I've learned that it's hard to determine heart attack pain from spasms or microvascular angina. My symptoms varie from day to day and week to week. Several days in a row with:
A. No pain, or
B. Mild aching between shoulder blades or forarms & hands, or
C. Moderate / Distracting pain between sholder blades, down arms & hands and mild shortness of air and fatigue.
In the past 2 months, I've had 2 trips to ER with positive troponins, disections & stents, and I've had 1 ER visit with minimal troponin and followup clean cath.
A few weeks ago, when I had moderate pain, my doc just wrote for
out-patient cardiac enzymes & and EKG.
He called me that evening and said my troponin was fine (he didn't tell me the actual number). He said this is likely my new normal for a while and I should just go on with life. (He's also mentioned a time or two that he thinks I would feel better if had another heart attack in that area to get it over with so I'd stop having pain. )
I agree that this is probably my new normal, but I've also learned that it's important to listen to my body.
Last week I had 4 days w/o pain!!! 2 days with mild pain (onset of menstration) and now 2 days with Moderate pain. I called my cardiologist yesterday and asked for an outpatient troponin lab order. He said: No, this pain is expected and I need not worry.
So.... I'm pretty ticked that my doc won't write for a troponin test. I'd like to take my symptoms and place them in his body, then see how he feels! I bet he'd be begging for a Troponin test.
My PCP also refused to write for the test, stating she thought the cardiologist needed to do that.
After 5 trips to the ER, I just don't want to waist the time and money. At this point, I feel like it should be as simple as checking a bloodsugar.
I've heard from many of you who have experienced intermittent pain for some time, and most everyone says to that I need to give myself time, and I agree.
But, how do I tell? I routinly use more than 3 nitro's, so that's not a good judge. If it were, I'd have been in the ER 30 times already.
I don't want to lose a small percintage of my heart muscle with each menstrual cycle.


