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angina after heart attack

Thank you for this great forum.
History: 39 yr old female, 15 pounds over weight, blood pressure fine, cholesterol fine, no other health problems, no family history of heart problems, smoker for past 7 years.
About 6 weeks ago I had a heart attack with 90% blockage LAD.  A stent was placed and I was put on blood pressure med, cholesterold med, plavix as well as a few other meds. About a week to 10 tens after the heart attack, I began having brief periods of shortness of breath.  Shortly after that, I began having the similar symptoms (but to a much lesser degree) that I had the day of the heart attack.  I have a sqeezing sensation almost like when food is stuck in one's throat and chest.  My left arm would tingle off and on.  None of this was painful, but my GP was concerned the stent was blocking.  Nitro spray helped, but only briefly.  The only thing that cleared the slight pressure feeling in my chest and unusual choking feeling was IV nitro. EKG was fine.  I have not heard results of treadmill stress test yet, but I assume it was fine.
I was released from the hospital with no diagnosis and put on the nitro patch (doesn't fix completely).
They did not want to do another angiogram as the cardiologist felt that it was not a stent blocking up because he said that never happens as a gradual thing, but only occurs suddenly. I honestly had the impression he felt it was in my head.
Any idea as to what would cause these chest and neck symptoms? GI tests ok. Can EKG and stress test be normal if something is wrong? Why at my age did I have a heart attack?
12 Responses
239757 tn?1213813182

As you can see by the brisk response, there are alot of people that wonder, "why did I have a heart attack?"  The psychological impact is often just as long lasting as the physical. The answers are often unknown. One big focus of research here at the clinic is looking into the genetic components that explain why you get a heart attack at age 37 and some other people never get one.  While the genetic components are unknown, several risk factors such as smoking and cholesterol are, and you should be vigilent about them. Homocyteine has been controversial, but it plays some role, is easily modifiable and is worth checking.

The answer to your other question about chest pain is difficult. While people who experience pain after a heart attack sometimes have pain that is psychological in origin, that needs to be a diagnosis of exclusion. There are several ways a stent can reocclude.  One is the reccurrence of a blood clot in the stent. This usually happens in the first 30 days and is related to the stent causing a clot. The occurence of this is rare, especially if you took your plavix. It would reappear as another heart attack, probably with very similar symptoms to your original event.

The other way stents can cause pain is by narrowing down with a type of scar tissue. This usually occurs slowly over several months and appears as anginal symptoms with exertion.  These are usually reproduced and will get worse with exertion.  

The only 100% way to see what is happening would be another angiogram. However, depending where the stent is placed, some people will do a stress test to see if there are areas in the heart that arent recieving blood because of narrowing of the stent. You should inquire about the results of your test, but im assuming it was negative from your statements.  

hope this helps.

Avatar universal
Many things can cause a heart attack in people at any age.Very over looked in today's medicine are Homocysteine levels which can damage the arterial linings and lead to heart attack and stroke. Also CRP (C-Reactive Protein) levels that are high cause inflamation and can cause unstable plaque to break away from an artery wall and block an already narrow artery causing a heart attack. Although scientists are getting the word out about measuring these blood levels as a regular practice in medicine. You should read up on how to lower these levels. Actually, half of all heart attack victims have normal cholesterol levels.

As far as your pain and tingling sensations. My father had a stent placed several years ago and still gets occasional pain in his chest and he's had EKG's and stress tests that were all normal. But it is possible for an EKG to not pick up a problem. Stress tests are more accurate, but also not 100%. A repeat catheterization would rule out new stenosis. It is possible that you have developed anxiety after your heart attack and that can certainly cause these symptoms.
Avatar universal
I'm a 35 M and had an MI in April.  You've probably done the research and found out that its not entirely clear why we had heart attacks.  I'm experiencing chest pain of apparently the "non-cardiac" variety.  GI tests are normal.  Since mine make me panicky, I'm approaching this from a mental health point of view.  I know its still kind of taboo, but we are at HUGE risk for anxiety, depression, etc. after a heart attack.  Keep up the good work on the physical, risk reduction side and don't ingnore the mental side.  Good Luck!
Avatar universal
Thanks Terry. I just finished my other long winded post and saw yours. I would really appreciate receiving your email address.
Thanks again.
Avatar universal

It is ***@**** - I would love to hear from you.

Avatar universal

I am sorry to hear about your problems.  I had a very similar situation but if you feel that you are having re-stenosis, please ask for a second opinion. I also had none of the traditional problems, ie high cholesteral, high BP, inactive, overweight.  I hope you have stopped your smoking because that can be a big factor in cardiac health.

My blockage was also in my LAD and I have since learned that everyone has some plaque in that artery.  I had a plaque rupture which caused the blockage but was lucky and didn't have a heart attack.

If you would like to talk somemore, please let me know and I will give you my e-mail address.  It is hard to find a women who has had the same problems (lucky us!)

Anyway, good luck and don't ignore your symptoms - keep pestering your Doctor till he gives you an answer or finds something to help.

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