Coronary vasospasm/Vasospastic Angina

[NaToth]

Finally diagnosed today after seven years of being fobbed off by the NHS.

Anyone else got this? Any hints or tips for me?

Don't take beta-blockers. Avoid decongestants unless you've used them previously without ill-effects.

They've given me a prescription for calcium channel blockers, but I’m a bit concerned about taking them as they seem to be designed to lower blood pressure and mine is usually hovering around the 100/50 or 110/60 mark when I measure it at home.

Any thoughts?

I have this. I am not on a calcium channel blocker, I am on Nicorandil and a beta blocker, Bisoprolol, as I also have SVT. These were prescribed by a cardiologist and as they are the expert, I took the drugs and have been on them for around 4 years now and am doing very well. No more episodes. I think my blood pressure is a little low but I manage ok, drink plenty of water.

I would advise to try not to stress too much (easier said than done!) and avoid all the usual stressors, such as smoking, very cold weather, etc. I also cut down on caffeine too.

Which calcium channel blocker, NaToth? Some have relatively minor effects on systemic blood pressure but can alleviate coronary vasospasm. Are you also on a nitrate?

also interesting to note, I have read about the effect of oestrogen on coronary spasms, I had a hysterectomy aged 39, am on oestrogen replacement, but wonder if this could have contributed in some way. There is an interesting article about this on the BHF website.

The CCB is Diltiazem. I also have a GTN spray, which is very effective.

I have already given up smoking (seven years ago) and am caffeine free. I also don't use decongestants.

I have picked up the connection between going from hot to cold or cold to hot, which means I have had episodes after coming in to a warm house after being outside in winter, or getting into a hot car after being in freezing cold Sainsburys last week.

Given that this started about two years before menopause and I know I have low estrogen levels, I suspect that has something to do with it. I'm also aware of a connection with low magnesium levels, which is something I need to explore.

Diltiazem doesn't cause much of a drop in systemic blood pressure of people who aren't hypertensive, but it does dilate coronary arteries, as well as reducing the heart's oxygen demand: www.drugs.com/pro/diltiazem.html. This is why you'll have been prescribed this particular drug. Calcium channel blockers of the dihydropyridine class (amlodipine, nifedipine, etc.) have a much bigger effect on blood pressure.

Thanks, that's useful to know.