Angina or something else?

[Mickeycaregiver]

My Mother has just had a pacemaker put into her heart. She went into the hospital with chest pain that she described as a burning sensation that covered the chest area and up into the neck which was much more than just an uncomfortable feeling. after admitting her and hooking her up to a monitor it was discovered that she had some significant heart interruption. Her heart would stop for long periods of time. She was transferred to a heart hospital where she had the pacemaker put into her heart. I was under the mistaken impression that the burning in the chest would cease. It has not. When I mentioned this to the Cardiologist, he said no, it would do nothing for that symptom, which he said was angina. I might add that this conversation took place as the Doctor was on his way out and we were actually on the sidewalk detaining him. My point is, he was in a hurry and made the statement on the run. At present I am giving Mom pain medication which does seem to relieve the symptoms somewhat. I am looking for someone who has had personnel experience with a burning sensation in the upper chest going up the neck. Nitro did not relieve this symptom, even after three tablets under the tongue. (given by the nurses in the hospital) Mother had an Aortic Valve Replacement in 1999. She has experienced the symptoms in varying degrees since that time and has in the last six months gotten more frequent and more intense. I am anxious that we are missing something.

[Jack51]

I feel like your Mother's doctors are missing something! I don't know your Mom's age, but if she is older, then you must be more persistent with her doctors. My experience with elderly people and medical treatment is a sad one. I think doctors want to give up too fast on the elderly. It sounds crazy, I know, but I have witnessed it 2 times.

Look at your Mother's history! Aortic valve replacement in 1999. How much damage did the deffective aortic valve do to her heart, before it was replaced? This may have damaged the electrical pathways in her heart, that caused the need for a pacemaker (do a search on all the affects of a malfunctioning aortic valve). Records, records, records my friend. Get a cardiologist to take a look at the big picture of ALL your Mother's past treatments/records.

I cannot believe that the nurses gave her 3 doses of nitro, which didn't relieve the angina, and nothing more was done to check for coronary artery blockages. It may well be that the doctors do not believe she is healthy enough to have a cardiac catheterization at this time, but if so, they should have told you this.

I would be willing to bet that she has had at least 1 cardiac catheterization, which is still on record somewhere, that would give the docs an idea of any coronary artery blockages. Coronary artery blockages cause angina, and the description of your Mother's pain, sounds exactly like angina.

If your Mother is experiencing true angina, it is because the muscles of her heart are not receiving enough blood due to blockages (this can lead to a heart attack). It could also be due to coronary artery spasms (but not likely, due to the statistics). Does this pain occur while she is at rest, or while she is exerting herself? Does she have other symptoms, such as shortness of breath, or nausea when the angina occurs?

So sorry about the lack of time the doc had for you, but this is not uncommon, as you probably know. Best of good health to your Mom.

[Mickeycaregiver]

Thank you for your reply. Yes, you are right on, Mother is 87 and I too am worried that no one is all that committed to "fixing" her heart problems. Mother's surgeon did take a look at the condition of her arteries before the valve replacement and told us that her arteries were in great shape, no blockages, "clean as a whistle" were his exact words. However, Mother, who was a dedicated fast walker, (three miles every day), never recovered enough to do her daily walking exercise after the surgery. She began to complain of a burning sensation in her chest and radiating into the neck. It was maybe once or twice a week and most often when she was sleeping. then she began to have the symptoms during the day also. She has not had nausea with the pain and she has it when she bends over with some shortness of breath but she also has it "come-on" for no apparent reason, such as while she is sitting watching TV. She also began to have thick white, cottony phlem come up in her throat. Sometimes several times a day but mostly at night. She also began to have serious pain in her right leg from the hip to the knee anytime she was up walking, even just inside the house. To make a long story short she started experiencing the chest pain more and more frequently and more intense until it was almost constant which took us to the hospital.

I found this website out of desperation to try and find answers to symptoms that I believe are being disregarded. I am concerned that she may have an infection that has been slowly working on the sac around her heart for the last 3 plus years. I may be way off base, but while she was in the hospital taking IV antibiotics she did not have the burning, but it returned within 12 hours of arriving home.

I have given her pain meds (Hydroco/APAP 5-500) for the burning with some success but not much. Just today I gave her 400mg of Ibupropen and it seemed to give her more relief. However, reading over her pamplet on the drug Coumadin (given after the pacemaker surgery) it lists Ibupropen as one of almost every other pain reliever that you should not take while taking Coumadin. I think that the burning indicates inflammation, but I'm not a doctor. Does Angina present itself as a burning pain or a crushing or both or what??? My Mother is not wimpy, when she says it's bad, you can bet it is serious.

Sorry to go on and on, but it feels really good to just be telling this to someone who is listening. Your comments are greatly appreciated.

thanks for responding.

[zip2play]

Mickey,

The "burning" sensation is classic angina pain. I never had any of the "crushing pressure" that is often mentioned but rather 10 years of BURN on FAST exertion (heavy was never a problem- I'm very strong.)
My burn would exten up to the jaw and when really bad radiate into both upper arms.

Whether or not she has a classic "plaque blocking an artery" kind of angina, or whether she has some problem with that valve is something for the cardiologists to decide. Whatever the cause, the burning is ischemic angina from poor bllood flow to a portion of her heart.

She needs another angiogram if anything further is to be done, but I'm sure they don't want to get too invasive at her age.. Drugs that might help a lot are the beta blocker and the calcium-channel blocker families. Giving NSAID analgesics for this kind of pains is BAD medicine all 'round.

I too am surprised that the nitro didn't help your mom, but they didn't help my mother much with the same symptoms either. I personally have never tried nitro except for sex kicks years ago, so I don't know first hand how well it works for angina (except that it caused banging headaches.)

[Jack51]

She has not had nausea with the pain and she has it when she bends over with some shortness of breath but she also has it "come-on" for no apparent reason, such as while she is sitting watching TV. She also began to have thick white, cottony phlem come up in her throat. Sometimes several times a day but mostly at night.

A "frothy" phlem is a symptom of pulmonary edema, or fluid on the lungs. So is the shortness of breath. These are telltale symptoms for sure. This could occur due to failure of the right side of her heart, which circulates blood through the lungs. Does she appear to have fluid retention in any of her extremities? Has she limited her sodium intake, and is she on any type of diuretic? Has her potassium been checked?