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Old 10-29-2004, 04:58 PM   #1
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COPEING HB User
Angina Pain Or Stress?

What Is Varient Angina Pain Or Coronary Arterey Spasm? I Have Developed This Pain Over The Last Couple Of Weeks In The Center Of My Chest. It Last About A Second And Is Brought On By Stress Or By Walking Up A Flight Of Stairs. Its Kind Of Like A Flash Of Pain. Although When I Ride My Bike And Get My Heart Rate Up To 150 There Is No Problem. I Think That Is Because During Exercise My Blood Vessels Are Dialating. I Think During Rest Periods The Blood Vessels Are More Constricted And A Bit Of Stress Will Put A Coranary Spasm In Place For A Brief Second Causing The Pain. I Have Have Palps Now Controlled By Topral. I Am Also A Canidate For Metabolic Syndrome Which I Think Is Also Related To Sydrome X. Can Somebody Tell Me If This Sounds Like Varient Angina Or Can It Be Stress Related? Does Angina Last A Breif Second Or Alot Longer ? Does It Spread Across Your Chest? My Pain Is Located In The Center And Last For A Second Only.

 
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Old 10-29-2004, 06:58 PM   #2
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Jack51 HB User
Re: Angina Pain Or Stress?

The description of the pain of angina varies from person to person, that know for sure that they have it (due to having CAD/heart disease diagnosed). Many have experienced the pain for years. I have had 3 variations of the pain, for over 2 years. Most accounts of angina that I have heard of, last for longer than a few seconds. It takes me more than a few seconds to figure out than I am having a bout with angina. The pain is never sharp for me (and from others I have heard describe it). It is a dull, burning, ache off center of the chest to the left a bit, and that can spread over the chest, or a chrushing pain w/o the ache but really uncomfortable, or I can have the pain originate in my back, to the right side of my left shoulder blade (behind my heart), and radiate directly toward the heart. This is a numb, burning pain, brought on only by activity, such as exercise. (I believe it is caused by the backside of my heart not receiving enough blood, due to my known blockages. A cardiologist would laugh at me for making this assumption.) Since I had a heart attack in 03, I have had 3 or 4 sharp, electrical type sensations (a tickle more than a pain) that seem to come directly from my heart, and only last less than a second. This is not angina though.
Best of health to you I got some info from some very good sources, on the 3 topics you mention, and that are so easy to confuse:

Syndrome X

*Question: What is syndrome X? My doctor says it's some new finding on coronary artery disease.

*Answer : The term syndrome X may cause confusion because it's used to describe two different conditions:

A metabolic syndrome
A chest pain condition

Metabolic syndrome X refers to a group of risk factors for heart disease that seem to cluster in some people. It's defined as the presence of three or more of the following conditions:

Glucose intolerance — a fasting glucose of 110 milligrams of glucose per deciliter of blood (milligrams per deciliter, or mg/dL) or greater

Blood pressure of 130/80 millimeters of mercury (mm Hg) or greater
High triglycerides — 150 mg/dL or greater

Low levels of high-density lipoprotein (HDL) cholesterol (the "good" cholesterol) — less than 40 mg/dL in men and 50 mg/dL in women

Abdominal obesity — a waist circumference of 40 inches or more in men and 35 inches or more in women

People with the metabolic syndrome have an increased risk of coronary artery disease (CAD). It's important to discuss with your doctor what steps to take to lower your risk of CAD. Treatment may include lifestyle changes and medications directed at managing the different components of this syndrome.

The term syndrome X sometimes also refers to a chest pain condition. People with this condition have chest pain (angina) but no evidence of serious blockages in their coronary arteries. As many as 20 percent of people with angina who undergo coronary angiography, a test that detects narrowing or blockage of arteries, have normal results.

The cause of this syndrome X isn't clear. Possible factors may include:

Improper function or spasm of tiny blood vessels (microvascular dysfunction)
Abnormally acute perception of heart function, which allows some people to sense changes in their heart rate or in the strength of their heartbeat.
Treatment may include drugs to help improve function of the small blood vessels and control symptoms.
________________________________________ _

What is cardiac syndrome X?

Cardiac syndrome X is a condition where patients have the pain of angina, but they do not have CAD. So even though patients with cardiac syndrome X have symptoms of CAD, the coronary arteries are clear of blockages.

Cardiac syndrome X is more common in women, especially women who have gone through menopause. It is not life threatening and does not increase your risk of heart attack or CAD.

What are the symptoms?

