Angina and what happens next
Discussion
I started feeling a slight pain in my chest in March after exercise, I also had slight arrhythmia, although I don't have that now, winding forward to the end of June the pain was becoming worse and occurring more regularly and I was also getting breathless easily, this was born out with my cycling stats which showed a declining pulse rate, inability to raise heart rate even when breathless.
I went to docs who did a quick ECG then I had to wear a 24hr monitor, although I didn't suffer from any arrhythmia during that time.
I was also referred to a cardiac clinic and a week later had a telephone consultation where angina was diagnosed, a week or so later I received a letter also copied to docs with recommendation to start Asparin, Atorvastatin and Isodur and also a mouth spray when I have an attack, also a requirement to see docs again in a month and if no better to be referred for an angi0gram.
What's concerning me is the pain is becoming persistent, and the letter from telephone consultation said if pain doesn't recede after exertion within 15 minutes to call an ambulance, I'm reluctant to do that as it seems the pain is now always present so may be something else, and I would feel a right pillock calling 999 when I'm still able to talk, walk and drink beer.
Has anybody been in a similar situation and what did you do?
I went to docs who did a quick ECG then I had to wear a 24hr monitor, although I didn't suffer from any arrhythmia during that time.
I was also referred to a cardiac clinic and a week later had a telephone consultation where angina was diagnosed, a week or so later I received a letter also copied to docs with recommendation to start Asparin, Atorvastatin and Isodur and also a mouth spray when I have an attack, also a requirement to see docs again in a month and if no better to be referred for an angi0gram.
What's concerning me is the pain is becoming persistent, and the letter from telephone consultation said if pain doesn't recede after exertion within 15 minutes to call an ambulance, I'm reluctant to do that as it seems the pain is now always present so may be something else, and I would feel a right pillock calling 999 when I'm still able to talk, walk and drink beer.
Has anybody been in a similar situation and what did you do?
k about, get down to hospital'.If it makes a difference, Doctor here: as above and if for some reason you’re still reading this, call 999 now.
One thing that I’ve noticed over the years is that, possibly because of how dramatic “heart attacks” are depicted in fiction, blokes will assume they can’t possibly be having one because the pain isn’t that bad. Diabetics can have one and experience no pain at all. I’ve seen numerous folk who’ve had an MI without knowing it.
One thing that I’ve noticed over the years is that, possibly because of how dramatic “heart attacks” are depicted in fiction, blokes will assume they can’t possibly be having one because the pain isn’t that bad. Diabetics can have one and experience no pain at all. I’ve seen numerous folk who’ve had an MI without knowing it.
Edited by DeWar on Saturday 25th July 17:09
Thanks for your well intentioned replies, I needed a kick up my arse!
Spent yesterday evening through to this afternoon in hospital, barrage of blood tests, x-ray, etc, thought being that I had either had a series of angina attacks or a heart attack, blood tests conclusively proved I hadn't had a heart attack, but symptoms were not as expected for angina.
At the moment it is still being treated as angina with time for meds to quick in properly, then a view to having an angiogram if no relief within about a month.
Also BP was 196/99, so that needs to be dealt with, It's always been borderline high but over past few months has been increasing.
Spent yesterday evening through to this afternoon in hospital, barrage of blood tests, x-ray, etc, thought being that I had either had a series of angina attacks or a heart attack, blood tests conclusively proved I hadn't had a heart attack, but symptoms were not as expected for angina.
At the moment it is still being treated as angina with time for meds to quick in properly, then a view to having an angiogram if no relief within about a month.
Also BP was 196/99, so that needs to be dealt with, It's always been borderline high but over past few months has been increasing.
sherbertdip said:
Thanks for your well intentioned replies, I needed a kick up my arse!
Spent yesterday evening through to this afternoon in hospital, barrage of blood tests, x-ray, etc, thought being that I had either had a series of angina attacks or a heart attack, blood tests conclusively proved I hadn't had a heart attack, but symptoms were not as expected for angina.
At the moment it is still being treated as angina with time for meds to quick in properly, then a view to having an angiogram if no relief within about a month.
Also BP was 196/99, so that needs to be dealt with, It's always been borderline high but over past few months has been increasing.
