I'm asking you folks for help because I'm a little confused by my cardiologist. In late January I was admitted to the hospital for chest pains that were relieved by nitroglycerine. A heart cath showed I had a 50% blockage in a posterior artery and didn't require a stent. I put myself on a low fat/cholesterol/salt diet and have lost 75lbs. Over the past few months I started getting brief, mild angina that lasted only a few minutes so the cardiologist put me on 30mg on Imdur once a day. This is on top of Diovan, Toprol, Vytorin, Tricor and a daily aspirin. A few weeks ago when I'd get angina it'd be at rest, more severe, with sweating, nausea and headache and would affect my chest, left jaw, arm and shoulder blade and wouldn't subside for several hours. The doc doubled my Imdur dosage and said he wasn't worried about me because my blockage isn't significant, my EKG is normal and my cholesterol and BP have improved. But I'm still having these angina spells. So my question is: What's causing the angina and is this normal? He tells me not to worry unless the pain gets worse and doesn't go away. I don't want to be a worry wart, but it does get my attention when I'm not sure if one of these episodes will end up with me in the ER and finding out a heart attack could have been prevented. Any comments would be appreciated!

Hello Spurbob45,
It appears that your doctors have been been careful with their evaluation of your cardiac condition. Also, you have taken the right steps yourself to improve your situation (weight reduction, good diet). Are you able to do much physical exercise - even just walking ? However,I think you are right to be concerned about the angina (if that's what it is) and should definintely seek a second opinion if it continues,especially if it gets worse, or more easily induced. I am unclear about the drugs you are taking because here (Australia) some trade names are quite different. Are you on a medication specifically for angina relief ? And, if so how effective is it ? I am not medically qualified, but your "angina"should be controlled (treated). All the best.Please let us know how you get on. Your doctor should not mind if you tell him of your concerns and would like a second opinion.
Regards, Excelsior

Over the past few months I started getting brief, mild angina that lasted only a few minutes so the cardiologist put me on 30mg on Imdur once a day. This is on top of Diovan, Toprol, Vytorin, Tricor and a daily aspirin.

I'm on several different heart meds. I've found out that I've had to take them an hour or two apart or I would get increased symptoms, including angina. I've also found out that there were certain foods that would interact with my meds and cause nasty side effects.

Many medicine interactions with other meds or foods are not documented or known about by medical professionals, IMHO. For instance, my doctor refuses to accept that my medicines interact with each other when I take them too close together. Regardless, I separate my meds by an hour or two and I avoid the nasty side effects.

Quote: The doc doubled my Imdur dosage and said he wasn't worried about me because my blockage isn't significant, my EKG is normal and my cholesterol and BP have improved. But I'm still having these angina spells. So my question is: What's causing the angina and is this normal? He tells me not to worry unless the pain gets worse and doesn't go away. I don't want to be a worry wart, but it does get my attention when I'm not sure if one of these episodes will end up with me in the ER and finding out a heart attack could have been prevented. Any comments would be appreciated!

Angina is almost always due to the heart muscle not receiving enough oxygen/blood. Medication can/does dilate the arteries and improve blood flow to all areas of the heart and provide relief to pain. I don't believe it is normal to have pain, but it may be due to a low dosage of medication and/or the interaction with other medication.

It may be wise to have a stress test. I don't believe it is prudent to wait and see if the pain gets worse. The Jan. blockage may have increased to 70% or higher. There is a hereditary factor for high cholesterol as well as diet.

My condition precluded a timely intervention for CAD and the heart muscle was damaged. I had no warning of blocked arteries.