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Should I Suspect Prinzmetals?
Hi. Im worried I may have
P.A. Seeing how symptoms may match with others and what to do.
34/Male/Formerly way more active than I am now due to fears around my heart.
I cut out alcohol and weed over a year ago. No other vices. If I even touch caffiene its from green tea.
Symptoms are namely a short, stabbing pain in the center of my chest. No pattern I can pick up when awake. Not reliably triggered by cold or exercise, nor at my desk at work, or walking around.
When Im asleep, I can say I usually get pain around 6am, usually accompanied by a sudden sense of alertness/wakefulness. The pain typically come and goes in a second or two.
I was recently seen in the ER for having multiple PVCs over the course of multiple hours. They noticed my potassium was at 3.2 gave me something for it then sent me on my way.
My cardiologist and second opinion both think its not my heart given I just had a negative standard cath, ct angio, and the year before I had a mostly normal echo stress test with the exception being a "mildly thick" left heart wall in 2023. Monitor early 2024 was negative. Further invasive testing is likely not in my future selectively, as I just had a cath and the doctors think currently the risks will outweigh the benefits. While the cath procedure wasnt terrible I'd rather not do another and am confused the cardiologist didnt just do a provocative cath.
Microvascular/Prizmetal is one of the few things left on the list.
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@prodigy314 Well, it looks like your docs have ruled out the most common causes, and that you have done some research and made lifestyle changes to help yourself.
Has the doctor suggested the possibility of angina to you? If not, maybe you can ask.
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1 ReactionI have. He said "my heart is fine" but we've not done any testing specifically for it that have ruled it out that I am aware of and when I inquired specifically he just reiterated that.
My second opinion said prinzmetal occurs while exercising so he is not concerned.
What is prinzmetal?
I am totally not a medical professional but what you describe feels familiar. You obviously have something going on and are trying everything you know to manage it. Kudos! It seems like you have a valid question worth pursuing. Maybe it isn’t your heart but it is something. You want to protect it!
I was told I did not have a heart problem if my chest hurt at rest instead of while exercising, and given nitroglycerin to use should that happen. After eventually seeing a new doc I tried a tablet under my tongue (while at rest). It offered relief and also served as diagnostic. I have used one form or another of nitroglycerin since. Figuring out a schedule helped my nights as well. Protecting my heart was my new care teams priority and took one symptom at a time after that. I hope you are able to prevent irreversible problems rather than to wait to react to them when they come up. Stay persistent!