Patients with cardiac syndrome X have the pain of angina, but they do not have CAD.

The pain of angina starts in the center of the chest, but the pain may spread to your left arm or your neck, back, throat, or jaw. You may have numbness or a loss of feeling in your arms, shoulders, or wrists. Patients with cardiac syndrome X often have chest pain after they exercise.

When patients with cardiac syndrome X have an exercise stress test, the results may look as though they have CAD. But when doctors use a test called coronary angiography to look for blockages in the coronary arteries, the arteries look clear and normal.

What causes cardiac syndrome X?

There are many theories about what causes cardiac syndrome X. Some doctors think it has to do with how patients feel pain, while others think it may be linked to low levels of the female hormone estrogen.

New research has shown that cardiac syndrome X is most likely caused by a form of angina called microvascular angina. In microvascular angina, the small blood vessels in the heart (called capillaries) tighten or constrict. This tightening reduces the blood flow in the heart and causes the pain of angina. But because these capillaries are so tiny, they do not increase the risk of heart attack. They are also too small to detect with the standard tests that doctors would normally use to see larger vessels

Variant Angina

Variant angina (also known as Prinzmetal's angina)
This is angina caused by focal spasm of angiographically normal coronary arteries. In about 75% of patients there is also atherosclerotic coronary artery obstruction. In cases where there is atherosclerotic obstruction the vasospasm occurs near the stenotic lesion. (This can happen to a normal artery, or one that is blocked)

The chest pain may:

occur at rest or wake the patient from sleep
be accompanied by dyspnoea and/or palpitations
be triggered by exertion; there is variability in the workload required to precipitate pain
This unusual anginal syndrome is characterised by ST segment elevation on the ECG.

The management of variant angina resembles that for other forms of angina. Nifedipine and nitrates are particularly effective (1). Coronary stenting can be useful for refractory spasm, CABG can be used for important coronary atherosclerosis (1).

Once treated the prognosis is excellent and severe complications such as arrhythmias, myocardial infarction or sudden death are rare (1).

 
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Old 10-30-2004, 08:57 PM   #3
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Join Date: Feb 2003
Location: Plano, Texas USA
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McLink HB User
Re: Angina Pain Or Stress?

Quote:
Originally Posted by Jack51
The description of the pain of angina varies from person to person, that know for sure that they have it (due to having CAD/heart disease diagnosed). Many have experienced the pain for years. I have had 3 variations of the pain, for over 2 years. Most accounts of angina that I have heard of, last for longer than a few seconds. It takes me more than a few seconds to figure out than I am having a bout with angina. The pain is never sharp for me (and from others I have heard describe it). It is a dull, burning, ache off center of the chest to the left a bit, and that can spread over the chest, or a chrushing pain w/o the ache but really uncomfortable, or I can have the pain originate in my back, to the right side of my left shoulder blade (behind my heart), and radiate directly toward the heart. This is a numb, burning pain, brought on only by activity, such as exercise. (I believe it is caused by the backside of my heart not receiving enough blood, due to my known blockages. A cardiologist would laugh at me for making this assumption.) Since I had a heart attack in 03, I have had 3 or 4 sharp, electrical type sensations (a tickle more than a pain) that seem to come directly from my heart, and only last less than a second. This is not angina though.
Best of health to you I got some info from some very good sources, on the 3 topics you mention, and that are so easy to confuse:

Syndrome X

*Question: What is syndrome X? My doctor says it's some new finding on coronary artery disease.

*Answer : The term syndrome X may cause confusion because it's used to describe two different conditions:

A metabolic syndrome
A chest pain condition

Metabolic syndrome X refers to a group of risk factors for heart disease that seem to cluster in some people. It's defined as the presence of three or more of the following conditions:

Glucose intolerance — a fasting glucose of 110 milligrams of glucose per deciliter of blood (milligrams per deciliter, or mg/dL) or greater

Blood pressure of 130/80 millimeters of mercury (mm Hg) or greater
High triglycerides — 150 mg/dL or greater

Low levels of high-density lipoprotein (HDL) cholesterol (the "good" cholesterol) — less than 40 mg/dL in men and 50 mg/dL in women

Abdominal obesity — a waist circumference of 40 inches or more in men and 35 inches or more in women

People with the metabolic syndrome have an increased risk of coronary artery disease (CAD). It's important to discuss with your doctor what steps to take to lower your risk of CAD. Treatment may include lifestyle changes and medications directed at managing the different components of this syndrome.

