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Friday, July, 10, 2009
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how do you live with coronary artery spasms, 35 f had heart attack 5/30/08

dawn
06/28/08

my grandmother of 68 past away mother's day this year and during this time is when i noticed a crushing feeling in my chest, but dismissed it from being upset.  One week later we went to the lake to stay for our Anniversary and noticed on the way up a heavy feeling and weird pains in my chest, also thinking that i slept wrong because my neck and jaw had pain.  For three days during the stay, i felt these pains on and off, but then completely went away.  I did notice that instead of going out on the boats and riding the jet skis, i took every minute possible sleeping on the sofa...so tired and besides out of breath to walk to the activity, which is not me.  Then by the time the trip was over, i felt fine and it was out of site, out of mind.  That was the week of May 25.  I went back to as normal as an activity as possible, i just felt really drained and had a feeling of lazy.  On the thirtieth of May 08 I went to my sons honor program and was fine, came home and began working at our office.  I was on the phone with one of our employees and at the same time bending over (from sitting position) to file a paper and i felt like something was crushing on my chest really bad, then everything went black and i felt as if i got up, i would fall, and i did, then my chest began to really hurt and i felt like it was hard to catch a breath.  Then i felt like i had to hurry to a restroom, i was extremely sick to my stomach.  I tried lying on my bed to the left, right, straight up, on my stomach....every way i could and no matter what i did, the pains got worse and worse, of course my husband was very anxious to call the ambulance, but i wanted another few minutes to close my eyes and try to rest.  He gave me about 1 minute and then i told him yes please call, i was taken and stabilized best possible in the ambulance, then transported to a hospital close to home, i had positive enzymes, irregular ekg, etc.  I was then transfered to Mid Central Georgia Hospital in Macon's heart center, had a heart cath, but not a whole lot found, after a few heart doctor's, my current one has concluded by all of the tests and positive Lupus levels that it was a Coronary Artery Spasm and a possible clot?  Meds have been changed more times than i change my childrens diapers it seems like, and the chest pain is daily, still have no energy, out of breath alot, is this normal and how do you live with this.  will things get back to normal or will this be one of the things i have to alter my lifestyle in order to prevent?  Curiousity and not knowing enough is killing me.  any help would be wonderful.  thanks  dawn

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Answers (2)
Martin Cane, M.D.
Martin Cane, M.D.
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Martin Cane, M.D. is Physician - Internal Medicine
Physician

Tuesday, July 01, 2008

 

Dawn,

 

Thanks for your question and I'm sorry to hear of your problems.  Coronary spasm is a known cause for acute coronary syndrome and also myocardial infarction (heart attack).  As you've pointed out, catheterization does not reveal any major blockages to explain the area of damage on an electrocardiogram.  Sometimes, during the catheterization, the doctor actually sees the artery spasm and narrowing.  It's this narrowing that causes the problems.  It creates a situation as if there were a blockage, with less blood flow to the heart muscle.  If blood flow slows enough, a clot could also form which can lead to a heart attack.  

 

Fortunately there are several medications on the market that can be used for coronary spasm.  They  are in two broad classes.  One class is known as calcium channel blockers, available in different formulations and different doses.  These drugs cause blood vessels to dilate and deliver more blood.  Used on a regular basis, they can help prevent the spasm from occurring.  

 

The other class is nitrates, which also cause blood vessels to dilate.  They are available in many forms: pills; patches; pastes; and, small tabs to dissolve under the tongue. 

 

Though nitrates and Calcium Channel blockers are commonly used to treat heart disease, the Calcium Channel blockers are also used to treat high blood pressure.  Therefore, in a situation such as yours, your doctors are trying to control the spasm, and unfortunately you're experiencing the side effects, which probably include low blood pressure (which can be caused by both classes of drugs).  With trial and error, and fine adjustment of doses, you should be stabilized at some point.  Your body should adjust to most of the side effects.  And hopefully, you will then be leading a normal life again. 

 

Have patience.  It sounds like your doctors are on the right track.  Don't hesitate to discuss your feelings and concerns with your doctors who will provide explanations and reassurance.

 

Best wishes.

 

Martin Cane, M.D.

Michelle
Friday, March 20, 2009

Dawn,

I want to thank you for posting your story. I am currently in the cardiac wing of a local hospital, having had an emergency angiogram and diagnosed with coronary artery spasm as well. It has been 4 days since my diagnosis and I am still in shock and trying to understand what this is and how it happened to me. I am 40 years old and just gave birth to my 3rd child 8 months ago.  I am still carrying baby weight but not overly overweight, in decent condition with a history of playing soccer and my angio confirmed a healthy heart and no buildup in the arteries.  However, your description is exactly what I experienced...the chest pain, the abnormal ekg's, the release of enzymes and the vomiting that occurred during some of the episodes.  Strangely, I had been experiencing these episodes to a degree for over 4 years, starting with the birth of my first child, then subsiding, then after the birth of my second child, subsiding and now here I am after the birth of my 3rd.  Initially we thought it was a pinched nerve and treated with muscle relaxers and massage.

 

It is all so strange and I want to come home, but petrified.  Petrified that the episode will turn in to a heart attack.  So far the meds seem to be helping though not totally alleviating the symptoms.  However, it helps me to see that there is someone out there who had exactly what I had, diagnosed exactly as I have been and is out there living their life.  I am concerned about how tired you are and all, and that will be a concern in day to day.  But thank you for posting your symptoms, your story and your question.  With a quick internet search, I suddenly did not feel so alone.  I can't believe that I am 40 years old and a heart patient. I did not see that coming.  I hope you are doing well and the mix of meds has finally worked for you. I am now starting my own journey.

Michelle from Seattle

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