with exercise. Everything I can find to read about angina seems to refer to this 'stable' angina, but it does not seem to be what I am dealing with. My angina is at night, or before noon. It does not happen in response to stress, I am sleeping!
I am exercising about two hours a day, five days a week. 75 minutes yoga class, followed by 60 minutes on machines. I keep my heart rate at 110-125, and I am 42 yrs old. When I exercise, I have my nitro with me, but have never had to use it. No angina then.
I take Isosorbide before bedtime. A couple of times a week I still have angina, even with the Isosorbide. If in bed, laying on my left side is extremely uncomfortable, I can only lay on the right.
The other night I fell asleep on the couch and missed my bedtime medications. The pain I had throughout the night was intense. About once an hour, I took sublingual nitro each time, and the pain did recede. Once I was able to wake up enough to get up and take an Isosorbide, the pains stopped.
My questions - (1)could the Isosorbide be masking a greater problem in my case? (2) can you recommend anything to read on this type of angina, I can't find much.
It takes weeks to get into the cardiologist so I won't be able to ask my Dr for a while. Waking up in the middle of the night with chest pains in the middle of the night is not fun. Not only that, I would be in tough shape if my nitro got mislaid, or ran out on me!
Thanks!
I am exercising about two hours a day, five days a week. 75 minutes yoga class, followed by 60 minutes on machines. I keep my heart rate at 110-125, and I am 42 yrs old. When I exercise, I have my nitro with me, but have never had to use it. No angina then.
I take Isosorbide before bedtime. A couple of times a week I still have angina, even with the Isosorbide. If in bed, laying on my left side is extremely uncomfortable, I can only lay on the right.
The other night I fell asleep on the couch and missed my bedtime medications. The pain I had throughout the night was intense. About once an hour, I took sublingual nitro each time, and the pain did recede. Once I was able to wake up enough to get up and take an Isosorbide, the pains stopped.
My questions - (1)could the Isosorbide be masking a greater problem in my case? (2) can you recommend anything to read on this type of angina, I can't find much.
It takes weeks to get into the cardiologist so I won't be able to ask my Dr for a while. Waking up in the middle of the night with chest pains in the middle of the night is not fun. Not only that, I would be in tough shape if my nitro got mislaid, or ran out on me!
Thanks!
I'm a 38 year old female. Smoked but bp and cholesterol were normal. Experienced mile discomfort in left biceps for a couple weeks. Finally went in and failed EKG and stress test. Not diagnosed as having had a heart attack but did have a 90% blocked artery. Had stent put in October 27th. Since then on Plavix, Lopressor, Zocor, Nitro as needed and aspirin. I do the treadmill everyday with no angina but will experience it at other times. Today I got it after eating a bowl of cauliflower, of all things. Wondering how much Nitro is "normal" for people experiencing angina during the day. Are people needing to take it everyday? Twice a day? Read your stories and they felt similar to mine, especially since we are all close in age and female. Welcome your comments about angina and what you're experiencing. All EKG's since have been normal and was told all other arteries are clear. Thanks. K
Hi and welcome to the forum!
You may find you do not get a lot of responses to your post as the original post is old and people may not notice your post. I only noticed your post by fluke as I was scrolling down looking for a post on a different subject. You may want to try asking your question to the docs. I know it can be difficult to do this because of the 2 question limit, however, I found the best time to get on is around 9-10am.
I do not have any real technical advice to give you, only advice from my own experience. But, I thought I would at least welcome you and try to help a little.
It's good that you at least have a little time to research your problem so you can ask appropriate questions etc. Unfortunately, when I had my heart attack, everything happened so fast and I had a stent put in within a day, I didn't have the chance to think about what was going on.
I would try to find out what kind of blockage/size/area etc and that may be a start to you then learning more about how you would like to handle it. Even if you don't have an appointment with your doc between now and the angiogram, you will probably have a few minutes before the angiogram to speak with him/her. I know that isn't ideal, but it will give you some opportunity to have a few questions asked. Don't forget that you are awake for the procedure, so you may be a little groggy, but you are still aware of what is going on and everything should be explained to you(that's the way it was with me anyway).
I know an angiogram is an invasive procedure and I fully understand why you would like to avoid having one if possible because I have been in the same boat since my heart attack.
But, the fact that you have been having chest pain and have a positive thallium test may very well be a warning sign of a heart attack to come. So, if I were in your shoes, I would go ahead with the angiogram, if they don't find anything that needs absolute immediate attention, ask if you can "think about it" for awhile if they suggest a stent or something else you are not comfortable with. Of course it goes without saying that you should listen carefully to the pros and cons of anything suggested by your doc.
Aside from the angiogram being invasive, I didn't really find it bad at all. I think the worst part was lieing still for hours afterwards.
I wish you the best of luck and keep trying to post.
Take care, Janne
p.s. by the way, I am also having an angiogram on Dec. 5th(I've been trying to avoid it, but my test results are conflicting as to whether or not there is another blockage. Because I've already had a heart attack 5 months ago (at age 39)and I'm still having angina, I've finally agreed to have another angiogram.)
You may find you do not get a lot of responses to your post as the original post is old and people may not notice your post. I only noticed your post by fluke as I was scrolling down looking for a post on a different subject. You may want to try asking your question to the docs. I know it can be difficult to do this because of the 2 question limit, however, I found the best time to get on is around 9-10am.
I do not have any real technical advice to give you, only advice from my own experience. But, I thought I would at least welcome you and try to help a little.
It's good that you at least have a little time to research your problem so you can ask appropriate questions etc. Unfortunately, when I had my heart attack, everything happened so fast and I had a stent put in within a day, I didn't have the chance to think about what was going on.
I would try to find out what kind of blockage/size/area etc and that may be a start to you then learning more about how you would like to handle it. Even if you don't have an appointment with your doc between now and the angiogram, you will probably have a few minutes before the angiogram to speak with him/her. I know that isn't ideal, but it will give you some opportunity to have a few questions asked. Don't forget that you are awake for the procedure, so you may be a little groggy, but you are still aware of what is going on and everything should be explained to you(that's the way it was with me anyway).
I know an angiogram is an invasive procedure and I fully understand why you would like to avoid having one if possible because I have been in the same boat since my heart attack.
But, the fact that you have been having chest pain and have a positive thallium test may very well be a warning sign of a heart attack to come. So, if I were in your shoes, I would go ahead with the angiogram, if they don't find anything that needs absolute immediate attention, ask if you can "think about it" for awhile if they suggest a stent or something else you are not comfortable with. Of course it goes without saying that you should listen carefully to the pros and cons of anything suggested by your doc.
Aside from the angiogram being invasive, I didn't really find it bad at all. I think the worst part was lieing still for hours afterwards.
I wish you the best of luck and keep trying to post.
Take care, Janne
p.s. by the way, I am also having an angiogram on Dec. 5th(I've been trying to avoid it, but my test results are conflicting as to whether or not there is another blockage. Because I've already had a heart attack 5 months ago (at age 39)and I'm still having angina, I've finally agreed to have another angiogram.)
Hi,
I'm new to this forum and I really need your help!! I just turned 50 and have had chest pains on and off for one year. I am 20 lbs. overweight and have not exercised regularly as I use to. I have an 8 and 12 year old, just graduated from Masters
in Education and now subbing. I have been exhausted lately and
I finally had a stress test and a nuclear scan. I did fine on
the stress test but the scan showed a blockage of somesort...
