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Old 07-15-2003, 09:17 PM   #1
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Post Stable Angina/Unstable Angina

At what point does stable become unstable angina? My experience since onset has been that it has been a gradually worsening thing anyway so at what point do you say, okay now it is unstable?

Last edited by crabbycdn; 01-04-2004 at 05:28 PM.

 
Old 07-16-2003, 03:57 AM   #2
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Unstable angina is angina that occurs during periods of rest. Stable angina occurs when you are exercising, for example. Unstable angina is considered more dangerous because there is a possibility a segment of plaque in a coronary artery has broken loose and is cutting off bloodflow to the heart.
Hope this helps
Nancy

 
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Old 07-16-2003, 09:06 AM   #3
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Thank you. Yes, that is somewhat helpful but leads to another question. I don't ALWAYS have chest pain at rest. For example, last night I was sitting at the computer and I had an attack of angina. I used nitro and it subsided. I also awoke in the middle of the night with terrible crushing pain. I used nitro and eventually went back to sleep but awoke twice more with same pain. This morning I am out of breath because I do not have my nitro patch on yet. So, is this stable or unstable?
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Last edited by crabbycdn; 01-04-2004 at 05:29 PM.

 
Old 07-16-2003, 02:27 PM   #4
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crabby,

If you are sure its angina, then it is unstable. The weeks before my heart attack, I always felt my pain at the computer, it went down both arms, but further down my left arm, through my left biceps and stopped at my elbow.

If you are feeling this at the computer with minimal physical exertion, its probably best that you get to the ER. The night before my heart attack I sat there with the pain, typing away on the computer, clueless to what would happen the next day.

Even if there is a chance its not angina, you should go to the ER and make sure. I have done this twice and I don't regret it--after having a heart attack the first time, I am relieved to be told it all looks fine. Granted, I was a bit paranoid, but that subsides in time.

 
Old 07-17-2003, 04:00 AM   #5
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Hi again crabby
What you are describing while working at your computer sounds like unstable angina, and is something you shouldn't "sit and wait out". The episode that woke you from your sleep actually sounds more like a coronary spasm (Printzmetal's angina?) - but the results can be same, so next time it happens, get yourself to an ER.
Is the Calgary Stampede over yet? What became of those fellows who "pied" the premier?

 
Old 07-17-2003, 10:36 AM   #6
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We have a local rodeo that I pay more attention to. The entry fees at the Stampeded are pretty high so our local boys often leave it to the Texans. As for the pie tossers. I imagine they will probably get off with a slap on the wrist. The pie only hurt ole Ralph's dignity and from his usual conduct his dignity is pretty calloused so I imagine all that will happen is his security people will get fired. Thanks for the advice. I am getting so tired of going to the ER every time I get terrible angina that is why I have been just trying to wait it out.
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Old 07-17-2003, 05:19 PM   #7
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Hi again crabby:
No, I'm not stalking you! I'm curious why they haven't performed an angiogram on you to determine the degree of coronary blockage. Your frequent episodes of angina are not good for your heart - have you discussed this with the physician? You can't keep popping ntg - they eventually stop having the desired effect (I think I read that somewhere <scratching my head> ).
As for Ralph (Kline??), I thought it a terrible waste of a perfectly good lemon meringe pie.

 
Old 07-17-2003, 05:58 PM   #8
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First, let me compliment you on your knowledge of Canadian current events. Quite unusual among your countrymen. I agree. Terrible waste of a perfectly good pie. The problem is that I did have an angiogram back in April which showed a minimal blockage (40%) but symptoms and subsequent tests have shown either that there are new or worsening lesions. Doctors can't agree. Genetic history indicates that unstable plaque rupture is common (all of my aunts had heart attacks before they were 55). The doctors can't agree. One says, "Oh no, it is not possible for atherosclerosis to worsen that quickly." Another says "Anything is possible." I just know that I am very tired of the shortness of breath, lightheadedness and pain. I collapsed last week so now I can't drive. I tried to do without a nitro patch today (.4)but ended up in bed with dizziness and caved in and put the patch on at 4:00. I am sitting at my computer now and my chest is tight, I am nauseated, lightheaded and clammy. My dogs are at my feet so I know I am "not right" but my family is out and I do not want to call anyone to take me in for another wasted trip to ER.
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Old 07-18-2003, 04:31 AM   #9
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Crabby,

They symptoms you describe are classic for angina and remarkably similar to the ones that I experienced. I also read your other posts where you describe the poor state of health care in your area.