The term syndrome X sometimes also refers to a chest pain condition. People with this condition have chest pain (angina) but no evidence of serious blockages in their coronary arteries. As many as 20 percent of people with angina who undergo coronary angiography, a test that detects narrowing or blockage of arteries, have normal results.

The cause of this syndrome X isn't clear. Possible factors may include:

Improper function or spasm of tiny blood vessels (microvascular dysfunction)
Abnormally acute perception of heart function, which allows some people to sense changes in their heart rate or in the strength of their heartbeat.
Treatment may include drugs to help improve function of the small blood vessels and control symptoms.
________________________________________ _

What is cardiac syndrome X?

Cardiac syndrome X is a condition where patients have the pain of angina, but they do not have CAD. So even though patients with cardiac syndrome X have symptoms of CAD, the coronary arteries are clear of blockages.

Cardiac syndrome X is more common in women, especially women who have gone through menopause. It is not life threatening and does not increase your risk of heart attack or CAD.

What are the symptoms?

Patients with cardiac syndrome X have the pain of angina, but they do not have CAD.

The pain of angina starts in the center of the chest, but the pain may spread to your left arm or your neck, back, throat, or jaw. You may have numbness or a loss of feeling in your arms, shoulders, or wrists. Patients with cardiac syndrome X often have chest pain after they exercise.

When patients with cardiac syndrome X have an exercise stress test, the results may look as though they have CAD. But when doctors use a test called coronary angiography to look for blockages in the coronary arteries, the arteries look clear and normal.

What causes cardiac syndrome X?

There are many theories about what causes cardiac syndrome X. Some doctors think it has to do with how patients feel pain, while others think it may be linked to low levels of the female hormone estrogen.

New research has shown that cardiac syndrome X is most likely caused by a form of angina called microvascular angina. In microvascular angina, the small blood vessels in the heart (called capillaries) tighten or constrict. This tightening reduces the blood flow in the heart and causes the pain of angina. But because these capillaries are so tiny, they do not increase the risk of heart attack. They are also too small to detect with the standard tests that doctors would normally use to see larger vessels

Variant Angina

Variant angina (also known as Prinzmetal's angina)
This is angina caused by focal spasm of angiographically normal coronary arteries. In about 75% of patients there is also atherosclerotic coronary artery obstruction. In cases where there is atherosclerotic obstruction the vasospasm occurs near the stenotic lesion. (This can happen to a normal artery, or one that is blocked)

The chest pain may:

occur at rest or wake the patient from sleep
be accompanied by dyspnoea and/or palpitations
be triggered by exertion; there is variability in the workload required to precipitate pain
This unusual anginal syndrome is characterised by ST segment elevation on the ECG.

The management of variant angina resembles that for other forms of angina. Nifedipine and nitrates are particularly effective (1). Coronary stenting can be useful for refractory spasm, CABG can be used for important coronary atherosclerosis (1).

Once treated the prognosis is excellent and severe complications such as arrhythmias, myocardial infarction or sudden death are rare (1).

Jack....before I had my heart attack, I was having chest pains on the right side of my chest (directly to the right of the center of my breasts). Due to standard descriptions of the left sided pain, I thought it could not be my heart. Afterwards the Doctors told me some people have the pain in differnet places. Then when I was having my 7th Angioplasty I began to have severe chest pain and it was centered on the right side of my chest, when they moved the camera around inside, they found that I was having a major spasm that had closed down the LAD. It took 3 boluses of liquid nitro directly into the spasm area to get it to let go.
Therfore I am sure that you can have angina on the right side of the chest.

 
Old 10-31-2004, 12:06 PM   #4
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Join Date: Oct 2004
Posts: 2
COPEING HB User
Re: Angina Pain Or Stress?

Thanks for the good information Jack. I am thinking this may not be angina because it only last a second. I think I will check into sydrome x a little more. I have had 2 nuc. test done and I went 15-20% past my goal. Jack it sounds like you have been thruogh alot, I appreciate you being so helpful.

 
Old 10-31-2004, 01:33 PM   #5
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Join Date: Aug 2004
Posts: 434
Jack51 HB User
Re: Angina Pain Or Stress?

Thank you COPEING, for your kind remarks
McLink, I shoud have been more clear in my post. I didn't mean to imply that angina is always to the left of center of the chest, but that is how it came across. I was speaking from my personal experience, as to where my pain is felt. Angina is a strange animal, and can be felt in various locations for sure. Be well

 
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