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Suggest Treatment For Stable Angina

Posted on Tue, 14 Feb 2017

Question: I was diagnosed with stable angina a couple of months ago. Increasing my bisoprolol to 7.5 mg per day has ellminated symptoms and let me return to the level of activity I had before. Today, however, I was talking with friends about a stressful situation, and became aware that my heart was doing "funny things" (a vague phrase, I know). Became rather short of breath, HR went from 54 (normal) to 90 or so. However, none of the pain that I associate with angina. Used nitroglycerin spray for the first time, "just in case." Didn't seem to help. One of the friends then drove me to emerg, but by the time we got there, HR was more or less back to normal, so I didn't go in. Was this just psychosomatic? ("Help, my heart is doing funny things!") P.S. This happened 2 hours ago, and I feel back to normal.

Answered by Dr. Ilir Sharka (16 minutes later)

Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Thank you for asking on HCM!

I carefully passed through your question and would explain that your symptoms seem to be related to anxiety or the stressful situation.

I don't think that these changes in heart rate are related to stable angina, especially considering the fact that you didn't have chest pain.

Anyway, if situation repeats, I would recommend going to the ER for a physical exam, a resting ECG and some blood lab tests (cardiac enzymes, complete blood count, blood electrolytes).

I would also recommend you to check your blood pressure values.

Hope to have been helpful!

Kind regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ilir Sharka (3 hours later)

Thank you, Dr Ilir. Sounds as though PAIN is the key to recognising angina, as opposed to simple anxiety, which only caused faster HR and (probably) higher BP. This is presumably why the nitroglycerin made no difference?

Answered by Dr. Ilir Sharka (12 hours later)

Brief Answer:
I would explain as follows :

Detailed Answer:
Hello! again!

Yes,I agree with you that the fact that you didn't have chest pain and nitroglycerin didn't help,
it is less probable that your symptoms are related to ishemia or angina.

Nevertheless, to exclude possible cardiac arrhythmia, a resting ECG coupled with the other above recommended tests would be necessary if these troubles persist.

Hope to have been helpful!

Best wishes,

Dr. Iliri

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng