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I had severe chest pain. My doctor thinks that is prinzmetal's angina. Maybe it is important to tell you that I am 57 years old. What does that mean?

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Hi! Prinzmetal's Angina is coronary artery spasm. This is an uncommon condition seen in both men and women. Episodes of typical angina are triggered when one of the major coronary arteries suddenly goes into spasm, temporarily shutting off blood flow. Episodes of this disease are accompanied by major changes on the ECG. The spasm almost always terminates spontaneously, it is uncommon (though possible) for a heart attack to occur. But during the period of spasm itself, the oxygen-starved heart muscle can trigger dangerous and potentially fatal heart arrhythmias. The spasm is usually relieved promptly by nitroglycerin. I hope that you are satisfied with information, if you want to know more you can ask me.
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I too am experiencing the symptoms for prinzmetal's angina. I am a 56 year old woman. I find it occurs more frequently after I have eaten or when I walk in the cold. I am waiting for a MIBI which is supposed to happen in approx 3 weeks. Is 3 weeks too long to wait? What are the odds that the nitro the Dr. gave me to use during these attacks will not work and result in a heart attack? I am high strung at the best of times and my Dr. is worried about my blood pressure. Should I be on anti anxiety or highblood pressure meds? I am terrified!!
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I was diagnosed with Prinzmetal Variant Angina 3 years ago after suffering years of symptoms and misdiagnosis and a mirad of medicines for everything from GERD to anxiety attacks because I didn't fit into the little box of typical male symptoms for heart problems.

My recommendations: If you have something that isn't feeling right, DON'T WAIT, seek medical attention immediately. You do not have to wait for your appointment. Go to the ER and also mention Prinzmetal, otherwise, you may be in for a bunch of testing that will show absolutely NOTHING. Believe me, I had every test you can imagine and that was one of the reasons they kept putting me on all the wrong medicines, some that were even hurting this little known and rare disease. I would get a "pat on the head you're just a nervous woman" treatment. DO NOT accept this. Women need to put their foot down on this male dominant thinking about heart disease. Women have different symptoms and their bodies are different.

The test that found out that I definately had Prinzmetal was a cardiac cath. I was injected with Ergovine, a drug that brings on a spasm. This was after I had spent thousands of dollars on useless test, was told I had an 80% blockage and needed surgery to have a stent put in. That would have been another useless and dangerous surgery. The cardiologist was angry when I refused the surgery. After my 3rd trip to the hospital in 8 weeks the 2nd cardiac cath was done which again showed an 80% blockage in a completely different spot! It was the dose of ergovine and complete opening of the arteries with a high dose of Nitro that told them what the problem was. So advice here is, don't rush into surgery, it will do no good for Prinzmetal. If you do have a true blockage, yes, by all means get it fixed, just remember, a Prinzmetal attack 'looks' like a true blockage but with Nitro it opens back up.

Next I would recommend that you have some genetic testing done. I had mine done at the Prinzmetal Research Study in Cincinnati OH. It is still going on and if you can't get there you can just have your bloodwork taken at your family doctors and have it sent there. It was from this research study that I discovered that I am missing the gene to produce Nitric Oxide, the amino acid that keeps your arteries from having spasms. I have the mutated gene and it was found out that both my parents also had a mutated gene. I am now having to write and tell my other siblings about this and that they need to be tested. Hard to find the right words.

There is no cure for Prinzmetal but there are medicines that can help. Your doctor will decide which ones are the best for you and there is also an amino acid called L-arginine that can give your body the needed Nitric Oxide to help show down the spasms. There are foods that are high in amino acid, stopping smoking and other life-style changes can help.

Many people have heart attacks before it is discovered that they have true Prinzmetal, that is why I ask you not to delay and not to let the doctors have the upper hand with your testing, it is YOUR life and YOUR health, take it into your own hands and take charge. You pay the doctors, they work for YOU, you have a RIGHT to an opinion and to say no to unnecessary test or to ask for a test that might find your disease quicker.

Patients often forget that they have a right to say yes or no, we are so used to letting doctors make all the decisions for our life and health. Doing that almost killed me as I suffered from this disease and was so out of it on depression medicines, pain pills, medicine for GERD and hyped up on hormones for the "typical women's syndromes".

Yes, I fired my doctors and my cardiologist, they were no longer on my payroll. I took my health into my own hands, started doing intensive research on my disease and got involved in the Cincinnati Research. I stopped all those pills that were actually hurting this disease and could have brought on a heart attack, blood clot or stroke.

Please, take your health into your own hands, do not let the doctors run your life. Research until you think you will go blind from reading, rest your eyes then research some more.

I noticed my symptoms more when I tried to relax and yes, the cold would set a spasm off. I have times that are worse than others. I go nowhere without my Nitro spray and especially keep it with me at night.

Good luck with your testing and your future. If it turns out that you do have Prinzmetal and it is from a mutated gene, be prepared, you will now live with this the rest of your life. Find people to talk with so the worry of it doesn't get you down. Stress is not a friend with this disease.

I wish you well,
Dee

**edited by moderator**
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I am really confused and do not know what to do. I had a heart attack at 19 years old and the doctors were astonished that I was so young. I was transported to another hospital specializing with heart matters. They performed a heart cath. that confirmed heart attack with no blockages. My troponin levels were 17 when they should have been no more than 1. After 2 months, a stress test was done and that was the end of it. Two years ago, I started having pains in the chest again (no heart attack symptoms, but just pain). I went to the ER for them to find nothing. I then had a heart ultrasound that again, showed nothing.

Now here I am today, 29 years old and about a month ago, I was laying in bed and started having chest pains, then my left arm proceeded to go numb and then pain into my back and neck, just like my first heart attack. I got out of bed and took an aspirin. It took about two hours before I felt any better or received any comfort. I refused to go to the ER because of recently losing my insurance due to my husband being laid off. I waited two days and spoke to a friend of mine which is an ER doctor and he told me to go. But they were unable to find anything wrong except the ER doctor told me that I might have Prinzmetal Angina and needed to be tested. I was put on atenonol and aspirin. I still continue to feel weird sensations in my chest like a burning feeling (not heart burn) and pain. They sent me for a nuclear stress test and echocardiogram and the doctor said the stress test part looked really good. My regular physician mentioned that he thought I might have Prinzmetal Angina and said this recent attack was most likely a heart attack but I did not go in time. The last heart attack was blamed on birth control and smoking but the papers say "presumably secondary to transient spasm or platelet aggregation."

I feel like a hypochondriac because they can not figure out anything. I also had a Complete Blood Work and everything came back normal even my cholesterol. Does anyone have any suggestions to what might be wrong? Does this sound like Prinzmetal Angina? I am about to give up on the doctors and go on living my life. I am just scared cause I have two children and wouldn't want anything to happen to me and these feelings I get in my chest are really weird.

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I am a 36 year old female and just had an episode for the first time that started as a sharp pain in my left arm and went to my heart. Shortly after my head had pins and needles like I would faint but I didn't. I went and had all the blood tests, EKG, Eco and everything came out perfectly normal. The doctor gave me something to thin my blood and sent me home saying I was too healthy to have had a heart attack and my cholesterol was good so it couldn't be angina. Feeling frustrated that I didn't imagine the whole thing I started researching on-line. I don't believe in traditional medicines usually, so I started to google. I found one article when I googled "natural healing of Prinzmetal's angina" that talked about zinc as a possible cure for angina pectoral but in the article it also mentioned that Magnesium Sulfate deficiency may be a cause for Prinzmetal. The dose was 500 milligrams taken in 4 doses of 125 mg at meals and bedtime. I'm too young to start a regime of medicine, so I've decided to try this out. Maybe it can help you too. This is the link: george-eby-research.com/html/angina.html
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I had a very bad cold/flu and afterwards came chestpain generating a pain in my left arm. I awoke sweating and pain severe in left chest and arm. I went to the emergency room and found the ekg borderline, Then came a chemical stress test that was very unpleasant, The doctor said there was something suspicios, so a heart cath was done, and I was told my heart was fine. While in the hospital I was given nitroglycerin and the pain subsided, yet I was dismissed from the hospital with no diagnosis and told to take aspirin. The next day I was having the same severe chest pain all over again. I told the many people involved with my care my father had angina,angina,angina and after getting home and researching found that a heart cath fcan miss spasms caused by angina. I called the heart doctors office to request them call in nitroglycerin, and they refused, told me to go back to ER. Is there any wonder so many people die from heart problems. They rush you in and rush you out with not much personal attention, and I have very good insurance. I am still having the pain 3 days later, and a nurse friend of mine gave me nitro and it subsides the pain. It is early in the morning and I wake with sweats and arm pain, and have discovered on my own this must be prinzmetal's angina,spasms at rest. I have rhumatoid arthritis for the past 20 years(mild with little deformaties) and still able to do activities until winter. I am 46 years old and want all women to know to not let them discharge you from a hospital when you have had these bad chest pains without nitro, because it could cost you your life, thank god for medical friends!
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Thank you so much. Your information was very helpful. I see myself in you...the Nitro spray with me at all times. I am into my second month with Prinzmetal. Headaches are not as strong. Nausea subsiding. And yes stress totally out of my life! Stopped smoking for this I am very proud, with Prinzmetal it was not even a choice.



