Help please

[Sherrylynn41]

Several weeks ago I was diagnoised with having angina attacks. I researched every little piece of information I could get my hands or computer on and the diagnosis does not make sense. Everything I have read states angina is cause by coranary artery disease, which I do not have. I have had 4 heart caths in 2.5 years and they all showed my arteries are crystal clear. The chest pain that sent me to the dr. and subsequent treadmill test supposedly indicate angina upon exertion, however, 4 days ago I began having even worse chest pain while sitting or if I got stressed or upset. This pain has been worse than any I have ever had. I comes on gradually as a slight pain and build up to a terrible pressure and pain that lasts anywhere from 2-5 minutes and the pain burns as it lessens. Can mild mital and tricuspid regurg cause this type of pain? Has anyone here experienced this type of pain?

 

[M&M]

Hi Sherrylynn41, Sorry to hear about your chest pains. First I want to say: I'm not a doctor but if you've had 4 caths in 2 and half years - then I think your doc is checking things pretty good. The way you describe how the pain intensifies sounds alot like what I have experienced on and off over the course of many years.. I refer to them as coronary 'spasms' and they are very painful - and intensify over a course of minutes - it almost feels like a 'knot' in my chest or "charlie horse". You could always ask for 'nitro' and see if the pain subsides. I usually get them when I'm stressed out and for me they can come on for a couple weeks and then they are gone and then I won't get them again for another couple years. I don't know if this is what your experiencing - but good communication with your cardiologist is the key to finding out what is happening in your particular situation. Good Luck and keep us posted.

Marilyn

 

[Karlynn]

I'm wondering if you are having some gastric reflux. Sometimes the pain of bile and other stomach acids refluxing into the esophogus can cause angina-like pain. Have you tried taking an antacid when you start to get the pain. If it is GERD related and severe, the antiacid may not get rid of the pain, but it may lessen it enough to let you know if you're in the ball park.

Before my valve surgery I had several bouts of severe chest pain - which felt like a white hot burning. I could always tell when it was coming on because it started slowly and at it's peak the pain radiated into my ear and jaw. I made 3 trips to the ER and came back with my typical, arrhythmia laiden EKG's, but no reason for chest pain. I even had one bout of it while in the CICU during a week they took me off my meds to start me at square one. The doctos and nurses were stumped. I have not had that type of pain since my surgery. Both my doctor and I always felt it was stress-induced GERD. This was more than 15 years ago and there wasn't a tried and true medication that would have mixed with my antiarrhythmics I was taking. Now there are several options.

 

[Sherrylynn41]

Marilyn do you know what causes the spasams? Karlyn I hope it'ts not gerd. I had surgery for gerd 5 years ago before my first ohs. The pain is different and so is the burning. My surgeon then told me if I had any repeat symptoms to call him. That surgery, while no where near as extensive, in its own way was worse than ohs.

 

[joanne6]

Hi, I have had esophageal spams on and off for years. They feel like what you are experiencing. The bad ones are really bad. The one thing that really does help is nitroglycerin. It relaxes the esophagus just the way it does the heart muscle.
Hope you get some help soon. I rarely need the pills but I always take the ntg with me. I also have clear coronary arteries so we know it is not that.
Joanne

 

[hensylee]

for GERD (spasms - esophageal) get some liquid antacid. It provides instant relief, usually, and that would tell you it's GERD, perhaps. But if it keeps on happening, go see your doctor.

 

[tobagotwo]

Angina occurs when the heart is overtaxed or short on oxygen. Poor functioning of the heart can and does cause angina, as the heart also pumps blood to itself. Leaking in two valves can cause angina. I have perfectly clear coronary arteries, but had angina from my aortic stenosis.

Coronary Artery Disease is just one thing that can cause angina. It's the most common, so it's often all that's pointed out on websites for patient use.

I find it alarming that you have had four catheter angiograms in 2½ years. Unless there is a specific need for a catheterization, a noninvasive echocardiogram is the most common method of determining valve status. I would seriously consider looking for a new cardiologist, or at least a second opinion before agreeing to any more of those. That just strikes me as a very unusual number of caths in a short span. Also realize that if your arteries are clear, they are not going to suddenly develop severe CAD in six months or a year without some terrible illness. In fact, they are likely to stay quite clear through most of your life, barring severe lifestyle abuse, and if they change, it will be quite slowly.

That aside, it is reasonable to pursue the possibility of GERD. Within the limited description of it in the posting, it is as reasonable an hypothesis as angina.

Best wishes,

 

[M&M]

Sherrylynn, I found for me - STRESS - caused my coronary spasms. Since I have a main artery that is 60-70% blocked - and I've had a prior heart attack - I really need to calm the arteries down when it happens. So I take medicine for it (can't remember what it is) but my cardio looks up my records and there it is and I know whatever it is it works great - I take it every couple years as the spasms come every couple years. My stress level must 'build' over time. For me I know its 'stress'. I find a good soak in a hot tub helps me but med works the best - the key is to not get stressed to begin with !!!! Holidays are very stressful and working full time and dealing with my CHF and ICD and Mechanical Mitral Valve and now a son-in-law is stationed n Iraq - I think I may be due for some spasms soon - so I guess - I'll not be surprised if they come on again. As I keep telling myself and I sing the song:

"Its the most wonderful time of the year" !!!

Best
Marilyn

 

[Georgia]

For several years before ohs I had really bad cramping in my back - lying down would relieve it; stress exacerbated it.

Found out it was "atypical" angina. Haven't had a single "back cramp" since surgery.

So, yes, I would guess that mitral valve problems can cause it.

 

[ALCapshaw2]

Hello Sherrylynn,

It sounds like you need a better diagnosis.

GERD (GastroEsophageal Reflux Disease) is certainly something that should be checked. It CAN cause severe chest pain that is indistinguishable from Heart Disease. It may be worthwhile to get a referal to a GastroEnterologist who could check your esophagus, lower esophageal sphincter, and stomach for problems by doing an upper endoscopy (been there, done that, serveral times). With enough Versed and Demerol, you won't feel or remember a thing.

Have you had an Echocardiogram? This will show the condition of your valves and may also be used to check for an aneurism which could be another possible cause of chest pain. This is a simple non-invasive procedure that can show a LOT about what is happening with your heart.

Please don't just 'let it go' because the symptoms went away. Chest Pain needs to be properly diagnosed to find the Root Cause.

Good Luck in your quest.

'AL Capshaw'