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-   -   Does anyone have "atypical" angina? (http://www.healthboards.com/boards/angina/628881-does-anyone-have-atypical-angina.html)

CircusSquirrel 08-25-2008 12:04 PM

Does anyone have "atypical" angina?
 
I am a 33 yr old female, first to admit I am anxious (it is well-treated), but I have an unrelated tachycardia and for the past several years I have had a seemingly unrelated discomfort/squeezing in my left neck/arm area. I have had EKGs during these episodes, gone to the ER for the full workup (at the urging of my doc) and everything is ok.
Tomorrow I go to the cardio for my skippy heartbeats/tachycardia workup I have every year or two and my primary told me to bring up the left sided discomfort to him again. I was diagnosed with fibromyalgia, which surprised me because I just thought I was sore and I don't give the whole thing much thought, but the primary said there are rare types of angina that usually occur in women that aren't as indicative of heart disease (at least severe heart disease) but they can be spasms or they can be microvascular disease. These arm/jaw discomfort/tightness episodes generally last anywhere from half an hour to hours on end, which is definitely NOT typical of "regular" angina, and I am not a very high risk cardiac patient as I have good cholesterol, HDL 55, can't remember the other latest cholesterol numbers, triglycerides of about 50, good blood sugar, non-smoker, no drugs, very little alcohol, and of course, the fact that I'm a 33 yr old female.
Just wanted to see if anyone here had any of these "atypical" anginas. My doc said the cardio he refers to in our town (we live in a mid-size military town) only sees about 2 or 3 of those types of anginas every few years or so, so I guess docs aren't real well-versed in detecting them since they don't see them, or maybe they ignore it?

confused32 08-25-2008 01:06 PM

Re: Does anyone have "atypical" angina?
 
I would love to learn more about this. I suffer the left arm and jaw pain. It can last for minutes-days. I of course have been told my heart is fine. I have never heard of this before.

cincyman78 08-25-2008 01:11 PM

Re: Does anyone have "atypical" angina?
 
What are your pains like? Where are they located? Are the sharp pains? Are they heavy pains?

confused32 08-25-2008 01:12 PM

Re: Does anyone have "atypical" angina?
 
My pains are all in my left arm from the shoulder to the elbow. The jaw pain is on the bottom left side of my jaw. The pains range from sharp to dull in my arm and the jaw pain is a dull pain.

cincyman78 08-25-2008 01:15 PM

Re: Does anyone have "atypical" angina?
 
[QUOTE=CircusSquirrel;3703229]I am a 33 yr old female, first to admit I am anxious (it is well-treated), but I have an unrelated tachycardia and for the past several years I have had a seemingly unrelated discomfort/squeezing in my left neck/arm area. I have had EKGs during these episodes, gone to the ER for the full workup (at the urging of my doc) and everything is ok.
Tomorrow I go to the cardio for my skippy heartbeats/tachycardia workup I have every year or two and my primary told me to bring up the left sided discomfort to him again. I was diagnosed with fibromyalgia, which surprised me because I just thought I was sore and I don't give the whole thing much thought, but the primary said there are rare types of angina that usually occur in women that aren't as indicative of heart disease (at least severe heart disease) but they can be spasms or they can be microvascular disease. These arm/jaw discomfort/tightness episodes generally last anywhere from half an hour to hours on end, which is definitely NOT typical of "regular" angina, and I am not a very high risk cardiac patient as I have good cholesterol, HDL 55, can't remember the other latest cholesterol numbers, triglycerides of about 50, good blood sugar, non-smoker, no drugs, very little alcohol, and of course, the fact that I'm a 33 yr old female.
Just wanted to see if anyone here had any of these "atypical" anginas. My doc said the cardio he refers to in our town (we live in a mid-size military town) only sees about 2 or 3 of those types of anginas every few years or so, so I guess docs aren't real well-versed in detecting them since they don't see them, or maybe they ignore it?[/QUOTE]


can you describe your pain, and where it is located?

confused32 08-25-2008 01:23 PM

Re: Does anyone have "atypical" angina?
 
Excuse me for answering your question.

cincyman78 08-25-2008 01:29 PM

Re: Does anyone have "atypical" angina?
 
No Problem Confused, hey the more info I get the better.

CircusSquirrel 08-25-2008 02:42 PM

Re: Does anyone have "atypical" angina?
 
