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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Recurring Angina Pain, Stress And Minimal Work Causes Chest Pressure?

Hello, I am a 70 year old male patient. Although I have never had a heart attack, when I was 57 years old, I started developing throat pain, and tiredness after walking three blocks to go to work, of which after a brief rest period, it was gone and I got on my city bus and started my job as a city bus driver. I eventually went to a cardiologist, got a stress test, and i was told to get an angiogram to look at my arteries because initial stress test results indicated some or several blocked arteries. The rest is history because since my catherization, at the time the heart surgeon did 5 by-passes and in 20010 and also had a stent inserted. My question is now, I have had recurring angina pain and stress and minimal work will bring or start chest pressure, and shortness of breath. JOE Muniz
Thu, 13 Mar 2014
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Emergency Medicine Specialist,  's  Response
Hi, your history is that you have ischemic heart disease - narrowing of multiple arteries that feed your heart. Bypass surgery renews blood flow and stents open up the vessels to increase blood flow to the heart muscle. After a few years, it is common for bypass grafts and stents to narrow or occlude (especially if there is high blood pressure, diabetes, high cholesterol, smoking, or an inactive lifestyle). This may have happened to you to cause your symptoms to come back.

Someone with blocked bypass grafts or stents is at risk of having a heart attack. Optimal management of someone with angina includes taking a beta blocker, nitrates, and or a calcium channel blocker, plus good control of your blood pressure.

Repeat angiogram and stenting or even repeat open heart surgery/bypass grafting are often done. Another approach to non surgical management is to follow a strict diet and carefully controlled exercise regimen to try to reverse the atherosclerosis (narrowing and blockages of your arteries). The Ornish program (Dr. Dean Ornish) has demonstrated that with sufficient effort, it is often possible to reverse narrowing of the coronary arteries (this is especially true if you are not very active, are a smoker, or have a high risk lipoprotein profile with high cholesterol, high LDL and low HDL).

Your cardiologist may be able to explain these options for you. Please seek immediate care for any increasing pattern of angina, or for pain that lasts longer than 20 minutes. Call 911 and go to the emergency room if you have more severe pain, or pain that makes you short of breath. Good luck.
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What Causes Recurring Angina Pain, Stress And Minimal Work Causes Chest Pressure?

Hi, your history is that you have ischemic heart disease - narrowing of multiple arteries that feed your heart. Bypass surgery renews blood flow and stents open up the vessels to increase blood flow to the heart muscle. After a few years, it is common for bypass grafts and stents to narrow or occlude (especially if there is high blood pressure, diabetes, high cholesterol, smoking, or an inactive lifestyle). This may have happened to you to cause your symptoms to come back. Someone with blocked bypass grafts or stents is at risk of having a heart attack. Optimal management of someone with angina includes taking a beta blocker, nitrates, and or a calcium channel blocker, plus good control of your blood pressure. Repeat angiogram and stenting or even repeat open heart surgery/bypass grafting are often done. Another approach to non surgical management is to follow a strict diet and carefully controlled exercise regimen to try to reverse the atherosclerosis (narrowing and blockages of your arteries). The Ornish program (Dr. Dean Ornish) has demonstrated that with sufficient effort, it is often possible to reverse narrowing of the coronary arteries (this is especially true if you are not very active, are a smoker, or have a high risk lipoprotein profile with high cholesterol, high LDL and low HDL). Your cardiologist may be able to explain these options for you. Please seek immediate care for any increasing pattern of angina, or for pain that lasts longer than 20 minutes. Call 911 and go to the emergency room if you have more severe pain, or pain that makes you short of breath. Good luck.