Cornonary artery spasms, arrythmia, and diastolic dysfunction

Definitley new here! I have been having chest pain off and on for about 2 months now. The week of Christmas, I had 3 nights of severe chest pain, but me ding the stubborn one, I stupidly didn't go to the ER! However I did finally got to my internal specialist the morning after my last episode. I ended up seeing the nurse practitioner. I was already aware that I have an arrythmia, but she heard a murmur also. Not uncommon for my family. They did an echo stress test, it went well other than I have mild diastolic dysfunction and left ventricular hypertrophy. Two day holter monitor showed constant tachycardia and I was placed on beta blockers then sent to the cardiologist. He has me on a 30 day event monitor that I push button when I have symptoms but this high tech thing also detects if I have something going on and records it on it's on. Just to be safe, dr had me go for a gallbladder ultrasound, in which they found gallstones. I go to surgeon for that next week. Before the ultrasound the Cardiologist seemed to think that I may be having coronary artery spasms, gave me nitro with the 30 day monitor. So now I dont know what to expect or where my pain is coming from! It is in the center of my chest between my breats, heavy squeezing pain that goes all the way thru to my back between my shoulder blades. So far I havent had an episode since Dec 30th. I am 37, not what they consider obese, I don't smoke or drink. I have low b/p and low heart rate until now! SOund familiar??

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Hmmm... You have a few things going on. So you are feeling relief since BB? (Beta blocker) and you used that te in plural... Exactly which BBa are you on? The diastolic dysfunction can often also show up on low diastolic number in your BP...

Does your tightness or pain occur mostly at rest? And you have not had any since the 30th of dec? Do you mean you have not had tachycardia or pain between breasts or both?? Just trying to be clear. We are all puzzles....

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Sorry I did ramble around. I am on one beta blocker, 50 mg of atenolol, and the only thing I feel from it is exshaustion! I am SO tired but they told me it would be that way a while. I already have low BP so I am sure that isn't helping. Tightness/unbearable pain, has always been at rest. Dec 30 was the last time I had this unbearable pain, how ever I am experienceing milder episodes of it since then. To my knowledge I am still having tachycardia I never feel it really, it's just on ekg and holter monitor. My pain is directly between my breast and tends to radiate upward. I am on a constant heart monitor/event monitor. I can push the button if I feel something but it will record if it sees an issues happening its self. This morning I am having vague chest pain from the middle of my chest that feels like it radiates up the front of my neck and chin. I did push the button, but it has already been recording things itself this morning anyway. It is supposed to transmit itself but it doesn't because I live and work out in the boonies! lol

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Sounds like you are getting a good work up. It can sometimes be difficult to distinguish between gallbladder pain and heart pain. I tended to feel my gallbladder pain lower, to the right of stomach and radiating to my shoulder blades. Are you using your nitro when you have symptoms? I would suggest that.

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I haven't had bad pain since I got the nitro. My dr said to let the pain start real good, hit the button on the monitor, let it record a min and then hit the nitro> Then get ready for a headache!

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Your symptoms sound eerily familiar to mine. About 3 years ago, I started off with chest pain in the center of the chest that radiated up the neck and jaw and down the left arm sometimes. Often the pain went through and I felt the pain between my shoulder blades. After a while, I did see a cardiologist who said it sounded like unstable angina and to take a nitro when it happened. If it worked it was probably my heart. I actually didn't believe her so didn't take one and ended up going into vtach after a very bad angina attack a week later. After almost two weeks in the hospital while they diagnosed me by an catherization and saw the spasm, they implanted a pace maker and put me on calcium channel blocks and long acting nitro - imdur. No one seems to really know if the coronary artery spasms cause the artheyia or vice versa but there seems to be a link. The pain would come mainly at night and when I was at rest. Sometimes my heart rate would get very irregular. Similar to you, I don't have high blood pressure and not more than about 10 lbs overweight, have good cholestoral and did not seem like heart disease was going to be a problem. I don't drink but until the attack I did smoke about 1 pack a day. Haven't had any since that episode though. I am doing pretty well now thanks to the meds and the icd which actually paces my heart rate up a bit. I keep reading how many doctors are missing this diagnosis. The attacks got further and further apart and I seem to be, thankfully in remission. Occasionally I get the pain between the shoulder blades. If it lasts very long or seems to be getting worse, take a nitro. In a lot of cases that works for me pretty quickly. particularly in women and putting it down to everything from panic attacks to indigestion. The problem with diagnosing it is that they need to see a spasm in action and that is difficult. There is a way to induce them but from what I have read, that is very dangerous and I don't suggest it. I would definitely keep following up with the cardiologist and take the nitro whenever the pain starts. Good luck with you gallstone surgery and keep us informed. Take care.