Can I suggest you see your GP immediately to deal with your BP? That is high enough to warrant admission to hospital.Spent yesterday evening through to this afternoon in hospital, barrage of blood tests, x-ray, etc, thought being that I had either had a series of angina attacks or a heart attack, blood tests conclusively proved I hadn't had a heart attack, but symptoms were not as expected for angina.
At the moment it is still being treated as angina with time for meds to quick in properly, then a view to having an angiogram if no relief within about a month.
Also BP was 196/99, so that needs to be dealt with, It's always been borderline high but over past few months has been increasing.
Jaw dropped reading this thread - thank goodness the A&E team found nothing wrong. If it happens again, please - return immediately.
Made me think of this: https://www.bicycling.com/health-nutrition/a253376...
MSBravo said:
Can I suggest you see your GP immediately to deal with your BP? That is high enough to warrant admission to hospital.
Jaw dropped reading this thread - thank goodness the A&E team found nothing wrong. If it happens again, please - return immediately.
I will be contacting the practice first thing, but of course in these strange times getting to see a doctor at the practice has proved difficult, strangely staff at hospital including GP didn't bat an eyelid at this reading and I asked the Doc specifically about it.Jaw dropped reading this thread - thank goodness the A&E team found nothing wrong. If it happens again, please - return immediately.
Hoofy said:
Made me think of this: https://www.bicycling.com/health-nutrition/a253376...
Thanks for that I hadn't seen it before.Endurance riders do seem to be at risk, I know a few with heart problems and unfortunately of 2 that died suddenly on rides, one of whom held a 24hr record (Chrstian von Ascheburg).
I do cycle a lot, or did having stopped in early June, I think nothing of having my dinner at 5pm and going for a 100 mile ride in under 4 hrs.
Last year I completed numerous 600km rides in under 18 hrs, and was in the first 100 of over 6000 riders in Paris - Brest - Paris which puts me firmly in the category of endurance rider.
As the write up says we tend to ignore pain it's all part of riding a long way, and the faster the ride the more it hurts, bloody stupid we are!
sherbertdip said:
Hoofy said:
Made me think of this: https://www.bicycling.com/health-nutrition/a253376...
Thanks for that I hadn't seen it before.Endurance riders do seem to be at risk, I know a few with heart problems and unfortunately of 2 that died suddenly on rides, one of whom held a 24hr record (Chrstian von Ascheburg).
I do cycle a lot, or did having stopped in early June, I think nothing of having my dinner at 5pm and going for a 100 mile ride in under 4 hrs.
Last year I completed numerous 600km rides in under 18 hrs, and was in the first 100 of over 6000 riders in Paris - Brest - Paris which puts me firmly in the category of endurance rider.
As the write up says we tend to ignore pain it's all part of riding a long way, and the faster the ride the more it hurts, bloody stupid we are!
I hope you manage to get whatever it is you're suffering from sorted out.
Cardiologist here - brief reply but agree with advice above to not panic but take this seriously.
The tests in the emergency department are likely to be that you haven't had any damage the the heart - this is good news - but it doesn't tell you that you haven't got any narrowings in the arteries.
It is relatively straightforward to rule out (or rule in) coronary artery disease these days - we use CT scans (i.e CT coronary angiography) for this (which avoids an invasive procedure like angiography unless you need a stent). One option is "treat for angina and see" (particularly during COVID) but the other is "do the test to see what is going on". There are problems with delivery of these scans regionally (i.e. matching demand - we do thousands of these every year but some areas of UK struggling to offer high volume).
For interest you should read this (absolutely no reason why patients shouldn't be aware of guidelines)
https://www.nice.org.uk/guidance/cg95/chapter/Reco...
I would have thought that BP also needs some gentle progressive (but prompt) treatment.
The tests in the emergency department are likely to be that you haven't had any damage the the heart - this is good news - but it doesn't tell you that you haven't got any narrowings in the arteries.
It is relatively straightforward to rule out (or rule in) coronary artery disease these days - we use CT scans (i.e CT coronary angiography) for this (which avoids an invasive procedure like angiography unless you need a stent). One option is "treat for angina and see" (particularly during COVID) but the other is "do the test to see what is going on". There are problems with delivery of these scans regionally (i.e. matching demand - we do thousands of these every year but some areas of UK struggling to offer high volume).
For interest you should read this (absolutely no reason why patients shouldn't be aware of guidelines)
https://www.nice.org.uk/guidance/cg95/chapter/Reco...
I would have thought that BP also needs some gentle progressive (but prompt) treatment.
sherbertdip said:
Hoofy said:
Made me think of this: https://www.bicycling.com/health-nutrition/a253376...
Thanks for that I hadn't seen it before.Endurance riders do seem to be at risk, I know a few with heart problems and unfortunately of 2 that died suddenly on rides, one of whom held a 24hr record (Chrstian von Ascheburg).
I do cycle a lot, or did having stopped in early June, I think nothing of having my dinner at 5pm and going for a 100 mile ride in under 4 hrs.
Last year I completed numerous 600km rides in under 18 hrs, and was in the first 100 of over 6000 riders in Paris - Brest - Paris which puts me firmly in the category of endurance rider.
As the write up says we tend to ignore pain it's all part of riding a long way, and the faster the ride the more it hurts, bloody stupid we are!
ikeepbuyingd5s said:
Cardiologist here - brief reply but agree with advice above to not panic but take this seriously.
The tests in the emergency department are likely to be that you haven't had any damage the the heart - this is good news - but it doesn't tell you that you haven't got any narrowings in the arteries.
It is relatively straightforward to rule out (or rule in) coronary artery disease these days - we use CT scans (i.e CT coronary angiography) for this (which avoids an invasive procedure like angiography unless you need a stent). One option is "treat for angina and see" (particularly during COVID) but the other is "do the test to see what is going on". There are problems with delivery of these scans regionally (i.e. matching demand - we do thousands of these every year but some areas of UK struggling to offer high volume).
For interest you should read this (absolutely no reason why patients shouldn't be aware of guidelines)
https://www.nice.org.uk/guidance/cg95/chapter/Reco...
I would have thought that BP also needs some gentle progressive (but prompt) treatment.
Thank you for taking the time to reply, It's reassuring to read that you are in agreement, not that I doubted the competence of the treatment I've had so far.The tests in the emergency department are likely to be that you haven't had any damage the the heart - this is good news - but it doesn't tell you that you haven't got any narrowings in the arteries.
It is relatively straightforward to rule out (or rule in) coronary artery disease these days - we use CT scans (i.e CT coronary angiography) for this (which avoids an invasive procedure like angiography unless you need a stent). One option is "treat for angina and see" (particularly during COVID) but the other is "do the test to see what is going on". There are problems with delivery of these scans regionally (i.e. matching demand - we do thousands of these every year but some areas of UK struggling to offer high volume).
For interest you should read this (absolutely no reason why patients shouldn't be aware of guidelines)
https://www.nice.org.uk/guidance/cg95/chapter/Reco...
I would have thought that BP also needs some gentle progressive (but prompt) treatment.
I have spoken with Doc and he's going to prescribe Ramipril for BP, and monitor.
Hoofy said:
25mph average speed? Bloody hell, that's quick.
I hope you manage to get whatever it is you're suffering from sorted out.
I went over to the dark side AKA recumbents in 2001 after damaging my neck in a spill off my mountain bike, some say it's cheating especially as I ride a velomobile now, but they are fast and efficient on the flat, stupendously fast downhill but a real chore uphill without a run up to get some momentum.I hope you manage to get whatever it is you're suffering from sorted out.
Thanks for the support, I'm sure it will be sorted one way or another.