Hi Everyone,

My pain is more of a discomfort and heaviness than an "oh my goodness, this hurts". It usually begins up near my left jaw and extends down over my shoulder to my pinky or ring finger, but sometimes it varies (sometimes it doesn't go all the way to my finger, sometimes my jaw is left out of the equation). It is very uncomfortable, can feel "squeezing" at times. It is never sharp or stinging or fleeting, it stays AT LEAST several minutes but is more likely to stick around for an hour or so at least.
Now, other than the facts I have mentioned that have led docs to think it isn't angina (I am married to a doc, BTW, but he is not a specialist) is the fact that I am sore in that area. BUT, there are docs who say that a person can be sore over an area where they have angina pain.
That said, the "atypical" anginas include one called Prinzmetal's angina, and there are at least a few others but they are rare and, again, they usually aren't associated with the immediate "bad" outcomes that "regular" angina is. It is up in the air as to whether it is a microvascular thing or what.
I don't really know how they would test me for this other than history.
One thing I know is that oxygen during an attack helped the discomfort, and that is a sign of an anginal type process, I'm told.
BUT, that has to be weighed against the fact that these types are rare, I'm young and pretty healthy, and I DO have musculoskeletal pain (but none of it ever feels like this left sided stuff!)
I am going to bring it up with the cardio tomorrow and if he feels that my heart is healthy (I've had my bloodwork, echo, and holter monitor so far but he may do more tests) then I will continue to lead a healthy lifestyle and watch out for my heart with supplements, etc. If he feels it MAY be one of these rare things, I will explore it while considering a risk/benefit ratio (and since he is my husband's coworker I am sure he will think about risk, too---for example, a cath would likely be overdoing it on me lol, at least I hope so!!!). Anyway, I am interested in everyone's opinion on this, but for those who think they may have it, do keep in mind that these types of anginas are pretty rare. I will report back tomorrow after my appt.

08-25-2008 05:46 PM

Re: Does anyone have "atypical" angina?
 
You may be having variant angina or "at rest angina" caused by coronary artery spasms. This seems to be hard to diagnose because coronary spasms can't be summoned up at will, and usually don't occur during exercise. Look on the web for Prinzmetal's angina.

Bill

CircusSquirrel 08-26-2008 11:48 AM

Re: Does anyone have "atypical" angina?
 
Hi Bill and Everyone,

Yeah, it could still be a variant angina, though the cardio said it didn't quite fit Prinzmetal's (believe it or not, there are other, rarer types of "atypical" angina).
Due to all my symptoms, my new cardio (who fortunately knows my husband and is just an all around good guy) really thinks that the talk of dysautonomia that docs have floated around about me for about a decade is probably true. My holter results, while normal in the sense that there were no "dangerous" rhythms on there, were unusual because my heart responds VERY strongly to my nervous system. My heart will be at 100, then dip to 50, and just generally go all over the place, causing me symptoms, which MAY include the left sided stuff (or may not). Our plan for the next month is no more beta blockers, keep my heart rate down by not exercising strenuously, stay very hydrated, get the blood moving out of my legs by wearing compression stockings and doing isometric leg exercises and drinking a bit more caffeine because I have been bradycardic lately even without meds. We'll see what that does, then my cardio may try a couple of meds OR he may have me get one of those implantable loop heart monitors to "lay to rest the issue of ANY bad arrhythmia once and for all". He said if we could really put the arrhythmia issue to bed, we could probably concentrate on what is causing my heart to behave this way, which is an overactive nervous system that isn't caused by anxiety, but by a dysautonomia. Soooo. . .that's where I am now. I am not looking for miracles, I just want to balance my life and lifestyle with awful symptoms, and I want docs to stop writing everything off as anxiety. This cardio said "anxiety does NOT cause the changes I see in your holter monitor" I said "hey, thanks for saying that. I'm pretty much only anxious because noone has ever figured out what the heck was wrong with me, otherwise I would be just a run of the mill, slightly neurotic person LOL!"

agni27 08-28-2008 05:26 AM

Re: Does anyone have "atypical" angina?
 
[QUOTE=Bill 1950;3703635]You may be having variant angina or "at rest angina" caused by coronary artery spasms. This seems to be hard to diagnose because coronary spasms can't be summoned up at will, and usually don't occur during exercise. Look on the web for Prinzmetal's angina.

Bill[/QUOTE]

Hello, I am new to this forum and have been reading through the posts. You are asking if anyone has "atypical" angina. Well, I have a confusing thing going on for which I would love some input. I am a 58yr old female, alone and working full time. Some months ago I felt unwell after carrying heavy shopping, slight pain (as if pulling a guitar string,) to left above breast. This lasted for over an hour. I would get this sort of pain sometimes, at rest or after exertion. About three weeks ago, I did some gardening and the same thing happened but the pain was worse and lasted longer. I was also getting breathless. I went to my doc and was sent for a stress test (my cholesterol is high despite an almost vegetarian/and good diet) The stress test showed a bit of strain towards the end and so I was told to come in for an angiogram which I did last week. After the stress test the pain became worse (more like burning) and started more from the middle of my chest totally into my left arm to little finger, also left shoulder, this pain could last for an hour or longer, it also came on in the night or at any unpredictable time while resting. The bedrest at hospital improved the pain very much, and I've been put on beta blockers, cholesterol tabs and aspirine for three weeks now. Today I have only the slightest of pain for a matter of minutes.
[B]What was I told by the cardio?[/B] My arteries are totally clear and healthy. He did say that they are very twisted. My blood pressure is perfect by the way. He gave no conclusive reason for my pain episodes, thinks it might be caused by stress, (I am a very happy person and apart from leading a busy life I travel a lot, everyone has some stress, so find that confusing) My mum got angina pectoris when she was in late forties.

I am happy to have found this forum, I felt very much alone with this problem, as if my body has let me down, very bad at having to take medicine etc..... I realise that I'll have to help myself by educating about these spasms..... can anyone put me on the right track.
Thank you so very much.


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