I am now scheduled for a Cath on December 5th. Now after reading
the comments I wonder if I am doing the right thing. I'm not
thrilled about having a metal piece inside if unnecessary, but
how do you know without having this invasive procedure. I'm
scared to even think about it. So do you think if I agessively
lost weight and raised my________(by taking meds) that would be
the way to go...I'm just so confused and want to feel better
without screwing my body up more than it is.
I'm new to this forum and I really need your help!! I just turned 50 and have had chest pains on and off for one year. I am 20 lbs. overweight and have not exercised regularly as I use to. I have an 8 and 12 year old, just graduated from Masters
in Education and now subbing. I have been exhausted lately and
I finally had a stress test and a nuclear scan. I did fine on
the stress test but the scan showed a blockage of somesort...
I am now scheduled for a Cath on December 5th. Now after reading
the comments I wonder if I am doing the right thing. I'm not
thrilled about having a metal piece inside if unnecessary, but
how do you know without having this invasive procedure. I'm
scared to even think about it. So do you think if I agessively
lost weight and raised my________(by taking meds) that would be
the way to go...I'm just so confused and want to feel better
without screwing my body up more than it is.
One thing about having angiograms is that the cardiologists are likely to drop a stent in any substantial narrowing that they see. Stents are forever and will prevent you from getting any natural reversal of your disease should you create the right conditions for that. Another thing that bothers me is messing up my femoral artery. I need my legs for walking, so I don't want to risk that anymore.
Your low HDL is you biggest risk factor. There are only three things that currently raise that: exercise, alcohol, and high doses of Niacin. I don't recommend that you become an alcoholic, but if you don't have a problem with alcohol, a glass of a deep red wine in the evening would be good. Also, if you don't have liver problems and have prescription insurance, Niaspan will raise your HDL. It can cause flushing if it's not taken correctly. No matter what the instructions say, I have found that the best way to take cholesterol meds are all at bedtime. For Niaspan you don't want to eat or drink within a couple of hours of taking it and don't take it with that low fat snack that they suggest.
A lot of doctors don't treat lipids aggressive enough in people that already have CAD. You need to be below 150 not 200 as recommended. Make sure that they prescribe the best statins, not ZOCOR or Pravachol like some are prone to do. Hopefully you have a healthy liver and can take statins.
Weight is your next biggest risk factor. Any habit can be developed within 3 weeks. Sometimes working out on machines only lasts a couple of weeks before people get bored with it. I have a dog and have developed a walking habit, that I feel very miserable if I don't do every day. Even though I live in a City, I try to find pleasant places with hills and trees to walk in. My dog also motivates me to walk twice a day. A 10,000 step per day program will keep you healthy. Exercise is totally necessary to burn the poisons out of your system. Your cells need to work in order to be healthy.
Af far as diet goes, they don't work. It's funny now that when I go to MacDonalds, I want the salad and not the burgers. If I go to a restaurant I will order the baked or broiled fish rather than red meat. I have cut out a lot of meat - we get about 95% more meat than we should in America. I stopped drinking milk several years ago and switched to soy milk on cereal. Also just so much eating is for comfort and socialization. I try to ask myself if I'm hungry or just eating for comfort. I try to limit eating out with friends to no more than a couple of times per week.
Stress is a problem. Stress hormones are toxic. As people get older, they tend to get their lives more under control, and lead more peaceful lives. Long working hours are deadly. Working 5 hours of overtime per week increases risk of sudden death by at least a factor of 2. Of course exercise helps burn out the toxic stress hormone buildup.
I believe that Beta Blockers should only be given to people to treat rythym problems or inactive people. Ace inhibitors and/or calcium channel blockers are better choices for BP control.
Remember that CAD is 98% a lifestyle disease although doctors will tell you that only 50% can be attributable to known risk factors. If you walk 20 miles into the woods, you will need to walk 20 miles out of the woods. That means years of practicing good habits. You can minimize your risk of a coronary event within 6 months however. Agressively control lipids, reduce weight, and exercise daily.
Good Luck.
Your low HDL is you biggest risk factor. There are only three things that currently raise that: exercise, alcohol, and high doses of Niacin. I don't recommend that you become an alcoholic, but if you don't have a problem with alcohol, a glass of a deep red wine in the evening would be good. Also, if you don't have liver problems and have prescription insurance, Niaspan will raise your HDL. It can cause flushing if it's not taken correctly. No matter what the instructions say, I have found that the best way to take cholesterol meds are all at bedtime. For Niaspan you don't want to eat or drink within a couple of hours of taking it and don't take it with that low fat snack that they suggest.
A lot of doctors don't treat lipids aggressive enough in people that already have CAD. You need to be below 150 not 200 as recommended. Make sure that they prescribe the best statins, not ZOCOR or Pravachol like some are prone to do. Hopefully you have a healthy liver and can take statins.
Weight is your next biggest risk factor. Any habit can be developed within 3 weeks. Sometimes working out on machines only lasts a couple of weeks before people get bored with it. I have a dog and have developed a walking habit, that I feel very miserable if I don't do every day. Even though I live in a City, I try to find pleasant places with hills and trees to walk in. My dog also motivates me to walk twice a day. A 10,000 step per day program will keep you healthy. Exercise is totally necessary to burn the poisons out of your system. Your cells need to work in order to be healthy.
Af far as diet goes, they don't work. It's funny now that when I go to MacDonalds, I want the salad and not the burgers. If I go to a restaurant I will order the baked or broiled fish rather than red meat. I have cut out a lot of meat - we get about 95% more meat than we should in America. I stopped drinking milk several years ago and switched to soy milk on cereal. Also just so much eating is for comfort and socialization. I try to ask myself if I'm hungry or just eating for comfort. I try to limit eating out with friends to no more than a couple of times per week.
Stress is a problem. Stress hormones are toxic. As people get older, they tend to get their lives more under control, and lead more peaceful lives. Long working hours are deadly. Working 5 hours of overtime per week increases risk of sudden death by at least a factor of 2. Of course exercise helps burn out the toxic stress hormone buildup.
I believe that Beta Blockers should only be given to people to treat rythym problems or inactive people. Ace inhibitors and/or calcium channel blockers are better choices for BP control.
Remember that CAD is 98% a lifestyle disease although doctors will tell you that only 50% can be attributable to known risk factors. If you walk 20 miles into the woods, you will need to walk 20 miles out of the woods. That means years of practicing good habits. You can minimize your risk of a coronary event within 6 months however. Agressively control lipids, reduce weight, and exercise daily.
Good Luck.
Wow - I can't imagine all of those things happening to 1 person. The accumulated stress must be off the Richter scale.
Of course you are young enough that you still have a lot of family responsibilities.
You need to take some time for yourself. Perhaps a Yoga course would be good. I take the summers off and just have fun, camp out and travel around. Of course I don't have to work all year just to support myself.
Now I am working where I have taken over a job with a lot of problems to solve and I need to make significant progress quickly. I don't let things get to me though. I just plan things out, take one thing at a time, and enjoy myself thoroughly. I have fun educating younger people and delegating much of the work to them, even though it takes longer at the beginning.
I stop at a park and walk a half hour on the way to work and walk 45 minutes and pick up a salad at McDonalds or a Subway for lunch. Today because the weather wasn't too good, I walked for 45 minutes in my park without encountering 1 person - amazing.
I must say that I rarely feel stressed anymore. I do think stress is about the 3rd most serious risk factor for coronary artery disease.
Good Luck To You.
