Angina - confused as just got fit! What now?
Discussion
I am lying awake in bed at 3am wondering WTF has happened? Google symptoms isn’t helping.
I am mid 40s and I started working out regularly in March, about 3 - 4 45min Online PT workouts per week Md started eating a bit better and less crap. I lost a bit of weight and thought I was in good shape. Looking good and feeling good - better shape than I have been in ages. I don’t smoke and not a big drinker.
During November I started taking my 10 year old for 6 mile walks in the hills and felt great.
Just around Christmas I started getting a burning sensation in my throat when I exerted myself slightly, which got worse with pain in my chest and eventually real strong pain in my jaw and ears. My left arm ached a little bit too sometimes when it kicks off. Felt like I had bad indigestion.
Stopped working out over Christmas and found it kept coming back even just walking. I called the doctors a couple of weeks ago and he called back within minutes and said I had to go to A and E straight away - they were great, did an ECG, blood tests and chest x-Ray - all seemed ok and they sent me off with tablets for acid reflux.
Week later I spoke to the doc who referred me for a cardiologist appointment which I had today and I am now lying here wondering how this could have happened as they think I may have Angina?
They have given me statins, aspirin, beta blockers more omeprazole and an emergency spray.
They are planning on doing an ultrasound and have me walking on a treadmill, but they are backed up so no idea how long it will take. I am a priority for a cancellation if one comes up.
Also, I am worried about the side effects of the tablets, as other than the pain when I exert myself, I feel completely healthy and great apart from a bit of wind.
Anyone else been here? Could it be anything else?
I am wondering if it is the statin keeping me awake or just the worry...
Sorry for the long post.
I am mid 40s and I started working out regularly in March, about 3 - 4 45min Online PT workouts per week Md started eating a bit better and less crap. I lost a bit of weight and thought I was in good shape. Looking good and feeling good - better shape than I have been in ages. I don’t smoke and not a big drinker.
During November I started taking my 10 year old for 6 mile walks in the hills and felt great.
Just around Christmas I started getting a burning sensation in my throat when I exerted myself slightly, which got worse with pain in my chest and eventually real strong pain in my jaw and ears. My left arm ached a little bit too sometimes when it kicks off. Felt like I had bad indigestion.
Stopped working out over Christmas and found it kept coming back even just walking. I called the doctors a couple of weeks ago and he called back within minutes and said I had to go to A and E straight away - they were great, did an ECG, blood tests and chest x-Ray - all seemed ok and they sent me off with tablets for acid reflux.
Week later I spoke to the doc who referred me for a cardiologist appointment which I had today and I am now lying here wondering how this could have happened as they think I may have Angina?
They have given me statins, aspirin, beta blockers more omeprazole and an emergency spray.
They are planning on doing an ultrasound and have me walking on a treadmill, but they are backed up so no idea how long it will take. I am a priority for a cancellation if one comes up.
Also, I am worried about the side effects of the tablets, as other than the pain when I exert myself, I feel completely healthy and great apart from a bit of wind.
Anyone else been here? Could it be anything else?
I am wondering if it is the statin keeping me awake or just the worry...
Sorry for the long post.
LimaDelta said:
Could be stress related. I had similar a while back but not related directly to physical exertion, ECGs etc were all normal. it just went away once the stress did. IANAD etc.
I am definitely stressed - ill father, four kids, two homeschooling, dad in hospital, extension constantly delayed, management job etc etc - I have been told that stress can trigger angina.Being told you could have a heart issue doesn't exactly reduce the pressure either!
Lim said:
I had stressed induced angina. had all the scans etc. don't laugh but meditation led by a therapist fixed it!
You need to make time and mental space for it which leads to chicken and egg type debate
I'll try anything! - by fixed it, do you mean you don't need to take medication any longer?You need to make time and mental space for it which leads to chicken and egg type debate
Emeye said:
I'll try anything! - by fixed it, do you mean you don't need to take medication any longer?
I didn't have medication unless you count the misdiagnosed acid reflux gastro stuff. I had the normal blood tests, xrays, and (I think it was) a CT scan, before doctor gave up and said whilst my blood work was high, I didn't meet criteria for statins so should try exercise and diet etc. However I had a bad period and went back, and Doc noticed a correlation with a bereavement and suggested therapy.
The therapist started off with talking stuff, but relatively quickly outed himself as a hippy (he was an ex GP though) and persuaded me to book a 10 session meditation group.
I havn't mediated much since but my mental health and agina has improved hugely.
I would say there is about an 80% chance it was a coincidence that it worked, god knows what really happened. But you take wins where you can get them!
The lesions which cause angina, the atheromatous plaques, take many years to develop, and unfortunately a few months of exercise does not reverse several years of build up. In fact, it isn't unusual for people in their 40s and 50s to decide to be healthier, start exercising and develop symptoms as a result, which is actually quite logical. The chest pain of angina is due to inadequate oxygen getting to the heart because it isn't getting enough blood. Heart beats 60-80 times a minute at rest or minimal activity, and pumps around 3-5 litres depending on your size. When you start exercising, it starts beating much faster and needs to pump anything up to 15 litres per minute or more depending on what exactly your exercise is. As a result, it needs a hell of a lot more oxygen, so a hell of a lot more blood. The amount of blood which was adequate at rest/minimal activity is suddenly no longer enough, and you get chest pain, which we call angina. Of course you didn't have symptoms before you started "living a healthy lifestyle" - you didn't do anything to get to the limit of your heart's blood supply. Even when you first started your exercise regime, you probably didn't get to that limit, but as you got "fitter" and could keep exercising for longer, you got closer and closer to that limit, and eventually you exceeded that threshold.
