Suspect heart condition deteriorating-Please advise

[nspower]

Just when I was begining to think that my heart condition is stabilizing (rather improving) after after a heart attack in 2007 which left my heart damaged with 30-35% EF, I am finding that something is going wrong with my heart.

In last one month I have noticed that I get pain in left side of my neck while walking (not always), intensity of which has increased in last one week.
What I am not able to understand is:

1.  During some walks I get the pain but sometimes for same length and speed of walk I do not get the pain.
2.  The pattern of BP and pulse remains same during and after walks and during resting.
3.  I neuclear stress test was negetive in October 2010.

Can this pain be because of low EF?
Because I was always told that if it is angina it shoiuld appear at each walk and it always increases pulse rate?


Thanks in advance for providing any explanation or advise..

[Occupant]

I don't know if this applies in your case, but I have neck problems off and on. It got so bad that for instance. when I took a walk the pain got so severe that I had so stop walking and stand  still for 10-15 minutes with my head held upright until the pain subsided enough for me to  continue the walk. The only remedy I was offered by the doctors was to get an epidural in my upper spine which I wasn't too keen of and declined.

[nspower]

Thanks for the insight.

I forgot to mention that:

1.  the pain in neck which appears during walking, disappears after 15-20 minutes of walking. This makes me believe that it may not be muscle-skeletal issue. Its intensity has increased in last week, which has worried me. The pain is also associated with some unpleasant sensation in left side of ribcage down to lowest rib.

2.  I have noticed that digsetion has some relationship with this pain. Although I keep a gap of two hrs after meals before walk, the digestion itself may sometimes take more time.

3.  I also feel there is some link between my bp when it is low.

I will try this nitro test you suggested.

The big question for me still remains "should I go for angiogram?"

[jrbon]

Let me go step by step:

1) The low EF it is not a justification for pain. I have a 23% without angina.
2) An stable angina (not the one that Ally mention) should appear under the same conditions, the problem is that are difficult to repeat: Humidity, Temperature, Wind, Time to digestion and to medication, clothing, effort...
3) If I were you I would do the nitro test .... when you get the pain, get a nitro pill, if the pain gets reduced, chances are that there is angina. If remains equal, I would think that it is not angina.
4) Keep in mind that pain in the neck can also be due to muscle-skeletal issues.

Jesus

Jesus

[nspower]

Thanks ChatterAlly and Ed34.

My condition is somewhat similar to what you have experienced except that my EF is low.
Looks like you have developed enough confidence to live with angina.

In my case with current angina episodes, I am afraid that I may end up having an heart attack. The cardiologist won't tell anything until he does angiogram.

How to decide that it is time to go to cardiologist or get an engiogram?

[ed34]

I never found my angina to be the same every day, in fact it was very different. I couldn't explain this and neither could the cardiologist. Some days I could walk a mile with no trouble at all, then others I could manage just a few paces. Maybe there are contributing factors that determine how strong the angina will be. For example, I did find that if my stomach had received food within 2 hours of starting the walk, the angina was a lot worse. Air temperature was another factor, the colder the air, the worse I felt. But it also worked the other way, if the air was very warm I would get short of breath.

[ChatterAlly]

"Because I was always told that if it is angina it shoiuld appear at each walk and it always increases pulse rate?"

I don't agree with that. I have heart spasms, or variant angina, and I do not ALWAYS get it with exercise.  I have days I feel I could run 5 miles and never get any angina,  and other days I have chest pains all day long and with exercise. I have nights were I sleep hard and sound and other nights when I wake up 4 or 5 times with angina.  I can't say whether my pulse rate changes, though. I never checked. But I don't seem to feel it racing.

Take care, Ally