Is Your Discomfort a Sign of Angina? Heart Health Symptoms

Could this situation be caused by angina?

Hello, Doctor.
I underwent a health examination at the end of last year, and a CT scan revealed signs of blockage at the distal end of the left anterior descending artery.
After further coronary angiography, my attending physician indicated that a stent placement was not yet necessary.
I have been maintaining a jogging routine every day after work and have not experienced any chest tightness, chest pain, or shortness of breath.
Since January of this year, I have been taking antihypertensive medication along with lipid-lowering medication (Rosuvastatin, 10mg) and Aspirin (Bayer, 100mg).
However, I have been troubled by the side effects of the antihypertensive medication.
I switched from Cardizem to Concor and then to my current medication, Sodium Nitroprusside (which I have been taking for two months).
My blood pressure is controlled between 125-130 systolic and 80-85 diastolic.

Currently, after taking Sodium Nitroprusside, I frequently feel a dull sensation and abnormal pain in the area between my left arm and left chest under the armpit, as well as in my left arm, left hand, ring finger, little finger, and back.
Initially, I thought this was caused by the lipid-lowering medication, and after discussing it with my doctor, I reduced the dosage to half a tablet every other day, but I still experience the discomfort.
In the past three weeks, I have also felt some discomfort in the left side of my stomach, below the sternum, and between my lower teeth.

I would like to ask if my discomfort could be caused by angina pectoris? What tests should I undergo to confirm the diagnosis? Or should I adjust my medication?

cheneng, 40~49 year old female. Ask Date: 2018/04/30

Dr. He Dongjin reply Cardiology

Hello, since the cardiac catheterization showed no need for stent placement and you are not experiencing any chest discomfort, chest pain, or shortness of breath while jogging, let's hold off on medication for now if your blood pressure is normal.
If the aforementioned symptoms improve, it may indicate that the symptoms were drug-related rather than angina.
What tests should be conducted to confirm the diagnosis? If necessary, we can consider an upper gastrointestinal endoscopy.
Changhua Hospital cares about your well-being.

Reply Date: 2018/04/30

More Info

It sounds like you have been experiencing a range of discomforts, particularly in your left arm, chest, and upper abdomen, which can understandably raise concerns about your heart health. Given your medical history, including the findings from your CT scan and heart catheterization, it's important to approach this situation with careful consideration.

First, let's clarify what angina is. Angina is chest pain or discomfort that occurs when your heart muscle doesn't get enough oxygen-rich blood. It can feel like pressure or squeezing in your chest, and it may also be felt in your shoulders, neck, arms, back, teeth, or jaw. Angina is often triggered by physical exertion or stress but can also occur at rest. Given that you have a history of coronary artery disease (as indicated by the blockage in the left anterior descending artery), it is crucial to monitor any symptoms that may suggest angina.

Your current symptoms, particularly the discomfort in your left arm and chest, could potentially be related to angina, especially considering your previous heart condition. However, it’s also important to note that other factors could be contributing to your discomfort. For instance, the side effects of your blood pressure medication, such as sodium channel blockers, can sometimes cause muscle pain or discomfort. Additionally, anxiety and stress can manifest as physical symptoms, including chest pain and discomfort in the arms.

Given your situation, here are some steps you should consider:
1. Consult Your Cardiologist: Since you have a history of heart issues, it’s essential to discuss your symptoms with your cardiologist. They may recommend further testing, such as a stress test or an echocardiogram, to assess your heart's function and blood flow.

2. Monitor Symptoms: Keep a detailed log of your symptoms, including when they occur, their intensity, and any associated activities. This information can be invaluable for your healthcare provider in determining the cause of your discomfort.

3. Medication Review: Discuss with your doctor the possibility that your current medications may be contributing to your symptoms. It might be necessary to adjust the dosage or switch to a different medication that may have fewer side effects.

4. Lifestyle Modifications: Continue with your exercise routine, as physical activity is beneficial for heart health. However, listen to your body and avoid overexertion. Additionally, consider dietary changes that can further support your cardiovascular health, such as reducing sodium intake and increasing fruits and vegetables.

5. Stress Management: Since anxiety can exacerbate physical symptoms, consider incorporating stress-reduction techniques into your routine, such as mindfulness, yoga, or deep-breathing exercises.

6. Follow-Up Appointments: Regular follow-ups with your healthcare provider are crucial, especially given your history of heart disease. These appointments can help ensure that any potential issues are caught early.

In conclusion, while your symptoms could potentially indicate angina, they may also be related to medication side effects or anxiety. It is essential to work closely with your healthcare provider to determine the underlying cause and appropriate management of your symptoms. Your proactive approach to monitoring your health and seeking medical advice is commendable and will serve you well in maintaining your heart health.

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