When to take Nitro?

Hello everyone? I know this probably seems like a stupid question, but I wanted to ask because I am just so uncertain with my symptoms. I have Prinzmetal's angina and all day yesterday I was having cardiac spams, not big ones, but sort of continuously. Then last night, I was having stronger ones and my left arm was weird feeling and tingly. I took some aspirins and went to bed. While laying in bed, I started feeling funny all over, sort of nauseous so I got up and got my nitro. I have not taken it yet at all, so am somewhat nervous (of the unknown). I decided to sit up in a chair we have in the living room. I was still having the other symptoms. I was so tired that at some point I fell asleep. My question is "When or if at all, should I have taken the nitro?" It did not get worse, I did sleep all night and just got up, but am wondering if it was a precursor to a heart attack or a really small one. Any advice would be welcome, thank you!

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Personally, I go thru the same thing at times. I have the symptoms and I have the nitro for them, but I hesitate to take it because of the headache I get from it. I also can fall asleep with my chest shaking like crazy. I don't ever get nauseated. tho. I mainly take the nitro if I am having pain or shortness of breath. In my case, the symptoms have not been the precursor to another heart attack. I had similar but worse symptoms and the troponin level came back negative from lab. Of course, this is just me so it may not be the same for you. Joyce

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I think for everyone it is kind of a personal call depending on what we have been through and what our symptoms are. I am a lot like Joyce in that I avoid taking nitro if at all possible due to the headache. That said, when I get left arm involvement with my spasms, I tend to go ahead and take my nitro. For me it is because when I had my MI my left arm started tinglng, went numb and then felt like it was going to explode. I don't take any chances since my MI was caused by a spasm and a blood clot.

Hope that you are feeling better soon.


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I hear ya with the nitro!! I used to try and wait it out because of the side effects and I just dreaded taking it. However, the other side of it is that it will open up those arteries to get a better blood flow and ease my pain and take the stress off of my heart, so I have stopped trying to be a hero. Toughing out symptoms got me in more trouble in the end. My angina was so unstable that I now wear a nitro patch for 12 hours a day, even after 7 stents. It was awful at first but my body adjusted, the headaches are very limited (most days no headache at all) and I can now live my life without grasping my chest and wondering if this is the 'big one'. I can do way more each day including excercise and am living with less fear of the dreaded 911 call and the ambulance in my laneway.
This is just me of course, and I preceded this course of action after a consult with my cardiologist and my pharmacist. Take care of yourself.

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Thank you Joyce and Dianna. I didn't even know it causes a headache, just was unsure when to take it. I guess I will just have to see how I feel at the time. I think maybe last night I should have.
BevH, wow, 7 stents. You sound encouraging though in that you have learned how to deal with it all and live your life.
Thank you to everyone. The support and understanding on here is so great. This is truly all new to me and I appreciate the answers to my questions.


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Hi Colleen,
I found I treated the nitro much like "bothering my doctor." I fretted and worried if I should take it or not. I finally realizing that it won't hurt a thing to take it so long as my blood pressure doesn't drop too much. So, after two, I check it. Even this week, it occurred to me to take it for the episodes of nausea I have. I took just one and instant relief. I can't believe that never occurred to me before even though that was one of the first symptoms I had! I had the thought then of how ridiculous it would be to die with an unopened bottle of nitro in my hand. The headache only lasts about five minutes with me so I don't give that a thought.
Hope that helps, Allie

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I agree with the others that say it does not harm us and we have it for a reason..........to take it when necessary. I don't think you have to over think it, worry, or suffer. The blood pressure drop is the only thing thing to watch out for if you take more than 3 in the 15 minute time period. My instructions are take one every 5 minutes up to 3, then call 911 if symptoms persist. When I have the spells of pain, they usually go on for a few days and then disappear. I have the spasms alot with no pain, pressure or shortness of breath. I never take the nitro for just the spasms.

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Hi All,

I can't believe I found a group that is confronting the same exact issues I am. I have sat with the nitro bottle, staring at it, with "kinda chest pain and kinda left arm numbness" feeling like I was a megga wimp if I took it. I also went two days with "horrible heartburn" not wanting to bother anyone, when it was a heart attack.

It blows my mind how little I valued my own life versus an ambulance bill and the embarassment of my neighbors seeing me carried down the stairs on a gurney. It's......heart-wrenching. And it was.

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That's what nitro is there for. To be used.

I met a woman who used to stop mid-tennis game, give herself a spray of nitro, wait a few minutes, and then resume her game happily.

A caution for nitro however: it's a vaso-dilator that also works on things like acid reflux. So if you're wondering if this is heartburn or heart attack, and pain responds to nitro, it doesn't necessarily mean it's just heartburn...



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Hi all

When my doctor prescribed nitrotablets to me, he referred to them as a kind of vitamin for the heart. Not that the nitro has anything to do with vitamins, but just to tell me that it is safe to take.
My nitrospray I used just the other day - having a bit chestpain and more severe pain in the jaw. At first I was bewildered because the pain was mainly in my right side, så I tried to wait for a while, kind of sitting it out. But these pains tend to scare me, so after a while I decided to take the spray, and it helped. So I won't hesitate to use the nitrospray next time, even if the pain is not like I'm dying. I think that the anxiety that often comes with the pain - at least for me - does more damage than using the nitrospray even if it is not really needed.
And the headache - it was horrible in the beginning, but it's not so bad now. And lasts only an hour or so.

Best wishes

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Thank you so much because I was treating it just like you said "sort of like bothering the doctor" and you are right, how stupid of me if I were to die holding an unopened can of nitro. I guess I was just somewhat afraid of the unknown and uncertain too. After reading all these posts, I realize that I should have taken it and I will next time. Thank you too Joyce again for words of wisdom! I have low blood pressure to begin with, so I will watch that. Willowbark, same thing, why should we worry if we call for an ambulance?? Thank you everyone for your responses, so helpful!!

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I have the exact fears you do, except my headacke will usually become a migraine. Two days ago my RIGHT arm was so heavy and hurt badly, my left side felt a little heavy and I had to lay down so my heart beat didn't feel so hard. I didn't take the Nitro because I thought I would feel worse, but finally I gave in and wound up having to take two, it did help the pain. Don't fear the least when the worst is heart failure. You can get over angina with Nitro but you can never get over damage by heart attacks .

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Dear IV,

You might want to plan on lying down when you use your Nitro rather than sitting up in a chair because you could go BOOM! :-)

May the Blessings Be!


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Oh, yes - and Jaynie's wise advice: take a Tylenol 20 minutes before your nitro spray/tablet so the famous nitro headache will not be an issue!

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I think we all tend to be freaked out by the idea of nitro at the beginning of this experience; however, I've really changed the way I think about it. It's been a year since my heart attack, and I am back in the gym now and finally getting my life back to nearly what is was. The big difference is I have to have the nitro-- especially if I am lifting weights with my lower body. That tends to give me more spasms than usual, so I almost always end up taking a nitro or two on leg days. I have talked to the doctor about it and he said that's ok, and actually told me to either take one before I exercise or to even take an extra Imdur on leg days. I can only tolerate 1/2 an Imdur or it causes bad headaches so I usually do the nitro. Anyway-- I've found it's better to err on the side of caution with the nitro. If it's not truly heart related pain-- it won't have any effect.
Good luck.

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Does anyone know if nitro helps with pain from pericarditis? I was just diagnosed with it a month after my heart attack. I have never been a fan of taking meds, guess I don't have a say in that anymore.
Just don't want to take the nitro if it won't help. However, Ibuprophen doesn't seem to do it.
Thanks, and am so grateful for this site.

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Hi, plexi
I've had several bouts with pericarditis (not fun!) after receiving my stents, but thankfully nothing in the last year! I am not a fan of taking meds either, but the pain was so intense that I had to take something. When I had my episodes, I initially took high dose ibuprofen, then I had a GI bleed in 2008 and couldn't take ibuprofen any longer. The last episode about a year ago I took Tylenol and it helped some. For me, the symptoms lasted generally four or five days. I did go to the ER a couple of times with it, and I don't believe they gave me nitro, or mentioned that it would help, but that is a good question! They did give me a narcotic pain reliever, but I get nausea with those class of drugs so I stuck to the Tylenol.

Hope you start feeling better!

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I know what you mean about taking a nitro and winding up with a migraine. That also happened when I was in the Cleveland Clinic. While I was in the 24 hour section, getting nitro, I got such a migraine, they had to give me a shot of Demoral, before releasing me. of course I suffer from migraines anyway.


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Thank you everyone for the words of wisdom. I will plan on laying down when I take my nitro and I will take it if I feel it is necessary!! You all are so great on here, so very helpful!

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I was hesitant to use my nitro because of the headache and feeling so weak -- and I was busy. Well, now it is my friend. The cardiologist explained to me that by the time you feel the chest pain the heart has already begun to stiffen from lack of oxygen. Thus the treatment for Prinzmetal angina is prevention of angina as much as possible. Nitro helps to prevent permanant damage to your heart. I would think that this would apply to other conditions of the heart, as well. I certainly don't want to scare anyone, just want to encourage each of you in the use of nitro. I don't take it when I have a brief pain that quickly goes away.
Each entry that I have read encourages me and lets me know that there are people who do understand. May God bless you all. Please, each of you take care of yourself.


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Thank you for your post. Your doctor is so right and I know that, I was just uncertain but all these posts have encouraged me and I appreciate that!
Take care of yourself!

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