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Forum Name: Cardiology Symptoms

Question: variant angina


 manic63 - Mon Jun 07, 2010 12:58 am

thanking u in advance.
dear doctor,
i am a 29/female diagnosed with bronchial asthma since 5 yrs old prinmetal angina since 2001. I've gone for a coronary angiography in 2001 and 2005. the one in 2001 was fairly normal but the one in 2005 showed fixed stenosis of the LAD. i m currently on nitrates, aspirin and CCB's and have suffered from 2 non-ST elevation MI's 2 and 3 years ago respectively. i m still suffering from squeezing chest pains in the early mornings, almost daily especially if i have had a long day. Recently, i m also having chest discomfort when i over exert myself, when i m having an asthma attack or when i have a heavy meal.it feels like a ton of weight on my chest that gets relieved with rest. i think i m no longer responding to the nitrates.my EF is 50-55%. my physician has suggested for another angiogram prefably one with ergonovine and a possible stenting if necessary. my question is, is there another drug to replace the nitrate?
is there structural damage to the heart due to the spasms?
 Faye Lang, RN, MSW - Sun Jul 04, 2010 7:15 pm

Hello, manic63,

You have a complex condition, but you describe all the appropriate measures being taken. The angiogram with ergonovine really is the next step to be taken, to identify any fixed stenotic lesions or to determine if revascularization is indicated. Your ejection fraction is within acceptable limits, all things considered. Calcium-channel blockers my also be effective, if the nitrates are no longer achieving the desired control. If there are fixed stenoses identified, beta-blockers may have a role in management of your symptoms. That would best be determined by your cardiologist, of course. Have you maintained a diary of your anginal episodes? If not, please consider doing so, noting when they occur, the duration, and what you were doing when they occurred. This can help your physician track any diagnostic patterns, contributing factors, and any acceleration of your condition. Always take it with you when you see your physicians. Memory can fallible, and a record of your symptoms is pretty clear. The anginal spasms probably do not cause any structural damage; rather, they may contribute to myocardial infarction, as you have already experienced, and the MI can result in at least temporary structural damage. However, often the residual scar tissue is stronger than the previously weakened heart muscle. I hope this is helpful to you, and I wish you the most positive results of your upcoming tests.

Good luck to you.
 manic63 - Sun Jul 18, 2010 9:12 am

thanks so much faye!!
right now i m on GTN patches... it is helping me a little...
but still having spasm on and off...
 Faye Lang, RN, MSW - Tue Aug 10, 2010 8:22 pm

Hi manic63,

Thank you for the update. I hope you're doing well and that your symptoms are under control.

All the best to you,

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