Of course you are young enough that you still have a lot of family responsibilities.
You need to take some time for yourself. Perhaps a Yoga course would be good. I take the summers off and just have fun, camp out and travel around. Of course I don't have to work all year just to support myself.
Now I am working where I have taken over a job with a lot of problems to solve and I need to make significant progress quickly. I don't let things get to me though. I just plan things out, take one thing at a time, and enjoy myself thoroughly. I have fun educating younger people and delegating much of the work to them, even though it takes longer at the beginning.
I stop at a park and walk a half hour on the way to work and walk 45 minutes and pick up a salad at McDonalds or a Subway for lunch. Today because the weather wasn't too good, I walked for 45 minutes in my park without encountering 1 person - amazing.
I must say that I rarely feel stressed anymore. I do think stress is about the 3rd most serious risk factor for coronary artery disease.
Good Luck To You.
Wow! You guys have been having quite a conversation since I last checked in. It is good somehow to know that there are other women my age out there going through what I am. I know no one asked to be in this 'club' but whether we like it or not, we're in for life :)
I have only a few risk factors - Type II diabetes for 7 years, pretty well controlled, and fat that I carry in the abdomen. I weigh about 180 so should lose about 40 pounds, which I just haven't been able to take off :( I have normal blood pressure, no family history and my lipid profile is out of range for someone with CAD but not horrible - LDL 124, Total 178, VLDL 27, HDL 37, Triglycerides 95. My HDL is the bad one, it has never been above 40 for as long as I've had it tested.
I'm focusing on lifestyle changes. Like some of you have commented, I am one that everyone worries about burning out. I tend to throw myself into everything and go overboard. I think this has been a big factor and has to CHANGE!
Stress is a big factor too. My first blockage and stent were one month to the day after my 36 year old sister died in my home after an extended illness. My second one comes just after my dear husband and I are facing some financial stress. It's not that this financial stress is greater than in the past, I think it's the fact that it's continued for 20 years with no progress. I'm just worn out.
I'm adding the daily exercise (well almost daily, I'm up to 5x a week) and yoga and meditation and prayer to help with the stress angle. I'm also avoiding the 'D' word - this time it's better, more healthy eating - not a diet. So I have made some good changes this time.
I didn't have a heart attack. And I don't want to have one. So I am making an effort now to effect permanent lifestyle changes. But I'm reluctant to take all the drugs they want to give me and do all the procedures they want to do. I will have another cath if it is recommended. I will not take beta blockers at this point. I took Metoprolol for about a week after my last cath and I felt HORRIBLE! Couldn't get myself off the couch, fatigued, depressed, you name it - I felt awful. I weaned myself off it gradually and I am scared to take that one again. I immediately noticed how much better I felt after eliminating that one.
Normally I would swear that I could not trigger my angina to happen, no matter how hard I would exercise. But now after making all that noise about never having angina with exercise, it happened today, 10 minutes into my recumbent bike session. Had to take a nitro before continuing. And the last 3 days have been very filled with angina attacks. I think it might be getting worse. Sigh. It might be back to the hospital I go once more.
Thanks for a stimulating conversation. I hope I can stand here four years from now and be like 'healthyself' and tell you all how good I feel.
I have only a few risk factors - Type II diabetes for 7 years, pretty well controlled, and fat that I carry in the abdomen. I weigh about 180 so should lose about 40 pounds, which I just haven't been able to take off :( I have normal blood pressure, no family history and my lipid profile is out of range for someone with CAD but not horrible - LDL 124, Total 178, VLDL 27, HDL 37, Triglycerides 95. My HDL is the bad one, it has never been above 40 for as long as I've had it tested.
I'm focusing on lifestyle changes. Like some of you have commented, I am one that everyone worries about burning out. I tend to throw myself into everything and go overboard. I think this has been a big factor and has to CHANGE!
Stress is a big factor too. My first blockage and stent were one month to the day after my 36 year old sister died in my home after an extended illness. My second one comes just after my dear husband and I are facing some financial stress. It's not that this financial stress is greater than in the past, I think it's the fact that it's continued for 20 years with no progress. I'm just worn out.
I'm adding the daily exercise (well almost daily, I'm up to 5x a week) and yoga and meditation and prayer to help with the stress angle. I'm also avoiding the 'D' word - this time it's better, more healthy eating - not a diet. So I have made some good changes this time.
I didn't have a heart attack. And I don't want to have one. So I am making an effort now to effect permanent lifestyle changes. But I'm reluctant to take all the drugs they want to give me and do all the procedures they want to do. I will have another cath if it is recommended. I will not take beta blockers at this point. I took Metoprolol for about a week after my last cath and I felt HORRIBLE! Couldn't get myself off the couch, fatigued, depressed, you name it - I felt awful. I weaned myself off it gradually and I am scared to take that one again. I immediately noticed how much better I felt after eliminating that one.
Normally I would swear that I could not trigger my angina to happen, no matter how hard I would exercise. But now after making all that noise about never having angina with exercise, it happened today, 10 minutes into my recumbent bike session. Had to take a nitro before continuing. And the last 3 days have been very filled with angina attacks. I think it might be getting worse. Sigh. It might be back to the hospital I go once more.
Thanks for a stimulating conversation. I hope I can stand here four years from now and be like 'healthyself' and tell you all how good I feel.
Babbs, I'm not sure what my ejection fraction was after my most severe heart attack. That was about 6 years ago. It is probably better now than before the recent mitral valve surgery when it was 50ish. I think the severity of the heart attack (and presence of other underlying heart disease) pretty much determines the post-attack ejection fraction. As the heart heals by developing collateral circulation, the ejection fraction can improve too. I can't remember how long following my heart attack I had angina... but gradually over the course of a few years it just about vanished. It was an effort being patient, and at times I pushed myself to the point of angina, hoping that would encourage my body to create collateral circulation (not sure I shoud have done that). People vary in their ability to develop collateral circulation according to my dr. Sometimes with a severe enough heart attack and only partial recovery, a person can eventually wind up with heart failure and require a transplant. I really agree with healthyself in most ways: living right will help anyone live longer and feel better while they're at it, but I'm not opposed to invasive measures per se -- and I've read that genes can be a bigger determinant of coronary disease than lifestyle factors. I know for a fact I couldn't have healed my mitral valve problem... now I have a mechanical valve, and I feel so much better I cannot say. Longevity after a heart attack? My mother has a friend in her 80's who had a heart attack years and years ago. She has kept in good shape, and she's still going strong! To Sillysally and Janne... if you don't want to go through another angiogram and can afford a PET scan... someone in a post a week ago or so said they are very accurate at pinpointing blockages (insurance doesn't pay for these yet)... I don't know anything about them or how much they cost but maybe they're worth looking into online? Janne, I really feel for you. You have been through hell. Hope you feel a lot better in every way soon! Everyone else who's hurting too!!!
