Please help - severe angina taking over my life

[squashyhat]

TLDR: my long-standing angina has ramped up recently and I can't decide whether to go on holiday next week.

Long version: I have had angina for 6 years. An underlying cause hasn't been found, and until recently it's only occurred on exertion and GTN spray has sorted it, so has been manageable.

Since the beginning of April it has got much worse. Pretty much continuous feeling of pressure in my chest and throat and sometimes quite severe pain. I know it is exacerbated by stress. I have had several ECGs but no other tests so far. I am on low-dose beta blockers which don't seem to be helping. I can't walk far without it worsening and it can take hours to subside.

I have an appointment at a "rapid access" (joke - it's been a 6 week wait) chest pain clinic in 2 weeks, but meanwhile am supposed to be going on holiday on my own on Monday. It's a straightforward trip - European country, short flight, easy transfer, beach side hotel, nothing to do but enjoy the sun - but I'm really worried about going. I'm worried about the pain, not being able to walk, skulking in my room desperate to get home and possibly having to access medical help in a foreign country where I don't speak the language.

My chest is tightening up as I type this. Should I go?

Definitely not. Can you move the holiday without losing too much money? I would do that if you can

No, you don't want to become unwell on the flight and the holiday. Have you had a suggestion of troponin tests, stress test, angio and an echo. Do you call an ambulance when the pain is bad.

No more tests suggested yet. I guess that's what the clinic is for. I did call 999 a couple of times initially and went to A&E once, but left because the waiting time was so long. No chance of rebooking or recouping costs. I assume insurance won't pay out because I don't have an actual diagnosis or Dr's advice not to travel.

Thanks for the advice. I'm currently leaning towards not going

IIRC ‘Unstable’ angina is a contraindication to flight as per the UK civil aviation authority. The airline will probably decline your travel (as well as your insurance company). The environment is relatively hypoxic at altitude which means your heart a) has to work harder and b) has less oxygen itself to do that work with and if you do in fact have unstable angina you could find yourself becoming a medical emergency at altitude.

Definitely don't go. Your insurance will not cover you. Have you phoned your insurance company

Call your insurance company. If you tell them you have been to ER several times for chest pain and are awaiting a rapid referral for follow up evaluation they will likely jump at the chance to advise you not to travel. If they need documentation, call the airline special services team and ask them what the advise (which will be that they wont allow you to fly) and then ask them to send you an email confirming their advice..then give that to the insurance company. You can also pay a private GP for an evaluation and a letter for the insurance company and the cost of that will likely be less than the money you would loose from cancelling the holiday

lastly start taking magnesium supplements daily, the full rda. Most people are deficient and it has a big impact on heart function. If you can find magnesium glycinate and taurate, they are the best forms.

You should definitely be able to get a GP letter saying you shouldn't fly due to unstable angina (for a fee of course). But does your insurance actually cover angina and related conditions given it's an existing condition? Might need to read the smallprint

Where did you have the ecg done, did they take bloods, it might be a good idea to wait at the hospital if you can, or call 999 when the pain is severe especially as the gtn isn't relieving it, has a doctor diagnosed you with unstable or exertional angina.

No don't go.
I have a raft of heart problems including a heart attack while holidaying alone ... not an experience I am keen to repeat.
You need an angiogram and exercise tolerance test as well as ecg and echocardiogram.
I have a pacemaker and have had av node ablation but am still getting problems. The wait time to see the cardiologist is 10 months which is crazy as my quality of life is so poor.
I have organised a remote consultation privately.

By the way, my heart attack was diagnosed after a very very long wait in A&E ... you need to wait it out. If I had not I wpuld no longer be here.

You need to go to an and e when the pain is bad and not relieved by gtn. Presumably your bloods have been ok at an and e previously? You need to push for an echocardiogram. I wouldn’t be going on holiday. If your insurance were aware then it should be covered?

Has anyone suggested an echocardiogram and an angiogram?
Severe angina needs investigating to establish a cause.
Whatever,travel insurance won't cover you if it's got worse.

There's a difference between severe angina and unstable angina. The OP has a diagnosis of angina which is getting worse.
I wouldn't go. I cancelled a holiday earlier this year when I became unwell with an infection. My GP had to fill a form out but I got the money I lost back from the insurer less an excess.
In any event you should notify your travel insurer of the change in your health. I can pretty much guarantee they will tell you you won't be covered.

If you do travel research the local medical facilities and have your GHIC with you.