What do you know about angina, please?

Susan BAV · Sep 29, 2004

I just got back from a trip back east and we went hiking one day in New York on Shawangunk Ridge and into the Ice Caves below. Beautiful place! It was a fairly steep trail up though, and I had to stop pretty often to get my breath, and I had angina.

(I had my bicuspid aortic valve replaced nearly a year ago. The mitral valve has only something like "mild to moderate" regurgitation, or whatever, in a recent stress echo.)

I thought I was better than that with the new valve and I'm pretty disappointed that I didn't do very well with the hike. Aside from that, however, could anyone tell me what they know about angina, especially upon exertion, with valve issues? As soon as I would stop, the ache would stop. I know it was angina because I also had it upon exertion (though much worse then) before the new valve.

bvdr · Sep 29, 2004

Hi Susan,

I'm glad you had a good trip but I'm sorry you experienced Angina during your hike. The pain very simply is caused by the heart not getting enough oxygen for it's needs at a particular time. Exercise, high altitude, recent meals, valve disease, vessel disease, stress, high blood pressure, and anemia are some of the causes of angina. I always carry nitro with me and that always helps as it increases the blood flow (more oxygen) to the heart. I don't know if my valve problems cause it or if it is my CAD but I know not to worry about it unless it becomes more frequent or the nitro ceases to be effective.

It seems like you had a couple of factors that may have combined to trigger your episodes. If this seems like a usual combination of things to you that had an unusual response then I think you need to have it investigated. Sometimes even our mix of medications can predispose us to angina. Run it by your PCP or Cardio and let us know what you find out.

ALCapshaw2 · Sep 29, 2004

Hello Susan,

That sounds like something you need to discuss with your Cardiologist. The usual approach is to get an Rx for NitroStat (0.4 mg tablets) that you stick under your tongue. You can take one every 5 minutes up to a maximum of 3. If that does not stop the angina then you should head to an ER. Since yours stops when you rest, I suspect that NitroStat would be helpful to you. Your cardiologist may want you to take a stress test to see what is going on when you exert yourself.

I sometimes take one tablet BEFORE I begin exercising (with my Cardiologist's approval) and it seems to help me get a 'jump start' and often prevents or at least minimizes the discomfort from exertionally induced angina.

Hopefully you and your cardiologist will find a better way to manage your angina.

Best wishes,

'AL' (CAD, CABG, and AVR)

Susan BAV · Sep 30, 2004

Thanks Betty

and thanks Al

-

I was thinking I'd have to call the cardio on this but since I'd had it before, for at least several months pre-op, I wondered how seriously and/or quickly I should address it with him. Climbing inclines isn't as difficult for me as it had become pre-op but it still isn't pleasant to me so I usually avoid them and just exercise on a flat track. We don't have any stairs in our house so I rarely have to climb any stairs either but that really winded me on our trip also.

I don't have CAD. Al, what is CABG? Guess I'll think about putting a call in to the cardio. Thanks again.

ALCapshaw2 · Sep 30, 2004

CABG stands for Coronary Artery Bypass Graft (i.e. Bypass Surgery).

It sounds like you may simply be 'deconditioned' since you do not do any stair climbing or any other vertical exercising. You may want to find some place to add climbing to your exercise routine. Many gyms have 'stair climber' machines, or just find a public place with stairs that you can use to train your legs, heart, and lungs. As with any new program, begin SLOWLY and build up your stamina gradually.

'AL'