Babbs, I'm not sure what my ejection fraction was after my most severe heart attack. That was about 6 years ago. It is probably better now than before the recent mitral valve surgery when it was 50ish. I think the severity of the heart attack (and presence of other underlying heart disease) pretty much determines the post-attack ejection fraction. As the heart heals by developing collateral circulation, the ejection fraction can improve too. I can't remember how long following my heart attack I had angina... but gradually over the course of a few years it just about vanished. It was an effort being patient, and at times I pushed myself to the point of angina, hoping that would encourage my body to create collateral circulation (not sure I shoud have done that). People vary in their ability to develop collateral circulation according to my dr. Sometimes with a severe enough heart attack and only partial recovery, a person can eventually wind up with heart failure and require a transplant. I really agree with healthyself in most ways: living right will help anyone live longer and feel better while they're at it, but I'm not opposed to invasive measures per se -- and I've read that genes can be a bigger determinant of coronary disease than lifestyle factors. I know for a fact I couldn't have healed my mitral valve problem... now I have a mechanical valve, and I feel so much better I cannot say. Longevity after a heart attack? My mother has a friend in her 80's who had a heart attack years and years ago. She has kept in good shape, and she's still going strong! To Sillysally and Janne... if you don't want to go through another angiogram and can afford a PET scan... someone in a post a week ago or so said they are very accurate at pinpointing blockages (insurance doesn't pay for these yet)... I don't know anything about them or how much they cost but maybe they're worth looking into online? Janne, I really feel for you. You have been through hell. Hope you feel a lot better in every way soon! Everyone else who's hurting too!!!
Hi
I was lucky in that the damage to my heart was only small. My EF is 60. No one has said anything about long term prognosis. I assume I will just resume my normal life after awhile when they sort out what is going on.
I didn' t have a lot of lifestyle changes to make other than to quit smoking (which I did). I could also lose about 15 pounds. My cholesterol is excellent, but they put me on lipitor anyway just to make sure it stays that way. My eating habits are good with the exception that I don't eat enough fish. I have done aerobics and worked out in a gym since I was about 20. I have no family history of heart problems. In fact, my Mom was the youngest woman to die in our family at age 64 last year from cancer. Her Mom and her Aunts are all still alive and they're over 95 years old. I have to wonder sometimes where the plaque in my arteries came from if I have never had high cholesterol and I exercise regularly.
The one thing I was told was to slow my lifestyle down. I have had a lot of stress over the past 7 years and have run myself down. I never used to be a believer in stress causing major illnesses, but now I'm wondering. My Mom's death, a suicide in the family, I had 3 car accidents (none were my fault), being an executor of my Mom's estate, my brother was on life support, I have a stressful job, our family home burned down, my marriage broke up, my teenage son had emergency surgery, the list goes on and on and although I thought I was coping okay over the past few years, I think it took its toll on my body.
Before my Mom passed away, she kept telling me that I should slow my life down before I burned out. It sounds strange, but I honestly believe that my heart attack was my Mom kicking my *** and telling me to slow down. I have to smile at that. Sometimes I get angry that I had the heart attack, but for the most part, I feel I am lucky that I have been given a second chance at life. I am learning to take it more easy, I took a stress management course and I have changed my priorities in my life. These are changes that I believe will make the big difference in my health.
Take care, Janne
I was lucky in that the damage to my heart was only small. My EF is 60. No one has said anything about long term prognosis. I assume I will just resume my normal life after awhile when they sort out what is going on.
I didn' t have a lot of lifestyle changes to make other than to quit smoking (which I did). I could also lose about 15 pounds. My cholesterol is excellent, but they put me on lipitor anyway just to make sure it stays that way. My eating habits are good with the exception that I don't eat enough fish. I have done aerobics and worked out in a gym since I was about 20. I have no family history of heart problems. In fact, my Mom was the youngest woman to die in our family at age 64 last year from cancer. Her Mom and her Aunts are all still alive and they're over 95 years old. I have to wonder sometimes where the plaque in my arteries came from if I have never had high cholesterol and I exercise regularly.
The one thing I was told was to slow my lifestyle down. I have had a lot of stress over the past 7 years and have run myself down. I never used to be a believer in stress causing major illnesses, but now I'm wondering. My Mom's death, a suicide in the family, I had 3 car accidents (none were my fault), being an executor of my Mom's estate, my brother was on life support, I have a stressful job, our family home burned down, my marriage broke up, my teenage son had emergency surgery, the list goes on and on and although I thought I was coping okay over the past few years, I think it took its toll on my body.
Before my Mom passed away, she kept telling me that I should slow my life down before I burned out. It sounds strange, but I honestly believe that my heart attack was my Mom kicking my *** and telling me to slow down. I have to smile at that. Sometimes I get angry that I had the heart attack, but for the most part, I feel I am lucky that I have been given a second chance at life. I am learning to take it more easy, I took a stress management course and I have changed my priorities in my life. These are changes that I believe will make the big difference in my health.
Take care, Janne
When I first had the heart attack I was like everyone else. It made sense that if you have a plugged water pipe in your front yard you need to call the plumber to unplug it. If you have plaques closing your coronary arteries it made sense to me that you had to have them stented or bypassed.
The doctors will see a narrowing and stick a piece of metal in there. Your artery is not meant to have metal in it. That will just lead to more problems in the future and prevent you from returning yourself to health.
But these plaques in you arteries won't kill you, it's the rupture of lipid rich plaques that cause blood clots and sometimes sudden death.
In order to stop the progression of the disease, you need to dry up the lipid pools within your arteries and live a lifestyle which renews the health of your endothelial system.
In my opinion the main three things that will save you are the aggressive treatment of lipids with medications, daily exercise, and eating better.
If you get and keep your cholesterol well below 150, walk at least and hour per day, eat more greens, cut out the dairy, you can stop your disease and lead a normal life.
Also I see people that have had bypass surgery leading the same crazy life that they lead before. You need to relax and enjoy what's left of you life. No one on their death bed says they wished they would worked more.
You are at a point where you can walk away from all of this stuff and go forth and sin no more, or you can live your life as a heart patient with the doctors as your priests. They can prop your arteries open with metal tubes or split open your chest and bypass your arteries. You can sit in a big chair and take beta blockers and blood thinners and go to doctors every 2 months, or you can get your lipids real low and walk in the woods every day.
Good Luck.
The doctors will see a narrowing and stick a piece of metal in there. Your artery is not meant to have metal in it. That will just lead to more problems in the future and prevent you from returning yourself to health.
But these plaques in you arteries won't kill you, it's the rupture of lipid rich plaques that cause blood clots and sometimes sudden death.
In order to stop the progression of the disease, you need to dry up the lipid pools within your arteries and live a lifestyle which renews the health of your endothelial system.
In my opinion the main three things that will save you are the aggressive treatment of lipids with medications, daily exercise, and eating better.
If you get and keep your cholesterol well below 150, walk at least and hour per day, eat more greens, cut out the dairy, you can stop your disease and lead a normal life.
Also I see people that have had bypass surgery leading the same crazy life that they lead before. You need to relax and enjoy what's left of you life. No one on their death bed says they wished they would worked more.
You are at a point where you can walk away from all of this stuff and go forth and sin no more, or you can live your life as a heart patient with the doctors as your priests. They can prop your arteries open with metal tubes or split open your chest and bypass your arteries. You can sit in a big chair and take beta blockers and blood thinners and go to doctors every 2 months, or you can get your lipids real low and walk in the woods every day.
Good Luck.
I have also had a heart attack and I wasn't even aware of it (a silent heart attack) sometime in my 20's. I am curious - how much damage did you have from your heart attacks? Do you know what your EF is? What kind of long-term prognosis do you have?
Hi
Thanks for the response and advice. It sounds like you have had your fair share of troubles. You may be correct with the colder weather, I hadn't thought of that. I've had a hysterectomy, so that co-relation does not exist. I have the angina daily, but it comes and goes and peaks and valleys in pain level. The heart attack was not so much painful as it was uncomfortable. It felt like I was choking and that an elephant was on my chest. The day before the heart attack I was not feeling well at all and it felt like a huge gas bubble was stuck across my chest, shoulder to shoulder. I went to a wedding reception that day and danced my butt off and no one would have known I was feeling crappy. I was probably lucky I didn't have the heart attack then instead of the next day, but the dancing did not seem to have an effect on my chest discomfort. I only found I was more tired than usual.
Other than the seriousness involved, I would rather have a heart attack or a hysterectomy again before I'd ever want to have another kidney stone or give birth again. I consider those things painful, where heart attack and hysterectomy are more uncomfortable than they were painful.
The only day recently that I have had that was completely without chest discomfort was last weekend. I tried and tried to figure out what I had done differently that kept me pain free. I was beginning to think it was a GI problem and that maybe I had eaten something different. But, I came to the conclusion that I had actually done nothing all day but work on a school project with my daughter. I had no physical or emotional stress. That is the only thing that was different. I don't plan on living my life sitting on my *** all day, so I hope my problem is soon sorted out.
Although I could live with this discomfort if I had to, I hate having my life up in the air all of the time. I also hate the exhaustion that comes with either the meds or my physical condition. I'm only back to work 3 days per week yet and that's exhausting me. Having 4 children, 3 step children and a full time job was not always easy, but I could handle it without being as tired as I am now only working 3 days per week.
I appreciate your comments and hope the best for you.
Thanks, Janne
Thanks for the response and advice. It sounds like you have had your fair share of troubles. You may be correct with the colder weather, I hadn't thought of that. I've had a hysterectomy, so that co-relation does not exist. I have the angina daily, but it comes and goes and peaks and valleys in pain level. The heart attack was not so much painful as it was uncomfortable. It felt like I was choking and that an elephant was on my chest. The day before the heart attack I was not feeling well at all and it felt like a huge gas bubble was stuck across my chest, shoulder to shoulder. I went to a wedding reception that day and danced my butt off and no one would have known I was feeling crappy. I was probably lucky I didn't have the heart attack then instead of the next day, but the dancing did not seem to have an effect on my chest discomfort. I only found I was more tired than usual.
Other than the seriousness involved, I would rather have a heart attack or a hysterectomy again before I'd ever want to have another kidney stone or give birth again. I consider those things painful, where heart attack and hysterectomy are more uncomfortable than they were painful.
The only day recently that I have had that was completely without chest discomfort was last weekend. I tried and tried to figure out what I had done differently that kept me pain free. I was beginning to think it was a GI problem and that maybe I had eaten something different. But, I came to the conclusion that I had actually done nothing all day but work on a school project with my daughter. I had no physical or emotional stress. That is the only thing that was different. I don't plan on living my life sitting on my *** all day, so I hope my problem is soon sorted out.
Although I could live with this discomfort if I had to, I hate having my life up in the air all of the time. I also hate the exhaustion that comes with either the meds or my physical condition. I'm only back to work 3 days per week yet and that's exhausting me. Having 4 children, 3 step children and a full time job was not always easy, but I could handle it without being as tired as I am now only working 3 days per week.
I appreciate your comments and hope the best for you.
Thanks, Janne
Here are a few more random thoughts... Janne, could your symptoms be getting worse with the cooler weather? That happened to me for several years... Also, I noticed angina symptoms were always worse before I got my period - and had it confirmed by my dr. that that was to be expected. Silly Sally, I am recalling now that I did have some angina in the middle of the night, but it was related to having the tachy at that time. It was actually the most painful angina I ever had. Wonder if a 30-day monitor would help explain what is going on...
I don't know.... I have had a heart attack while also having serious mitral valve problem.... It was a surprise to me but the heart attack did not feel like an elephant sitting on my chest. On a scale of 1-10, 10 being the most painful, I would rate it at 4. (I've read that women don't experience as much pain as men... wonder if we aren't just more used to pain!) I was short of breath but did not sweat. I could walk around and communicate with people without their knowing anything was wrong with me - no collapsing. This heart attack knocked out my circumflex system. After the heart attack, I had angina just driving on the NYS thruway and seeing a trooper's car behind me or waiting in a long line of cars with the gas tank near empty. I also felt angina while walking up a very slight incline for like 1 minute to get to my car. But Janne, I would take seriously the pain you had when your heart was beating fast. I had SV tachycardia from the valve problem, and when I was sloppy about taking meds (Toprol and Verapamil)and started having tachy, the angina would start in. I would have the angiogram if I were you... you could have the test just to know what is going on and specify that you want to decide later about action you wanted to take if there were a problem. Eventually, my angina subsided. My body recovered, and I can walk for miles now and rollerblade too. (My mitral valve was replaced too, which really helped my energy, SOB,and I feel lucky.) Take care both of you. I hope my post might have helped in some way!
Hi SillySally
I can relate to what you are going through. I had a heart attack (LAD blockage fixed with stent) in June. I am a 39 year old female, also with children. I have had on-going angina since shortly after the attack and even though I'm not an anxious person normally, I do not want my children finding me on the floor someday or growing up without their mother. Having my 9 year old watch me while I had my heart attack was bad enough.
With the except that I used to smoke, I have no risk factors. My angina is similar to yours, with the exception of the fact I do not tend to have it while I'm sleeping. The odd time recently I have noticed shortness of breath while in bed with a sinking feeling/pressure in my chest, but an extra pillow seemed to help.
My symptoms are increasing over the past few weeks in frequency and intensity. My gut instinct says there is something wrong, but I'm trying to be objective thinking that maybe it's just in my head. I had a treadmill stress test in July that showed myocardial ischemia. The cardiologist wanted to go straight to an angiogram. I requested that I have a thallium stress test first to rule out a false positive. Even though some of my symptoms are typical, some are atypical (Like you, I can exercise and not necessarily have angina), and I was hoping if the thallium test was negative, I would feel better mentally and that the chest discomfort would eventually go away.
I had the thallium test in Sept and it was negative with the exception of a few abnormal "findings" on the ecg part that went away quickly afterwards.
Now, I am left with the decision to have an angiogram or not. I really don't want to have one if this chest discomfort and shortness of breath is anxiety related. But, I'd also like to have confirmation of what is going on inside. I have received various opinions from the cardiologists I get sent to. Some look at me like it's in my head (GI problems have been ruled out) and some think there is another blockage and I should have the angiogram.
I hate to waste our health care money on an unnecessary test when so many people are on waiting lists, yet I want to put an end to this. One cardiologist said my case is unusual to begin with (my age and lack of risk factors) so it would not surprise him that I am presenting with some atypical symptoms and still have a blockage.
Although I can do 20 or more laps around the track and 15 minutes on the elliptical machine at the cardiac rehab and not have chest discomfort (or sometime have it shortly afterwards), I find things like folding laundry, hanging laundry, dusting etc. (arm movement activity) provokes the discomfort most of the time. Chest wall problems have also been ruled out...maybe I'm allergic to housework haha.
The shortness of breath has only started in the past month or so, and comes and goes sometimes when I'm just sitting or talking to someone. The chest discomfort feels like food is stuck in my neck, throat and chest and off and on I feel like there is a small person sitting on my chest (as opposed to the elephant on my chest during the heart attack). Nitro works well, but sometimes takes a few sprays to get rid of the discomfort. I'd be interested to know if your symptoms were/are similar. I know the thallium test has an approx. 90-95% accuracy rate, but I'd also be interested to know how many people that read this have passed a thallim test and a blockage was found through angiogram shortly after.
The other thing I noticed was a problem when I was taken off the metoprolol (50mg twice per day). I was taken off it for the stress test for 24 hours about 6 weeks ago and didn't experience any symptoms. But, about a week ago, I ran out and the pharmacy was closed and I missed it for 24 hours and had a lot of symptoms. My resting heart rate is about 42-48 bpm and blood pressure is about 100/60, so I wasn't concerned about waiting 'till the pharmacy was open.
I ended up having to leave work early that day to fill the 'script because I felt like my heart was pounding out of my chest, my heart rate was 90bpm and my chest discomfort was the same type and area as I usually have, but much more intensified. I also had increased shortness of breath and slight tingling in my left arm. I debated whether I was having another heart attack and I was in denial, or if it was withdrawal from the medication. I thought it was too much a coincidence that I had the symptoms after missing the meds, so I took my chances and went to the pharmacy. Shortly after I took the medication, things settled down to normal (normal for me anyway). I know that the increased heart rate can be a withdrawal symptom, but I have to wonder if the chest discomfort was too or was it an indication that the metoprolol is masking a blockage. Strange that I didn't experience any symptoms when off the medication a month ago.
Anyway, I thought I'd write to you and let you know that you are not alone. I think there are many of us out here who are going through similar things and this forum certainly helps to bounce ideas off of other people and learn more about our bodies. You mentioned that you passed stress tests with a blockage. Did you have a thallium test?
Take care, Janne
I can relate to what you are going through. I had a heart attack (LAD blockage fixed with stent) in June. I am a 39 year old female, also with children. I have had on-going angina since shortly after the attack and even though I'm not an anxious person normally, I do not want my children finding me on the floor someday or growing up without their mother. Having my 9 year old watch me while I had my heart attack was bad enough.
With the except that I used to smoke, I have no risk factors. My angina is similar to yours, with the exception of the fact I do not tend to have it while I'm sleeping. The odd time recently I have noticed shortness of breath while in bed with a sinking feeling/pressure in my chest, but an extra pillow seemed to help.
My symptoms are increasing over the past few weeks in frequency and intensity. My gut instinct says there is something wrong, but I'm trying to be objective thinking that maybe it's just in my head. I had a treadmill stress test in July that showed myocardial ischemia. The cardiologist wanted to go straight to an angiogram. I requested that I have a thallium stress test first to rule out a false positive. Even though some of my symptoms are typical, some are atypical (Like you, I can exercise and not necessarily have angina), and I was hoping if the thallium test was negative, I would feel better mentally and that the chest discomfort would eventually go away.
I had the thallium test in Sept and it was negative with the exception of a few abnormal "findings" on the ecg part that went away quickly afterwards.
Now, I am left with the decision to have an angiogram or not. I really don't want to have one if this chest discomfort and shortness of breath is anxiety related. But, I'd also like to have confirmation of what is going on inside. I have received various opinions from the cardiologists I get sent to. Some look at me like it's in my head (GI problems have been ruled out) and some think there is another blockage and I should have the angiogram.
I hate to waste our health care money on an unnecessary test when so many people are on waiting lists, yet I want to put an end to this. One cardiologist said my case is unusual to begin with (my age and lack of risk factors) so it would not surprise him that I am presenting with some atypical symptoms and still have a blockage.
Although I can do 20 or more laps around the track and 15 minutes on the elliptical machine at the cardiac rehab and not have chest discomfort (or sometime have it shortly afterwards), I find things like folding laundry, hanging laundry, dusting etc. (arm movement activity) provokes the discomfort most of the time. Chest wall problems have also been ruled out...maybe I'm allergic to housework haha.
The shortness of breath has only started in the past month or so, and comes and goes sometimes when I'm just sitting or talking to someone. The chest discomfort feels like food is stuck in my neck, throat and chest and off and on I feel like there is a small person sitting on my chest (as opposed to the elephant on my chest during the heart attack). Nitro works well, but sometimes takes a few sprays to get rid of the discomfort. I'd be interested to know if your symptoms were/are similar. I know the thallium test has an approx. 90-95% accuracy rate, but I'd also be interested to know how many people that read this have passed a thallim test and a blockage was found through angiogram shortly after.
The other thing I noticed was a problem when I was taken off the metoprolol (50mg twice per day). I was taken off it for the stress test for 24 hours about 6 weeks ago and didn't experience any symptoms. But, about a week ago, I ran out and the pharmacy was closed and I missed it for 24 hours and had a lot of symptoms. My resting heart rate is about 42-48 bpm and blood pressure is about 100/60, so I wasn't concerned about waiting 'till the pharmacy was open.
I ended up having to leave work early that day to fill the 'script because I felt like my heart was pounding out of my chest, my heart rate was 90bpm and my chest discomfort was the same type and area as I usually have, but much more intensified. I also had increased shortness of breath and slight tingling in my left arm. I debated whether I was having another heart attack and I was in denial, or if it was withdrawal from the medication. I thought it was too much a coincidence that I had the symptoms after missing the meds, so I took my chances and went to the pharmacy. Shortly after I took the medication, things settled down to normal (normal for me anyway). I know that the increased heart rate can be a withdrawal symptom, but I have to wonder if the chest discomfort was too or was it an indication that the metoprolol is masking a blockage. Strange that I didn't experience any symptoms when off the medication a month ago.
Anyway, I thought I'd write to you and let you know that you are not alone. I think there are many of us out here who are going through similar things and this forum certainly helps to bounce ideas off of other people and learn more about our bodies. You mentioned that you passed stress tests with a blockage. Did you have a thallium test?
Take care, Janne
Healthyself,
So,if you had to go back and do it over would you have gone through with the procedures? I
MEDICAL PROFESSIONAL
sally, i've looked back at your post.
Its difficult to tell what is causing your symptoms, given you have coronary disease.
To simplify a angina classification to you:
Stable angina refers to people with set blockages that cause flow limitation of blood with increasing demands such as exercise. Rest or nitro can relieve the symptoms. The symptoms are reproducible and do not vary or increase over long periods of time.
Unstable angina refers to people with a plaque in the artery that has become unstable. These symptoms can feel the same as stable angina but are new in occurence, occur with increasing frequency, occur for longer periods of time, occur with less exertion or occur at rest. This type of angina can be a warning sign for a heart attack.
variant, prinzmetals or vasospasm refers to a hyperreactivity of the artery that cases spasm. this can occur in the setting of known coronary disease or normal arteries and typicall occurs in younger women. This presents as sporadic pain.
If the thought is you have vasospasm, the treatment would be increased doses of calcium channel and beta blockers in addition to nitrates.
If it is unclear where your angina is originating from then you need another catheterization to evaluate your stents. If everything is 'open' that might support vasospasm.
remember also alot of other things including GI and musculoskeletal pain can sometimes mimic angina, but these are diagnosis of exclusion.
hope this is a start
Its difficult to tell what is causing your symptoms, given you have coronary disease.
To simplify a angina classification to you:
Stable angina refers to people with set blockages that cause flow limitation of blood with increasing demands such as exercise. Rest or nitro can relieve the symptoms. The symptoms are reproducible and do not vary or increase over long periods of time.
Unstable angina refers to people with a plaque in the artery that has become unstable. These symptoms can feel the same as stable angina but are new in occurence, occur with increasing frequency, occur for longer periods of time, occur with less exertion or occur at rest. This type of angina can be a warning sign for a heart attack.
variant, prinzmetals or vasospasm refers to a hyperreactivity of the artery that cases spasm. this can occur in the setting of known coronary disease or normal arteries and typicall occurs in younger women. This presents as sporadic pain.