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Please view my recent PBS show about cardiac microvascular dysfunction Episode Angina with me, Joan Jahnke. See if you find anything similar.
Also google 'joanincarolina' and that will link you to the same subject and my journey. I post here and on MedHelp under 'joanincaroina'. Pay attention to these signs you have and altho you may have other stuff going on, the fact that you find relief with nitro is diagnostic in itself. I'll answer questions and good luck. Joan.
ps : look here at Inspire and look at the thread posted titled : Angina! must see tv docu on cardiac nurse w microvascular spasm onset. Kennarina posted a link to another video I did at Emory. Lots of good info here and help.

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Last month I went through what I hope to be my last cardiac ablation for several forms of SVT, the AVNRT the most threatening. I've also been positively diagnosed through an angiogram with coronary artery spasms and am on imdur, nefedipine, and nitro tablets as needed. I also have already low blood pressure and am extremely physically active and have a healthy Mayo Clinic cardiologist believes that coronary artery spasm may actually lessen as I get older as my arteries naturally relax. He wants to repeat the angiogram in two years to see if it is getting better. When I have chest pain it feels like a large balloon under my breast bone. I was on verapimil but have much less side effects on the new drugs. Good luck to you!!

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What is cardiac ablation

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Crestav: I am 67 years old. My first episode of coronary spasm happened at the nice senior age of 60. While most of the ladies I know start with this ailment in their cluster age group of 40, I also know a few in their 20s. So I am only mildly taken aback that you were told that as you age and your vessels relax that this would be better. I ask you to stay on your toes and keep track of your signs and how they develop. Unfortunately for me, my abrupt start in 2005 and continuing increase in symptoms despite no CAD, has continued without any relief except for what I get thru a calcium channel blocker and nitroglycerine.
Emory would love to do another cath on me since they did the last one in 2008 just to see how I have physically progressed based on my limited and ongoing cardiac demand obstacles.

Keep ahead of the of the doctors. I am a cardiac nurse but will leave the question of ablation for you to answer. If not, just google ablation and see what Crestav and many others go thru to try and correct difficult situations in the hearts' natural rhythms when medications do not help.


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Saw surgeon today for my gallbladder, he is doing it the day after tommorow!! Not what I expected! I normally don't worry about surgery, especially one that is outpatient. But I am scared this time. I sure hope my heart is ok for this! Especially since they haven't really diagnosed me yet! Have pre op tommorow that will include an EKG and cardiologist is calling for an updated report on my 30 day monitor, so hopefully everything will be fine!

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Thank you Joan for your response and dawnsc47, I truly hope that your surgery goes well tomorrow. I am sure you are in good hands!

A cardiac ablation is where they insert catheters into the heart, in my case through both femoral, radial, and jugular arteries, to burn/ablate (or freeze depending on the tissue and any nerves that may lay nearby) the muscle to create scar tissue that blocks irregular electrical rhythms. The most common reason is to correct A-Fib, but it can be used to fix other arrythmias or defects.

Good luck tomorrow!

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Surgery went well I am back at work today after 11 days. I had a large diseased gallbladder, they did it lapro, but I do have a much larger insicion than normal at the top because gallbladder was big. I did fine, but my 30 event monitor is recording "events" all day, even though I feel nothing other than tired/weak. Who knows if it is surgery or heart or meds. (Only took pain meds a couple of days after surgery). I wear monitor until Friday and go to Dr a week from tommorow.

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Dawnsc47: I will be looking forward to your report after visiting the doctor.Then it will be time to see if this was referred pain from GB or if it is indeed implicating your heart. Above all, have the heart issue high on your list. Wishing you the best outcome. Hugs Joan.

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