@brenda88. I take both Metoprolol 50 mg 3 times a daily and Isosorbide 120mg in the morning it does give you headaches lasting 2weeks for me. If you are on Facebook search Prinzmetal Angina support it's a closed group helping each other. I see a Cardiologist in Rochester. I wasn't able to have heart bypass so they put in a Spinal Cord Stimulator to help with pain. My cardio Dr told me this rare condition is extremely painful. If you haven't done a full blood work up start making phone calls to see if you can find a Hematologist that is familiar with PA. It's very important your potassium, iron, magnesium and Vit Dis enough to support your heart. If your upset try breathing slowly in and out. They may give you anxiety meds which will help. I highly recommend keeping a journal. When the spasm starts ends, what were you doing, heart rate and blood pressure and describe the pain where it is. Is it tight, squeeze, heavy pressure etc. also list when you took a nitro did it relieve any symptoms ❤️Praying
Metoprolol mad me much worse in fact that was the medication they put me on that ended up having the Cardiologist that was treating me to refer me to Mayo. Metoprolol is a Beta Blocker not recommend and in fact often makes things much worse. They kept insisting they wanted to try new ones some so at times they tried two more with disastrous affects. "The treatment for coronary vasospasm includes dihydropyridine calcium channel blockers (such as amlodipine or nifedipine), alpha blockers, and avoiding the use of beta-blockers. Animal studies have shown these to be effective, however no human trials have been performed. Beta-blockers are thought to cause “unopposed alpha receptor agonism”. Since the beta receptors would be occupied by the beta-blockers, substances (epinephrine, norepinephrine etc...) can stimulate the alpha receptors more easily causing worsened vasospasm. Avoidance of alpha agonists are important to treat coronary vasospasm. These include pseudoephedrine and oxymetazoline."
@brenda88. I take both Metoprolol 50 mg 3 times a daily and Isosorbide 120mg in the morning it does give you headaches lasting 2weeks for me. If you are on Facebook search Prinzmetal Angina support it's a closed group helping each other. I see a Cardiologist in Rochester. I wasn't able to have heart bypass so they put in a Spinal Cord Stimulator to help with pain. My cardio Dr told me this rare condition is extremely painful. If you haven't done a full blood work up start making phone calls to see if you can find a Hematologist that is familiar with PA. It's very important your potassium, iron, magnesium and Vit Dis enough to support your heart. If your upset try breathing slowly in and out. They may give you anxiety meds which will help. I highly recommend keeping a journal. When the spasm starts ends, what were you doing, heart rate and blood pressure and describe the pain where it is. Is it tight, squeeze, heavy pressure etc. also list when you took a nitro did it relieve any symptoms ❤️Praying
Even the insert for it indicates this.
Beta-blockers may increase the number and duration of angina attacks in patients with Prinzmetal's angina (variant angina pectoris). However, relatively selective β1-receptor blockers, such as metoprolol, can be used in such patients, but only with the utmost care.
@brenda88. I take both Metoprolol 50 mg 3 times a daily and Isosorbide 120mg in the morning it does give you headaches lasting 2weeks for me. If you are on Facebook search Prinzmetal Angina support it's a closed group helping each other. I see a Cardiologist in Rochester. I wasn't able to have heart bypass so they put in a Spinal Cord Stimulator to help with pain. My cardio Dr told me this rare condition is extremely painful. If you haven't done a full blood work up start making phone calls to see if you can find a Hematologist that is familiar with PA. It's very important your potassium, iron, magnesium and Vit Dis enough to support your heart. If your upset try breathing slowly in and out. They may give you anxiety meds which will help. I highly recommend keeping a journal. When the spasm starts ends, what were you doing, heart rate and blood pressure and describe the pain where it is. Is it tight, squeeze, heavy pressure etc. also list when you took a nitro did it relieve any symptoms ❤️Praying
These are meds that mad the Coronary Artery Spasms worse on me ANGINA Dicyclomine, Ergonovine , Methacholine, Metoprolol, Nebivolol Hcl , Ergot Alkaloids, Isometh-dichloral-acetaminophn
@brenda88. I take both Metoprolol 50 mg 3 times a daily and Isosorbide 120mg in the morning it does give you headaches lasting 2weeks for me. If you are on Facebook search Prinzmetal Angina support it's a closed group helping each other. I see a Cardiologist in Rochester. I wasn't able to have heart bypass so they put in a Spinal Cord Stimulator to help with pain. My cardio Dr told me this rare condition is extremely painful. If you haven't done a full blood work up start making phone calls to see if you can find a Hematologist that is familiar with PA. It's very important your potassium, iron, magnesium and Vit Dis enough to support your heart. If your upset try breathing slowly in and out. They may give you anxiety meds which will help. I highly recommend keeping a journal. When the spasm starts ends, what were you doing, heart rate and blood pressure and describe the pain where it is. Is it tight, squeeze, heavy pressure etc. also list when you took a nitro did it relieve any symptoms ❤️Praying
Also when I started on Coq10 I started gettiin worse and it was the Piperine/bioperine
Piperine inhibits metabolizim of Verapamil & Nifedipine reduces the effectiveness thus kicking off the Coronary Artery Spams.