If the thought is you have vasospasm, the treatment would be increased doses of calcium channel and beta blockers in addition to nitrates.
If it is unclear where your angina is originating from then you need another catheterization to evaluate your stents. If everything is 'open' that might support vasospasm.
remember also alot of other things including GI and musculoskeletal pain can sometimes mimic angina, but these are diagnosis of exclusion.
hope this is a start
I had a heart attack 4 1/2 years ago at 49. The first attempt at Angioplasty failed to open my totally occluded Right Coronary Artery. I also had a 70% or so blockage in my circumflex and some other anomalies.
I had insurance and was urged to have bypass surgery. After reading a lot about it and considering it, I decided that I would attempt to manage the disease with cholesterol and bp therapy, diet, exercise, and lifestyle changes. With an average life of 7 years, I just couldn't see having bypass at 49 years old and facing it again at 56 or so. Perhaps if they could have used the mammary artery it would be longer, but I would still be facing it again in the future.
3 years ago I agreed to an experimental angioplasty to open my occluded artery, attempt to stent the circumflex artery. That ended 10 minutes after it started when it was discovered that a previously undiscovered plaque in my left main had ruptured and "cratered" since my last angiogram.
Again, I was urged to have bypass surgery and given a very poor prognosis with a high risk of sudden death within the next few years, if I didn't have the surgery.
By then, I had fine tuned my meds, had a cholesterol level of 130, a good daily exercise program, and felt pretty good, so I again declined the surgery.
Since then I have just given up on the idea of having any stenting or bypass surgery and have just concentrated on managing the disease as a chronic condition.
I have maintained my cholesterol between 110 and 130 and raised my HDL 50% by taking a cocktail of cholesterol meds exercising and eating a little more green, much less meat, and no dairy.
I feel that I have gained a little on the disease over the years. At this point I feel perfectly normal - not like a heart patient at all. I have great physical ability, and don't feel at high risk for another cardiac event. The last angiogram showed that my RCA blockage was now well collateralized, so the body does in fact heal itself given the opportunity.
I have learned a few things:
1. Stents are forever - don't take one if you think that you can do the right things to reverse the disease.
2. Beta Blockers, diuretics, and blood thinners are counterproductive for healthy active people.
3. Don't wait for doctors to get you on the right meds. You need to take as many meds as it takes to aggressively control cholesterol and BP. Hopefully you have a good liver. If you can keep total cholesterol well below 150, raise your HDL, get your weight down, and keep physically active, you can manage even severe end stage disease like I have.
The meds are not rocket science. The most effective statins are Lipitor, Crestor, and to a lesser extent Zocor. You should be on one if you can tolerate it. Niaspan is about the only current treatment to raise HDL. Raising HDL is the most important thing that you can do, so you should be on Niaspan if you have severe disease. You can add Welchol or Zetia as a third drug as needed.
4. The most important other thing that you can do is daily exercise. I walk 1 1/2 hours every day that I work and hike or ski on the weekends. I take the summers off and hike about 10,000' of elevation per week and 35 miles or so.
5. Then if you really want to live you can get down close to an ideal body weight. Don't use the Atkins diet. Eat plenty of greens, cut out all dairy, reduce the meat drastically.
And I have learned to never say never. There may be a point in the future that I will accept bypass surgery to save my life, if there is no other choice or I am very limited physically.
I do think that there will be better treatments to raise HDL in the next few years, perhaps even 1 shot genetic treatments. Of course that would kill a $50 billion industry, so it might not happen.
Also there will be much less traumatic methods of revascularization. On pump full chest open heart will be a thing of the past. So it will be good to keep pushing that date with the surgeon down the road as many years as possible.
So even people with plenty of insurance might not be smart to have pieces of metal stuck in their coronary arteries or their chest split open and veins grafted around their coronary arteries.
Good Luck To All.
I had insurance and was urged to have bypass surgery. After reading a lot about it and considering it, I decided that I would attempt to manage the disease with cholesterol and bp therapy, diet, exercise, and lifestyle changes. With an average life of 7 years, I just couldn't see having bypass at 49 years old and facing it again at 56 or so. Perhaps if they could have used the mammary artery it would be longer, but I would still be facing it again in the future.
3 years ago I agreed to an experimental angioplasty to open my occluded artery, attempt to stent the circumflex artery. That ended 10 minutes after it started when it was discovered that a previously undiscovered plaque in my left main had ruptured and "cratered" since my last angiogram.
Again, I was urged to have bypass surgery and given a very poor prognosis with a high risk of sudden death within the next few years, if I didn't have the surgery.
By then, I had fine tuned my meds, had a cholesterol level of 130, a good daily exercise program, and felt pretty good, so I again declined the surgery.
Since then I have just given up on the idea of having any stenting or bypass surgery and have just concentrated on managing the disease as a chronic condition.
I have maintained my cholesterol between 110 and 130 and raised my HDL 50% by taking a cocktail of cholesterol meds exercising and eating a little more green, much less meat, and no dairy.
I feel that I have gained a little on the disease over the years. At this point I feel perfectly normal - not like a heart patient at all. I have great physical ability, and don't feel at high risk for another cardiac event. The last angiogram showed that my RCA blockage was now well collateralized, so the body does in fact heal itself given the opportunity.
I have learned a few things:
1. Stents are forever - don't take one if you think that you can do the right things to reverse the disease.
2. Beta Blockers, diuretics, and blood thinners are counterproductive for healthy active people.
3. Don't wait for doctors to get you on the right meds. You need to take as many meds as it takes to aggressively control cholesterol and BP. Hopefully you have a good liver. If you can keep total cholesterol well below 150, raise your HDL, get your weight down, and keep physically active, you can manage even severe end stage disease like I have.
The meds are not rocket science. The most effective statins are Lipitor, Crestor, and to a lesser extent Zocor. You should be on one if you can tolerate it. Niaspan is about the only current treatment to raise HDL. Raising HDL is the most important thing that you can do, so you should be on Niaspan if you have severe disease. You can add Welchol or Zetia as a third drug as needed.
4. The most important other thing that you can do is daily exercise. I walk 1 1/2 hours every day that I work and hike or ski on the weekends. I take the summers off and hike about 10,000' of elevation per week and 35 miles or so.
5. Then if you really want to live you can get down close to an ideal body weight. Don't use the Atkins diet. Eat plenty of greens, cut out all dairy, reduce the meat drastically.
And I have learned to never say never. There may be a point in the future that I will accept bypass surgery to save my life, if there is no other choice or I am very limited physically.
I do think that there will be better treatments to raise HDL in the next few years, perhaps even 1 shot genetic treatments. Of course that would kill a $50 billion industry, so it might not happen.
Also there will be much less traumatic methods of revascularization. On pump full chest open heart will be a thing of the past. So it will be good to keep pushing that date with the surgeon down the road as many years as possible.
So even people with plenty of insurance might not be smart to have pieces of metal stuck in their coronary arteries or their chest split open and veins grafted around their coronary arteries.
Good Luck To All.
I'm not panicking-yet. You guys have hit the nail on the head about one thing though. I go for several days without incident and almost forget my CAD then when an angina attack suddenly hits I remember I'm not 'normal' anymore. 'Normal' people who would have the symptoms I do would call 911 and rush into the ER. But I'm walking around with nitro in my pocket, driving Mom's taxi after school every day and counting on the nitro working if I have to pull over in rush hour traffic and take one on the way to dance class. And thank God for cell phones.