They physician that mentioned that atherosclerosis cannot worsen that quickly is clearly out of touch. My LAD was ~50% blocked in March of 2002, and ~90% blocked in July of 2002. (I kept the photos from the two caths as souvenirs and reminders of how fast things can change). This progression happened even as I lost weight, increased exercise and brought my cholesterol down to <150 mg/dL total.

Back to the symptoms you experience at rest, you know its just not right. Its true that they generally won't perform a stent placement unless the blockage is >50%; however, based on your symptoms, it would be expected that you would have at least one highly occluded area. I don't think any trip to the ER is wasted, even my last two where there was nothing wrong with my heart after I went in because I thought I felt angina again. Its better to be safe than to take your chances with a MI.

I guess all I can do is encourage you to go in and have it checked out and to encourage you to insist that something needs to be done further. I had to insist that something was wrong the 2nd time I went in, based on my symptoms and sure enough, I did require stent placement in my LAD.

 
Old 07-18-2003, 06:21 AM   #10
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Thank you for the encouragement. I have been thinking for a long time about a trip to the city. My son suggested that instead of walking around the mall for 15 minutes without my nitro patch that I walk around the cardiology research centre at the University since. Not sure what I am going to do but I think a trip to the city is definitely in the picture. Like you said, I can feel a difference and I KNOW something is not right. I will keep you posted.
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Old 07-18-2003, 12:17 PM   #11
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Hi again Crabby:
I actually hope you're not at your computer and are on your way to a hospital. Preferably, one with a competent cardiac unit. You definitely need another angiogram - and possible stent placement. Your symptoms just aren't consistent with "minimal" blockage. Have you had a resting echo performed in the recent past? I wonder if you don't have an enlarged heart (hypertrophied), which may also account for your angina. Whatever the problem, it needs to be dealt with soon....
Nancy

 
Old 07-19-2003, 03:05 PM   #12
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I an new here and I guess I am becoming an authority on cardiad catherizations. I have had 5 between August, 2002 and April 2003. There are a few ways of closing the site. When they use a stitch to close it you are told to wait longer than when they use the new plugs. You also can get up very quickly after with the plug. You would know because they hand you information about the plug you received that you are supposed to carry with for telling any medical personnel that you have it and when. This is very important for the first 90 days.

I have had 3 MI's (when I had the 3rd and the did the cath they found evidence of dead tissue that were in 2 different locations plus the new dead tissue). I have had 3 angioplasties and a LAD stent. Unfortunately my arteries are very small and hard to stent so they are keeping a very close watch on things. I had the LAD close up in a different spot within 5 weeks after a cath and angio. They can close very quickly when they are small.

I have had stress tests every other month for the last 10 months as well as echos and other testing. At this time I am diagnosed with CAD and stable unstable angina. Still have not figured out that part.

In addition I have uncontrolled asthma and sleep apnea. So I visit many doctors and the one thing which I tell everyone is take control of your medical care or it will control you very quickly. By that I mean go online and research your condition and your meds. Prior to having a procedure done, find out all you can about it. Ask your doctor what to expect and what you can do. Right now I am in the midst of trying to convince the doctors that they are causing some of this asthma because I am taking the Plavix/325mg. asprin combination and know that the asprin causes me asthma problems. Convincing them that the asthma will mever get controlled as long as I take asprin in a tough thing to do.

 
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