Metabolizing enzymes inhibited or induced by piperine, and a few of the substances whose
bioavailability is affected by these enzymes. Metabolizing Enzymes: CYP1A1, CYP1B1, CYP1B2, CYP2E1, CYP3A4
@brenda88. I take both Metoprolol 50 mg 3 times a daily and Isosorbide 120mg in the morning it does give you headaches lasting 2weeks for me. If you are on Facebook search Prinzmetal Angina support it's a closed group helping each other. I see a Cardiologist in Rochester. I wasn't able to have heart bypass so they put in a Spinal Cord Stimulator to help with pain. My cardio Dr told me this rare condition is extremely painful. If you haven't done a full blood work up start making phone calls to see if you can find a Hematologist that is familiar with PA. It's very important your potassium, iron, magnesium and Vit Dis enough to support your heart. If your upset try breathing slowly in and out. They may give you anxiety meds which will help. I highly recommend keeping a journal. When the spasm starts ends, what were you doing, heart rate and blood pressure and describe the pain where it is. Is it tight, squeeze, heavy pressure etc. also list when you took a nitro did it relieve any symptoms ❤️Praying
The Piperine/bioperine is used in some COq10 it help it be absorbed but with heart patient it often affects absorption of med so they are less effective.
@brenda88. I take both Metoprolol 50 mg 3 times a daily and Isosorbide 120mg in the morning it does give you headaches lasting 2weeks for me. If you are on Facebook search Prinzmetal Angina support it's a closed group helping each other. I see a Cardiologist in Rochester. I wasn't able to have heart bypass so they put in a Spinal Cord Stimulator to help with pain. My cardio Dr told me this rare condition is extremely painful. If you haven't done a full blood work up start making phone calls to see if you can find a Hematologist that is familiar with PA. It's very important your potassium, iron, magnesium and Vit Dis enough to support your heart. If your upset try breathing slowly in and out. They may give you anxiety meds which will help. I highly recommend keeping a journal. When the spasm starts ends, what were you doing, heart rate and blood pressure and describe the pain where it is. Is it tight, squeeze, heavy pressure etc. also list when you took a nitro did it relieve any symptoms ❤️Praying
Yes I have Has Coronary Artery Spasms aka Variant Angina, PRINZMETAL Angina since I was 41 and am 63 now. I had NSTEMI dec 2016
We have support groups on the following facebook groups many have both Coronary Microvascular Disease (MVD or CMVD)
& CAS Cornary Artery Spasm
'Coronary Artery Spasms' 'coronary artery spasm (prinzmetal's angina) support group'
I was pretty stable with only a week or so of attacks every few years until 2010. When I developed hypoxia, Tachy/Brady. Hypertensive Emergency. I was referred to and traveled to Mayo AZ & Rochester both. I saw Dr. Abhiram Prasad until he left Mayo and went to UK. I then diverted an airplane flying back from Mayo. SO I then worked my way up the Colorado University system to top Cardio & Pulmonary and was then Referred to National Jewish Health NJH Denver. NJH it was detremined that I have not Only Coronary Artery Spasms aka Variant Angina (CAS) , Coronary Microvascular Disease (MVD) but also tracheobronchomalacia (TBM)., fibromuscular dysplasia (FMD) renal arteries and now a autoimmune issue They say Most Likely relapsing polychondritis. Meds are NIFEdipine 60 mg 24 hr tablet Take 1 tablet by mouth daily.8 PM Coronary Artery Spasm (CAS), Crestor 5 mg
verapamil 120 mg 24 hr capsule : Take 1 capsule by mouth nightly IN AM ****. Coronary Artery Spasm (CAS)
spironolactone 25 mg tablet Take 1 tablet by mouth daily.Reserve Potoasium
aspirin 81 mg EC tablet Instructions: Take 81 mg by mouth 3 times daily. when angian chew 3 as well
Coronary Artery Spasm
IMDUR ,isosorbide mononitrate 120 mg 24 hr tablet Take 1 tablet by mouth morning for Coronary Artery Spasm
arginine HCl (L-arginine) 1,000 mg Tab Instructions: Take 3,000 mg by mouth 3 times daily. , Potasium, Magnessium,
with attacks I take NIFEdipine 10 mg liquid gel capsule: Take 2 capsules by mouth 20 min apart up to 3 times daily as needed (for cp if sbp>90).
