Soreness and Angina Pain after Angioplasty

[Paul54]

Hi, I am a 54 years old. I have never smoked, am quite active but a little obese, no diabetes, nor have high bad cholesterols/triglyceride.

Seven weeks ago, in the middle of the night, I had gripping pain in both my wrists, which then  spread to my chest. My blood pressure (amazingly and for the first time in my life), shot up from my regular 130/90 to 200/120, and that too for no known reason. Pulse remained normal at 75/m. At my doctor's clinic, I was given anti-hypertensive drugs, but BP refused to come down. At CCU in hospital, I was diagnosed with having had a minor heart attack. Angiography showed a 90% blockage in the right coronary artery. Two medicated stents were later inserted. Presently, I am regularly taking Asprin, Clopedogrel, Rosuvastatin, Atenolol and Amlodipine. My blood pressure, except for once shooting up to 170/110, remains around 125/85. I am now fully active. How this happened ?

Now, I have again started having low grade pain in the left wrist and forearm, without any corresponding pain in the upper arm or the chest. Can this be a Referred Angina Pain? Is it possible to have pain when there is no pain at the source or along its supposed pathway?

Also, I am regularly  feeling soreness and pain coming from inside the body, in the region of the heart only. Why ?

I shall be grateful to know the reasons and solutions to the above problems, so that I can discuss it with my cardiologist.

Thanks,
Paul.

[Darcy Green Conaway, MD]

Hi Paul-
Pain can often be very strange when it comes to cardiac pain. Although hand pain is not typical, many patients have what we call "atypical pain" and end up having coronary artery disease.
Likely you have been hypertensive for quite some time and not known it.

Anytime I see a patient who has a return of atypical chest pain after presenting with atypical chest pain and been found to have a heart attack in that setting I consider a repeat cardiac catheterization. I think you see your cardiologist as soon as possible.

[Paul54]

Thanks for your advice. I checked out with my cardiologist and he felt it was not a cardio related problem. Since I have Cervical Spodylosis, I am being treated for that with neck exercises and the pain in my arm seems to have reduced.

Presently, post MI and post PCI, I am daily taking  Asprin, Clopedogrel, Rosuvastatin, Atenolol and Amlodipine. If I were your patient, what else would you have added or deleted ?

Also, I will be grateful to have your opinion, even if it were a off-hand guess, as to what in the first place could have made my BP go up from the regular 130/90  to 200/120 and cause the heart attack (or vice-versa) ? Yes I am hypertensive for last 3 years, but it was/is always well controlled with medication.

Thank you, Doctor, for your advice and time and looking forward to your reply.

Regards,

Paul.

[Nissy422]

For approximately one week when I take a deep breath, I experience tightness and discomfort in my upper chest, however mostly in my throat where my thyroid is located.
When I tighten my abdominal muscles and take a deep breath, I don't feel this discomfort.  And, when I drink something cold, it seems to dissipate, as well. It is not as comfortable to lie down, either.  I have been sleeping late in the mornings for some time and am not sure why.  I do have an infection or something going on in my lower gum area that I will be having checked by my dentist this week or next.
Thanks so much for any thoughts you can offer.
Gods blessings,
Susan