A bit confused

Prinzmetal's syndrome
#1

Hi, I have recently been diagnosed with Prinzmetal’s Variant Angina and have just joined this site.

Having read through some of the posts here, I’m a bit confused because some of the members talk about having angioplasties and stents and suchlike.

I thought that one of the flags of Prinzmetal was that sufferers do not have conventional heart disease and narrowing of the coronary arteries.

Instead, our otherwise normal coronary arteries go into spasm and contract, cutting off the blood supply to the heart muscle.

If that is the case, why would there be a need for stents and other conventional treatment?

I’m not picking holes - just trying to get as much info on this as I can as it might yet kill me. I’d just like to know more because so far, my doctors have said that Prinzmetal can be controlled with drugs. If my condition is likely to get worse in future, I’d like to know about it.

Many thanks,

Tony

#2

Tony - yes, that is my understanding as well. But the doctors all
seem to want to go the angioplasty route. So far, I have resisted,
because it doesn’t add up - there is no evidence of heart disease for
me - and the explanation I have been given for having it - Prinzmetal’s

  • is a) it’s a woman thing (not much help to you) and b) it may be
    linked to the chemo I had for cancer treatment.

Please do let me know if you discover anything further - and I will do
the same . best wishes, Jill
On 30 Sep 2007, at 01:28, tonyo wrote:

#3

Hello Tonyo-

You are correct. I have had no stints or angioplasty (except the one given to me in 1999 because of a blockage that did not exist). To date, I have had three heart attacks because of Prinzmetal. I usually get a catherization for each hospital stay but no one recommends a stint and there is certainly no need for angioplasty unless I had a blockage. I am on Diltiazen, Metoprolol, various other drugs including Nitro as well as most recently a small sedative to keep me from getting to excited.

Right now, I am suffering brief moments of tachacardia which hopefully these drugs will get under control. Before my two heart attacks this summer, I felt fine. I was excercising, working full time, and only had brief moments of chest pain. My attack came on while at work and I was feeling great! This is the scary part of Prinzmetal…My second attack came on while relaxing during mid day on my boat in the sun having a great time.

Stay warm when cold. Get cold when hot. Stay away from stress when possible. Take all your meds. With Prinzmetal, the affliction usually lasts in 3-6 month stints. Do not ignore being tired, I mean extremely tired to where your eyes burn. Do not ignore a sudden flush or sweating. These things I had just before my attacks.

I hope this can be of some help. Do not hesitate to contact me if you have additional questions.

Marilyn

#4

Thank you both for your replies which were most enlightening.

My consultant told me that a stent would be of no use because they could not know where the next spasm would occur so they could therefore not know where to put the stent.

Also, the constriction that occurs in my arteries is likely to occur in a different place (or places) every time I have an attack.

It was interesting to hear Marilyn say that Prinzmetal lasts for 3 to 6 months. I have heard elsewhere that the condition can just go away on its own after a while but nobody has yet been able to confirm that for me.

Like most heart specialists you may encounter, my doctors seem to know very little about this condition. It appears to be soooooo very rare that not much research has been carried out.

That may be why doctors dance around questions about prognosis. Perhaps they simply don’t know the answers!

Having said that, my consultant is always very positive and says that I should live to a ripe old age as long as I keep taking the tablets.

I wonder how mere patients can find out if any new research is going on?

Best wishes,

Tony

#5

Hi guys.

I do have prinzmetal amd I also have 2 stents. 4 years ago (before I
was diagnosed) my chest pain was severe but no doctor believed me. I
fianlly had a heart attack because of the spasming. My LAD artery
constricted enough to rupture and then clot which caused a 95% blockage
which had to be stented. 2 years later the same artery continued to
spasm most likely because of the original stent irritating it, so I
received another stent. I now have 46mm of stent throughout most of
my LAD. I then went to the university of michigan hospital. There
they told me that I shouldn’t have gotten the first stent. It just
makes the spasming worse. I was never treated with medication or nitro
before my first stent, and I should have been.

Medcation does seem to work for me. But I would agree that I seem to
have flareups for 2-3 months and then may be relatively pain free for
months afterward. I do wear nitro in a necklace everywhere I go. And
I know it has saved my life. Mostly because my prinzmetal seems to
target the main coronary arteries not just the smaller ones.

One good piece of information is that beta blockers make the condition
worse, so make sure that you say you are allergic to beta blockers when
asked about medication. Hospitals and doctors often give beta blockers
as standard protocal for chest pain. This can kill someone with
prinzmetal.

I have had great results with a fairly new drug called Ranexa. It is n
antispasmotic and works in the nervous system. I have also found that
regular chiropractic visits have helped since it is believed that
prinzmetal is related to incorrect nerve impulses which over constrict
arteries at rest.

Good luck. I know it sucks, because everytime my heart screams I think
"Is this the one that is going to kill me?" I have beenliving with
this for 4 years now and I thank God for every day that I am alive.

Mindy

-----Original Message-----
From: MStack prinzmetals-cpt6134@lists.careplace.com
To: parkermind@aol.com
Sent: Fri, 26 Oct 2007 9:26 pm
Subject: Re: [prinzmetals] A bit confused…

#6

Hello you two-

Tonyo-I agree my statment that Prinzmetal runs its course in stages sounds weird but I have read alot of studies and this seems to be the overall conclusion.

Mindy-Interesting about the chiropractor approach. Since little is known about this disease, its worth giving it a try. At least we can all get a great backrub! ha

Here is a great site which explains Prinzmetal in easy to read detail.
http://ip-72-167-32-149.ip.secureserver.net/~myhhwco/index.php?view=article&id=74&Itemid=1&option=com_content

Have a nice evening and stay well.
Marilyn