OP, don't mess about if your ticker is giving a warning signs, glad your getting yourself seen to
In one evening I went from thinking I'd got heartburn to dead in my bed for 10 mins, then back to alive after a few jump starts, had a quick op to fix me with a stent and woke up 3 days later after an induced coma packed in ice
I should have listened to my warning signs, it would have saved a lot worry for a lot of people so never worry about causing a false alarm
In one evening I went from thinking I'd got heartburn to dead in my bed for 10 mins, then back to alive after a few jump starts, had a quick op to fix me with a stent and woke up 3 days later after an induced coma packed in ice
I should have listened to my warning signs, it would have saved a lot worry for a lot of people so never worry about causing a false alarm
marine boy said:
OP, don't mess about if your ticker is giving a warning signs, glad your getting yourself seen to
In one evening I went from thinking I'd got heartburn to dead in my bed for 10 mins, then back to alive after a few jump starts, had a quick op to fix me with a stent and woke up 3 days later after an induced coma packed in ice
I should have listened to my warning signs, it would have saved a lot worry for a lot of people so never worry about causing a false alarm
Firstly I would like to say it's good that you are here and able to post that.In one evening I went from thinking I'd got heartburn to dead in my bed for 10 mins, then back to alive after a few jump starts, had a quick op to fix me with a stent and woke up 3 days later after an induced coma packed in ice
I should have listened to my warning signs, it would have saved a lot worry for a lot of people so never worry about causing a false alarm
I had a discussion with my GP yesterday, he echoed the don't worry about false alarms, don't ignore symptoms and do call 999 if I believe I'm in distress, as I explained to him it's the recognising bit that is difficult, and I think that is what catches people, I'm feeling upbeat, something is being done and i'm still here! Which is nice.
Glad you’re ok OP!
I’m going through the same, had a tight chest which wouldn’t go away. I put it down to stress/anxiety until a couple of months ago when it got worse and I bit the bullet and called my Doctor, fortunately she insisted further investigation so I had a CT scan at hospital just after lockdown lifted which showed a calcium score of 254 (medium risk of heart attack apparently!)
I’m now on aspirin, statins and beta blockers as required and waiting for further tests, unfortunately this is taking quite a while as I assume there is a serious waiting list.
I’m a mountain biker, eat healthily and don’t smoke or drink so it was quite a shock but can be hereditary apparently.
It’s definitely better to get symptoms checked!
I’m going through the same, had a tight chest which wouldn’t go away. I put it down to stress/anxiety until a couple of months ago when it got worse and I bit the bullet and called my Doctor, fortunately she insisted further investigation so I had a CT scan at hospital just after lockdown lifted which showed a calcium score of 254 (medium risk of heart attack apparently!)
I’m now on aspirin, statins and beta blockers as required and waiting for further tests, unfortunately this is taking quite a while as I assume there is a serious waiting list.
I’m a mountain biker, eat healthily and don’t smoke or drink so it was quite a shock but can be hereditary apparently.
It’s definitely better to get symptoms checked!
Edited by Joscal on Tuesday 28th July 08:47
Joscal said:
Glad you’re ok OP!
I’m going through the same, had a tight chest which wouldn’t go away. I put it down to stress/anxiety until a couple of months ago when it got worse and I bit the bullet and called my Doctor, fortunately she insisted further investigation so I had a CT scan at hospital just after lockdown lifted which showed a calcium score of 254 (medium risk of heart attack apparently!)
I’m now on aspirin, statins and beta blockers as required and waiting for further tests, unfortunately this is taking quite a while as I assume there is a serious waiting list.
I’m a mountain biker, eat healthily and don’t smoke or drink so it was quite a shock but can be hereditary apparently.
It’s definitely better to get symptoms checked!
I used to cycle everywhere, averaging (except in winter) 250 miles a week, mostly off-road. I had a back injury that was caused by cycling, and at the hospital gym my physio said 'We get lots of cyclists in here'. Further questioning revealed that most were recovering from heart problems. It seems cycling, even at my level, isn't as healthy as you might think. I'm a non-smoker/drinker but my blood pressure is up, this despite me having low blood pressure some years ago, and weekly tests at a doctors. I’m going through the same, had a tight chest which wouldn’t go away. I put it down to stress/anxiety until a couple of months ago when it got worse and I bit the bullet and called my Doctor, fortunately she insisted further investigation so I had a CT scan at hospital just after lockdown lifted which showed a calcium score of 254 (medium risk of heart attack apparently!)
I’m now on aspirin, statins and beta blockers as required and waiting for further tests, unfortunately this is taking quite a while as I assume there is a serious waiting list.
I’m a mountain biker, eat healthily and don’t smoke or drink so it was quite a shock but can be hereditary apparently.
It’s definitely better to get symptoms checked!
Edited by Joscal on Tuesday 28th July 08:47
I'm not in my first flush of youth, but was shocked to be told to keep my pulse rate below 120 when exercising. I assume 125 or so was allowed, as they wouldn't expect me to stick to that.
Thanks for worrying me, guys.
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