NitroGLYcerin spray 400 mcg/spray: Place 1 spray under the tongue every 5 minutes as needed for angina to 3x. So Nifedipine then 3 nitro spray then Nifedipine. Then I carry a leeter from my Cardiologist that stats I have VAS & MVD and if I present that even without ECG changes or increased Troponins I have CAS with cardiac flow deviation that causes my angina. It goes on to say I should be given IV Nitroglycern and remain on it until I can be titrated down with no angina.
Have you seen a Vascular Disease Specialist? I encourage you to see one. Did they look for Fibromuscular Dysplasia in you? Mayo missed my Fibromuscular Dysplasia.
@brenda88. I take both Metoprolol 50 mg 3 times a daily and Isosorbide 120mg in the morning it does give you headaches lasting 2weeks for me. If you are on Facebook search Prinzmetal Angina support it's a closed group helping each other. I see a Cardiologist in Rochester. I wasn't able to have heart bypass so they put in a Spinal Cord Stimulator to help with pain. My cardio Dr told me this rare condition is extremely painful. If you haven't done a full blood work up start making phone calls to see if you can find a Hematologist that is familiar with PA. It's very important your potassium, iron, magnesium and Vit Dis enough to support your heart. If your upset try breathing slowly in and out. They may give you anxiety meds which will help. I highly recommend keeping a journal. When the spasm starts ends, what were you doing, heart rate and blood pressure and describe the pain where it is. Is it tight, squeeze, heavy pressure etc. also list when you took a nitro did it relieve any symptoms ❤️Praying
I have brought it up with my PCP and when I see National Jewish this week I will bring it up there as well. My family all has issues with meds so highly likely genetic.
@brenda88. I take both Metoprolol 50 mg 3 times a daily and Isosorbide 120mg in the morning it does give you headaches lasting 2weeks for me. If you are on Facebook search Prinzmetal Angina support it's a closed group helping each other. I see a Cardiologist in Rochester. I wasn't able to have heart bypass so they put in a Spinal Cord Stimulator to help with pain. My cardio Dr told me this rare condition is extremely painful. If you haven't done a full blood work up start making phone calls to see if you can find a Hematologist that is familiar with PA. It's very important your potassium, iron, magnesium and Vit Dis enough to support your heart. If your upset try breathing slowly in and out. They may give you anxiety meds which will help. I highly recommend keeping a journal. When the spasm starts ends, what were you doing, heart rate and blood pressure and describe the pain where it is. Is it tight, squeeze, heavy pressure etc. also list when you took a nitro did it relieve any symptoms ❤️Praying
Yeah @cherfenn, if your family always had medication issues, I would definitely ask. Thankfully, I met a doctor in Mayo Allergy/Immunology who had experience with pharmacogenomic testing. These tests saved my life last year as I'm highly-polymorphic and can't take most medications. I now have that knowledge moving forward regarding what to avoid, and we have the knowledge to know that my daughters will need to be tested, too.
I am a 65 year old female and was diagnosed with Prinzmetal last year. I was taking a beta-blocker for high BP and was having a lot of chest pain. My dr switched me to a calcium channel blocker and now I rarely have an epoisode. This weekend I was having a lot of knee pain from an injury and called after office hours for a pain med. The doctor on call didn’t know me and prescribed Tramadol. I felt faint and had pretty bad chest pain. I discovered that Tramadol has ephenephrin which is a vasoconstrictor! Does anyone know if there is a list of meds that are safe to take with this condition? I will certainly call my regular doctor and have a flag of some kind put on my chart to hopefully prevent this from happening again.
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Metoprolol mad me much worse in fact that was the medication they put me on that ended up having the Cardiologist that was treating me to refer me to Mayo. Metoprolol is a Beta Blocker not recommend and in fact often makes things much worse. They kept insisting they wanted to try new ones some so at times they tried two more with disastrous affects. "The treatment for coronary vasospasm includes dihydropyridine calcium channel blockers (such as amlodipine or nifedipine), alpha blockers, and avoiding the use of beta-blockers. Animal studies have shown these to be effective, however no human trials have been performed. Beta-blockers are thought to cause “unopposed alpha receptor agonism”. Since the beta receptors would be occupied by the beta-blockers, substances (epinephrine, norepinephrine etc...) can stimulate the alpha receptors more easily causing worsened vasospasm. Avoidance of alpha agonists are important to treat coronary vasospasm. These include pseudoephedrine and oxymetazoline."
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2 ReactionsEven the insert for it indicates this.
Beta-blockers may increase the number and duration of angina attacks in patients with Prinzmetal's angina (variant angina pectoris). However, relatively selective β1-receptor blockers, such as metoprolol, can be used in such patients, but only with the utmost care.
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Helpful -
Hug
1 ReactionThese are meds that mad the Coronary Artery Spasms worse on me ANGINA Dicyclomine, Ergonovine , Methacholine, Metoprolol, Nebivolol Hcl , Ergot Alkaloids, Isometh-dichloral-acetaminophn
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Helpful -
Hug
1 ReactionAlso when I started on Coq10 I started gettiin worse and it was the Piperine/bioperine
Piperine inhibits metabolizim of Verapamil & Nifedipine reduces the effectiveness thus kicking off the Coronary Artery Spams.
Metabolizing enzymes inhibited or induced by piperine, and a few of the substances whose
bioavailability is affected by these enzymes. Metabolizing Enzymes: CYP1A1, CYP1B1, CYP1B2, CYP2E1, CYP3A4
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Hug
2 ReactionsThe Piperine/bioperine is used in some COq10 it help it be absorbed but with heart patient it often affects absorption of med so they are less effective.
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Hug
1 Reaction@cherfenn, have you had pharmacogenomics testing?
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1 ReactionHave you seen a Vascular Disease Specialist? I encourage you to see one. Did they look for Fibromuscular Dysplasia in you? Mayo missed my Fibromuscular Dysplasia.
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Helpful -
Hug
1 ReactionI have brought it up with my PCP and when I see National Jewish this week I will bring it up there as well. My family all has issues with meds so highly likely genetic.
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Helpful -
Hug
2 ReactionsYeah @cherfenn, if your family always had medication issues, I would definitely ask. Thankfully, I met a doctor in Mayo Allergy/Immunology who had experience with pharmacogenomic testing. These tests saved my life last year as I'm highly-polymorphic and can't take most medications. I now have that knowledge moving forward regarding what to avoid, and we have the knowledge to know that my daughters will need to be tested, too.
-
Like -
Helpful -
Hug
1 ReactionI am a 65 year old female and was diagnosed with Prinzmetal last year. I was taking a beta-blocker for high BP and was having a lot of chest pain. My dr switched me to a calcium channel blocker and now I rarely have an epoisode. This weekend I was having a lot of knee pain from an injury and called after office hours for a pain med. The doctor on call didn’t know me and prescribed Tramadol. I felt faint and had pretty bad chest pain. I discovered that Tramadol has ephenephrin which is a vasoconstrictor! Does anyone know if there is a list of meds that are safe to take with this condition? I will certainly call my regular doctor and have a flag of some kind put on my chart to hopefully prevent this from happening again.
-
Like -
Helpful -
Hug
2 Reactions