I too was not diagnosed right away. I was passed to an intern who was on the road to telling me it was probably anxiety. ( I have been caregiver to my husband who had a horrible accident five years ago, I don't believe I am an anxious person.) as the cardiologist was telling me this he asked when was the last time you had chest pain....I told him "well I am having a doozy right now" he immediately put me on a monitor and said "well we have proof now you have PA" Now all the cardiologist find me interesting and I will not be passed off to an intern.



I have been looking around the internet to see if there is a cure.....guess not. Well I found out the other day my maternal grandmother had angina and she lived until 92 - so we must take care of ourselves...good luck and take care.
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Absolutely sounds like it!
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Hi All,

I second the fact that Prinzmetal's Angina can be EXTREMELY difficult to diagnose.

After experiencing chest pain and being rushed to the ER multiple times, a doctor finally proposed Prinzmetal's Angina. I spent a week in the Swedish Coronary Care Unit in Seattle, WA undergoing stress tests, EKGs, blood checks, etc.

They started me on Imdur, Nitrostat (as needed), and later Calcium Channel Blockers + Cardura.

It's been a little over a year since I was discharged from the hospital and I'm finally getting my symptoms under control. It's a challening process that's different for eveyone and it takes tremendous patience and persistence.

I recently started an online community dedicated to people, like you and me, that suffer from Prinzmetal's Angina. We discuss coping, medications, treatment, research, prevention, and much more!

I'd ask that each of you share your experiences so that others in the future may benefit.

 ***this post is edited by moderator *** *** web addresses not allowed*** Please read our Terms of Use

I'm happy to talk to anyone on the forum about my experiences and shed some light on treatment options. Let me know.

Regards,

Trent

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I am a 48 year old firefighter that recently had a blockage of the LAD (widowmaker). They cathed me three times and placed two stents in the artery. After all of this I am now having the typical episodes of this type almost every day. My cardiologist has never heard of this so I am doing the research for him.

I saw reference to a study in Cincinatti that was looking for abrormalities in the genes. Does anybody have info on this?

I am open to any and all advice. This has been extremely life changing for myself and my family.

Thanks Ray

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Hi Dee, is there a way that i can make contact with you, maybe email?

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Hi Dee, I would like to email you and ask a few extra questions regarding PA.  We are on the same path as you were, and are really exhausted!  My husband has had 5 stents and is on various medication and had too many procedures done trying to pin point his chest pain.  After everything he is still getting these severe attacks, but he does not fit the criteria for PA?  He is a man, 60 years of age, stopped smoking three years ago, do not drink or use drugs .......

He gets the attacks almost every night - early morning between 1 and 3, and sometimes during the day.  usually when he is resting.  ECG under stress normal.  We need more info on his symptoms if any one can help!!!

Susan 

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Another rare cause could be Broken Heart Syndrome a non cardiovascular heart attack that would show on a angiogram. It is caused by stress and trauma.
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Hi DeePrinzmetallady, I found your post a very interesting reading, in particular the genetic testing part. I have been suffering what I have concluded may be coronary spasm pains now off and on for 1 1/2 years, during which I have also suffered daily heart arythmias. My mother also suffered regular angina-like attacks, though they never managed to find out what caused them. I have attacks, mild mostly, periodically, sometimes triggered by cold, others by unknown reasons. I first began to wonder about prinzmetal over a period over several days when these pains would show up at the exact same time many days in a row. I have benn through thorough cardiac checkups, several ECGs, holter monitor, ECG while exercising, calsium score imaging, cardiac ultrasound and everthing seems fine! I have recently undergone a genetic testing procedure with 23andme. A few interesting findings there revealed an 8 x higher risk of hypertension, increased likelyhood of high cholesterol and very interestingly I have a homozygotous mutation which appears to be related to 70% reduced production of BH4 which affects nitric oxide production (results gathered from a geneticgenie methylation analysis). I am wondering if this is the same mutation you have found or if there are other genes I should check against increased likelyhood of Prinzmetals? Please feel free to get in touch if you would like to exchange information or have any queries! Best regards and wishes for best possible health Lisa
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