That is the physiological explanation of how and why your symptoms have appeared when they did. The treadmill test is the exercise ECG. You'll be on the treadmill while attached to the ECG machine and every now and then the treadmill will get steeper. Someone will be looking at the monitors constantly and wiggly lines tell us whether there's any electrical evidence of reduced blood flow to different part of your heart at gradually increasing levels of exercise. Depending on the results of that, you may or may not need further tests and imaging all the way up to angiography which is an invasive procedure where a needle is inserted into an artery, usually in the groin but occasionally in the wrist, pushed all the way back to heart, and an x-ray opaque dye injected directly into the coronary arteries during live x-ray imaging.
The cocktail of drugs you're on is pretty standard for someone being investigated in the chest pain clinic. While the pain only comes on exertion, there isn't much else to do but to wait for the investigations and tests to be done and reviewed. Whilst everything is stable and there are no significant changes, even with the stress and anxiety of the wait, you are not at an increased risk of having a heart attack than you were 2 months ago. You were at an increased risk then, you are at an increased risk now.
At this stage, I would recommend that you try to relax as much as is possible, and try not to use Google, hard though as it is. Unfortunately, the internet is far too full of useless information. If you wish to make use of proper scientific information, look up PubMed on Google, and search for published articles in PubMed. If an article is not in PubMed, it isn't worth the data packet that's downloaded to your device. If it is on PubMed, that isn't a guarantee that it is, but at least the odds are much better!
However, there ARE times to be concerned. If you start getting pain:
1) with less and less exercise over a short period of time (e.g. 4 flights of stairs in the morning, 2 flights at lunchtime, 1 in the evening);
2) absolutely minimal exercise all of a sudden; or
3) pain at rest;
DO NOT DELAY and dial 999. 1 and 2 called unstable angina and are precursors of a heart attack, 3 IS a heart attack. Similar goes for shortness of breath. If you find yourself feeling short of breath in the above categories, even without chest pain, please do the same.
PM me if you'd like to ask more.
QQ
(IAAD, but IANYD. The heart also happens to be my specialty!)
That is the physiological explanation of how and why your symptoms have appeared when they did. The treadmill test is the exercise ECG. You'll be on the treadmill while attached to the ECG machine and every now and then the treadmill will get steeper. Someone will be looking at the monitors constantly and wiggly lines tell us whether there's any electrical evidence of reduced blood flow to different part of your heart at gradually increasing levels of exercise. Depending on the results of that, you may or may not need further tests and imaging all the way up to angiography which is an invasive procedure where a needle is inserted into an artery, usually in the groin but occasionally in the wrist, pushed all the way back to heart, and an x-ray opaque dye injected directly into the coronary arteries during live x-ray imaging.
The cocktail of drugs you're on is pretty standard for someone being investigated in the chest pain clinic. While the pain only comes on exertion, there isn't much else to do but to wait for the investigations and tests to be done and reviewed. Whilst everything is stable and there are no significant changes, even with the stress and anxiety of the wait, you are not at an increased risk of having a heart attack than you were 2 months ago. You were at an increased risk then, you are at an increased risk now.
At this stage, I would recommend that you try to relax as much as is possible, and try not to use Google, hard though as it is. Unfortunately, the internet is far too full of useless information. If you wish to make use of proper scientific information, look up PubMed on Google, and search for published articles in PubMed. If an article is not in PubMed, it isn't worth the data packet that's downloaded to your device. If it is on PubMed, that isn't a guarantee that it is, but at least the odds are much better!
However, there ARE times to be concerned. If you start getting pain:
1) with less and less exercise over a short period of time (e.g. 4 flights of stairs in the morning, 2 flights at lunchtime, 1 in the evening);
2) absolutely minimal exercise all of a sudden; or
3) pain at rest;
DO NOT DELAY and dial 999. 1 and 2 called unstable angina and are precursors of a heart attack, 3 IS a heart attack. Similar goes for shortness of breath. If you find yourself feeling short of breath in the above categories, even without chest pain, please do the same.
PM me if you'd like to ask more.
(IAAD, but IANYD. The heart also happens to be my specialty!)
Thanks for the very detailed response QQ I really appreciate it and I may take you up on your kind offer to DM you. Thanks to everyone else who has replied.
I've never been much overweight or smoked etc and have been fit on and off over the years - maybe this is just genetics and nothing much I can do other than minimise the impact?
I phoned the Alexandra hospital mear MAnchester and they told me the private wait for the stress echocardiography was 2 - 3 weeks and the NHS wait was up to 3 months! Because Covid.
About £577 to have it done privately.
It seems the plan is to throw the standard pills at me until they can find out exactly what is wrong.
My biggest concern is that having really been enjoying getting fit this time I am not going to continue exercising in future.
I took the beta blocker about lunch and having ordered a blood pressure machine for next day delivery from Amazon, it did seem to quite quickly reduce my blood pressure to something lower.
I need to work out when is the best time to take the tablets to avoid impacting my sleep and making me drowsy during the day.
Hope I sleep better tonight!
I've never been much overweight or smoked etc and have been fit on and off over the years - maybe this is just genetics and nothing much I can do other than minimise the impact?
I phoned the Alexandra hospital mear MAnchester and they told me the private wait for the stress echocardiography was 2 - 3 weeks and the NHS wait was up to 3 months! Because Covid.
About £577 to have it done privately.
It seems the plan is to throw the standard pills at me until they can find out exactly what is wrong.
My biggest concern is that having really been enjoying getting fit this time I am not going to continue exercising in future.
I took the beta blocker about lunch and having ordered a blood pressure machine for next day delivery from Amazon, it did seem to quite quickly reduce my blood pressure to something lower.
I need to work out when is the best time to take the tablets to avoid impacting my sleep and making me drowsy during the day.
Hope I sleep better tonight!
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