I was a smoker for eight years but gave it up at the age of 25. (12 years ago)
The desire had been brought on by the fact that I had become slightly overweight and generally wasn’t feeling to good about my state of health. I took up the sport of cycling in 1992, which gradually developed to a quite serious level and by 1995 was doing an average of 10000km per year. Since then I regularly took part in one-day events, the length of which varied between 70 and 100km.
My problems started around September last year when I started to develop arm pains, mainly at rest, but sometimes during extreme exertion.
I visited a cardiologist who noted some “inverted T-waves” on my ECG, but after stressing me quite harshly concluded that it didn’t appear that the problem was with heart related. Nevertheless he still prescribed a list if medications for me, which I ceased to use after one month. My layman’s reasoning was that if he told me that nothing was wrong, why then did he prescribe all of these medications. How wrong could I have been? My arm pains persisted and I visited several GPs, who too could not conclude the problem to be heart related.
On 23 Feb I took part in a 85km cycle race and started developing arm discomfort during the latter stages. By the time I finished, the pain had become quite bad but pretty much what I had been experiencing over the previous months.
Afterwards, the pain subsided for a 30 min period or so before it gradually got worse until it became almost unbearable. When I could no longer bear the pain, I decided to check myself into Casualty ward. (Something I had done a month earlier with very similar symptoms - only to be told that they could find nothing wrong) This time was different - The Oxygen mask (which hadn’t been administered on the previous occasion) made a huge difference as the pain in my arm subsided from 9/10 to 3/10. But worse was to follow as I went into fibrillation and needed a jump-start.
I stayed in ICU for a day or two before an angiogram could be done. The Cardiologist and technicians proceeded to rave at how smooth my arteries were and declared that no typical blockage had probably occurred. So angioplasty wasn’t necessary. The cardiologist seemed convinced that a narrowing of the offending artery was evident and ascribed the whole event to an arterial spasm - Prinzmetal’s or Variant Angina, I believe. On meeting with me after the procedure, my doctor was quite upbeat - his words were “I recommend a two week period of rest after which you return to your training program”. “Yeah right”, was my thought after the events of the previous few days?… I don’t think so. His idea of “training program” is probably a walk in the park.
I returned for a check-up - Stress ECG + Echo-Cardiogram and from what the Cardiologist tells me, things are about as good as could be expected under the circumstances.
His explanation to me was that I had probably entered the casualty ward in the early stages of an MI and that the drugs administered there had eased the spasm before too much damage could be done to the heart wall. He also ascribed the fibrillation to this sudden relaxation. He explained then that minimal long term damage had been done and only some “bruising” had occurred.
So the prognosis was extremely positive as the condition could easily be treated with medication.
What concerns me is the apparent lack of understanding of the causes of this condition - Besides the vaso-dilator, I’ve been placed on asprin, folic acid and anti-cholesterol medication - to “cover all the bases” it seems.
Also why did I continue to suffer arm and limited chest discomfort through my stay in hospital even though I had been placed on medication to dilate the arteries?
And why does the arm discomfort persist even now as I write this?
When I asked them of the arm pain they suggested that possibly it was unrelated. I find that pretty hard to believe - For years I’m okay and pretty fit as a result of all the cycling and suddenly start suffering occasional arm pain - Six months later I have a heart attack. No great investigative skills are required to see the trend here.
There are far too many “maybes” and “who knows” here for my liking. I suppose that’s the medical field.
Things could have been a lot worse - for instance if I hadn’t gone into hospital when I did. But still I feel in a state of depression, firstly because I don’t believe that they’ve found the root cause and therefore might not have done all that could be done to prevent a reoccurrence, and secondly because I’ve had to give up my first love - cycling. (At least at the intensity level I’ve been at)
In a way writing this is a means of giving vent to my frustrations as I realize that the questions I have cannot be answered without major additional testing, which would probably be extremely costly and impractical to say the least.
I guess I should just be happy to be alive, but still I hoped for more…
That is some story! Did you ever get a second opinion from another cardiologist?? That's what I would do. Did you ever have an MRI? Echocardiograms are good, but an MRI gives the doctor a clearer picture and more informative picture of the heart. But I would start by getting a second opinion...it's worth it, right?
Thanks for your response. You are probably right about getting another opinion, but thus far I've been treated by two cardiologists. (one before, one after, and a physician)My faith in medical practitioners is at an all time low. The expense has been considerable, but I guess I'll have to bite the bullet in an effort to delay kicking the bucket.
Going through something like that gives you a very real picture of what "practicing medicine" means. I knew that occasionally doctors miss things and don't know answers, but I evidently had very unreal expectations of what they can and cannot do with their tests.
Prinzmetal angina can be very dangerous so don't just stop taking your meds. I remember those "well it could be this or it could be that" and then they give you medicine for what they think it might be. It is all very scary.
You might consider going to a Pulmonary Specialist.It may be something in your lungs or pulmonary system.The pain stems from lack of oxygen and if you have covered the delivery system,the heart,then that leaves the beginning,the lungs.
Welcome to the ever-expanding membership of individuals who have been medically-mismanaged. 24-7 Chest pain is not normal. (As I remember and I have heard rumours to that affect as well.) Being misdiagnosed, undiagnosed and over/under/incorrectly-medicated is very normal in my experience. I now have a resting heart rate of 120, faint several times a day, have renal, liver and respiratory complications and cannot walk to the car without chest pain. I am in "community isolation" for 6-7 weeks while awaiting results of TB sputum cultures and have had pneumonia twice. The possible active TB is a result of mistreatment for the pneumonia, which was a result of mistreatment of the CHF, which was the result of a whole lot of medical mismanagement. I am registered with CDC and WHO for TB infection which will limit my travel even if the TB is not active. Because of the heart complications, I cannot receive treatment to be rid of the TB infection permanently. If the sputum cultures return positive for active TB disease, the treatment may kill me.
So, WELCOME! Get used to it if you can and by all means trust your own instincts first. If I had been more assertive and advocated for my own health a little better at the outset I would have been better off.
Life....nobody gets out alive....so laugh and slam the door when you leave!
Life....nobody gets out alive....so laugh and slam the door when you leave!