It's a little unnerving to live like JDM describes - the fine line comment about the difference between angina and heart attack. Which am I? Should I be making sure my affairs are in order in case I'm the walking time bomb, or will my adherence to my routines of yoga, meditation, prayer, stress relief, better diet, exercise, etc. etc. pay off? I don't have anxiety attacks, but I do sometimes worry that my kids will walk in the door from the bus someday and find me on the floor. For now, I just keep going day to day, keeping the faith, and making babysteps in the right direction.
There's a a couple of annoying things about life with CAD. One is - I can't see within my own body without my insurance company forking out $20K for an angiogram. If I go into the ER they slap the IV in and start injecting heparin, etc. and taking blood before I can say boo. I pass the stress tests, the ECGs are completely normal, but when they get to the cath they can finally see the blockages. There's just no way to definitively see without the cath, and I've now had three of those, and two stents in the LAD. The last inpatient visit, from 6:30 a.m. to 9:00 a.m. the next day was $40K!! (and they didn't even give me breakfast!)
Two - You can't get two cardiologists even in the same room to agree on anything. The last time I visited ER I had 3 of them, the last inpatient visit 3 more. All different partners from the same practice. One Dr said, do the cath, another said, don't do it. One Dr said, place the stent, another said, "I don't recommend it." And then they ask me for permission? I tell you what, I'm reading everything I possibly can find about this disease so that as I go through this with the docs I am informed to the best extent possible. They see me for 30 minutes in the office, but I live with my body 24/7. I am really listening to my body right now and trying to observe patterns, anything that can give the Drs more data.
The most depressing thing was waking up the morning after the 2nd stent was placed in my LAD 4 weeks ago and having the angina happening again just like before. They did an ECG just after each pain, but everything was normal. I wish they could have caught it when it was happening, instead of just after.
I guess had somewhat blindly assumed that an angiogram and stent would take care of it. Unfortunately, I am worse off than before - the angina is more frequent, more intense and now after I had that night off the Isosorbide accidentally - I know I can't live without the nitro at the moment, period. Perhaps it's temporary, perhaps it's just spasms of some sort, but how will I know? Another cath? Arrgggh!
I think I'm just venting now. I must remind myself to be patient and see if things get better, one day at a time....
It's a little unnerving to live like JDM describes - the fine line comment about the difference between angina and heart attack. Which am I? Should I be making sure my affairs are in order in case I'm the walking time bomb, or will my adherence to my routines of yoga, meditation, prayer, stress relief, better diet, exercise, etc. etc. pay off? I don't have anxiety attacks, but I do sometimes worry that my kids will walk in the door from the bus someday and find me on the floor. For now, I just keep going day to day, keeping the faith, and making babysteps in the right direction.
There's a a couple of annoying things about life with CAD. One is - I can't see within my own body without my insurance company forking out $20K for an angiogram. If I go into the ER they slap the IV in and start injecting heparin, etc. and taking blood before I can say boo. I pass the stress tests, the ECGs are completely normal, but when they get to the cath they can finally see the blockages. There's just no way to definitively see without the cath, and I've now had three of those, and two stents in the LAD. The last inpatient visit, from 6:30 a.m. to 9:00 a.m. the next day was $40K!! (and they didn't even give me breakfast!)
Two - You can't get two cardiologists even in the same room to agree on anything. The last time I visited ER I had 3 of them, the last inpatient visit 3 more. All different partners from the same practice. One Dr said, do the cath, another said, don't do it. One Dr said, place the stent, another said, "I don't recommend it." And then they ask me for permission? I tell you what, I'm reading everything I possibly can find about this disease so that as I go through this with the docs I am informed to the best extent possible. They see me for 30 minutes in the office, but I live with my body 24/7. I am really listening to my body right now and trying to observe patterns, anything that can give the Drs more data.
The most depressing thing was waking up the morning after the 2nd stent was placed in my LAD 4 weeks ago and having the angina happening again just like before. They did an ECG just after each pain, but everything was normal. I wish they could have caught it when it was happening, instead of just after.
I guess had somewhat blindly assumed that an angiogram and stent would take care of it. Unfortunately, I am worse off than before - the angina is more frequent, more intense and now after I had that night off the Isosorbide accidentally - I know I can't live without the nitro at the moment, period. Perhaps it's temporary, perhaps it's just spasms of some sort, but how will I know? Another cath? Arrgggh!
I think I'm just venting now. I must remind myself to be patient and see if things get better, one day at a time....
I like the way you think!
sillysally--I am just starting down the angina road--yet have the best lipid profile you ever saw. The doc is thinking cardiac syndrome X as the cause. Won't know until it is fully evaluated. In the meantime, I have my little nitro bottle at my side, but my Ace inhibitor for the most part is keeping me pain free. The doc here commented on the fact that there are some new studies using Ace inhibitors to treat microvascular spasms.
Wonder if that is what you have, in addition to your CAD? Seems that a chief symptom is angina at rest, particularly at night.
sillysally--I am just starting down the angina road--yet have the best lipid profile you ever saw. The doc is thinking cardiac syndrome X as the cause. Won't know until it is fully evaluated. In the meantime, I have my little nitro bottle at my side, but my Ace inhibitor for the most part is keeping me pain free. The doc here commented on the fact that there are some new studies using Ace inhibitors to treat microvascular spasms.
Wonder if that is what you have, in addition to your CAD? Seems that a chief symptom is angina at rest, particularly at night.
Several questions for anyone who cares to express an opinion or relate experiences. Angina indicates severe blockage of coronary arteries-correct? If this is the case then why do angina patients not receive bypass operations?
Some people get angioplasties, some get stents, some get bypasses, some get other treatments and many get no treatment at all. Is the triage decision based on need or the need/ability to pay quotient? It seems mighty easy to hand a person with angina a bottle of nitroglycerin tablets. That "treatment" must be over a hundred years old now.
If a person has angina and lots of money can that person buy themselves a bypass instead of gulping nitro and enduring less secure solutions such as stents-even if they would not "medically" be considered a candidate?
It seems to me that it is a very fine line that divides a night of recurrent and severe angina and a heart attack. Is the heart attack when the nitro fails to make the pain subside? Then the person goes to the ER with continuous pain. Is this continuous angina pain then a heart attack?
What are mortality expectations due to fatal heart attacks for a group of angina sufferers vs a similar aged group of non-sufferers?
How do angina patients manage what for some must be enormous difficulty with panic/anxiety attacks?
Just curious.
Some people get angioplasties, some get stents, some get bypasses, some get other treatments and many get no treatment at all. Is the triage decision based on need or the need/ability to pay quotient? It seems mighty easy to hand a person with angina a bottle of nitroglycerin tablets. That "treatment" must be over a hundred years old now.
If a person has angina and lots of money can that person buy themselves a bypass instead of gulping nitro and enduring less secure solutions such as stents-even if they would not "medically" be considered a candidate?
It seems to me that it is a very fine line that divides a night of recurrent and severe angina and a heart attack. Is the heart attack when the nitro fails to make the pain subside? Then the person goes to the ER with continuous pain. Is this continuous angina pain then a heart attack?
What are mortality expectations due to fatal heart attacks for a group of angina sufferers vs a similar aged group of non-sufferers?
How do angina patients manage what for some must be enormous difficulty with panic/anxiety attacks?
Just curious.
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