Can Prinzmetal's Symptoms Cause Other Heart Problems

[Julie62785]

I am a female, age 53, have been diagnosed with prinzmetal's angina 4 years ago. I have had 2 MI's, 4 heart caths, 3 stents and ongoing periodic flare ups with prinzmetal's symptoms for nearly 4 years.  I have been told that the heart problems I have experienced have been caused by Prinzmetal's as the spasms were observed during the angiograms/heart cath's.  The spasms lasted sometimes for over 4-5 hours at a time, which I understand is not the norm.  I am beginning to wonder if the spasms that are causing all the angina I experience on a regular basis is causing me other, more serious heart problems for the future?  Does this cause myopathy or wear out the heart or in some way predispose me for other cardio issues?  Also, I sometimes experience bradycardia and tachycardia (under 51 bpm to around 210 bpm).  Although I will occasionally get chest pain with it, I usually feel extremely fatigued and short of breath when I experience the arrhythmia's, even though the activity, such as walking 10-12 steps caused my pulse to go from 60 bpm to 150 bpm --extremely high for the activity experienced as I can normally walk briskly for nearly a mile-up and down stairs and hills with a pulse of only about 88 bpm.  

For the past four months my symptoms were nearly inactive as I wasn't having shortness of breath, spasms, chest pain, or arrhythmia's-bradycardia or tachycardia.  When symptoms did present, they were infrequent and mostly in the morning before noon.  They corrected on their own without intervention.  They were not brought on by exercise or activity and if I had any, they would present while I was sleeping or virtually inactive, like watching TV.  In fact, I thought and hoped they were going away permanently and I would be able to drop the meds and continue forware symptom free.  Now it is acting up again and starting to build in frequency yet again.  What should I expect of additional heart issues as the syndrome continues ???  Has any headway been made with regards to this syndrome and what causes it?

I do not smoke, am 5'7", 154 lbs.  I take a ccb 120 mg/day, Ranexa 2000 mg/day, Imdur 60 mg/day, Plavix 75 mg/day, Lipitor 40 mg/day, 80 mg aspirin/day.  0.4 mg Sublingual Nitro as needed.  I only use about 0-4 Nitro per month in my inactive phase, but when my spasms become active, I can sometimes use up to 12 or 13 per day which usually lands me in the hospital.  My bp is typically around 110/72 most days, and my pulse is most frequently at about 60 bpm.

[Julie62785]

Thanks Ally!  I got a good chuckle out of the falling down with all the nitro!  :O)

I did not have stents until they tried to stop the spasms with it, so my treatment is the opposite of yours.  I just wonder if anything has been done or if additional information is available yet regarding the long term prognosis of those of us with ongoing symptoms.  I have read where it will cause additional long term problems but nothing substantiating it or specifics regarding the long term issues.  Also, all the meds we take, where does that put us?  I am worried about taking plavix for so long but so afraid to go off it.  As you mentioned, the cold weather really takes it toll on the symptoms too although I do not have Reynauds.  Just wishing someone could shed some light on positive steps we could take toward recovery.  By the way, my stents are in my RCA as well.  Will update as I get info!  Good luck!

[ChatterAlly]

I have the same problem and have wondered if the stents actually brought on the spasms. Never had a spasm until the stent was first placed in my RCA. In addition to the heart spasms, I also suffer with Reynaud's Syndrome, which will get worse with the coming winter cold. I have been told the spasms can cause the arteries to completely block off.  I too  have to take the Nitro with me all the time. I remember one bad day recently I joked to my sister in law I thought if I fell down I would explode from all the Nitro I had to take that day. The spasms I get at night seem to come in waves and come at 1/2 hour intervals. I am sleep depraved on those days. I'll keep searching and let you know what I find out.  Ally

[Julie62785]

Hi Jesus!

Thanks for your input.  In Prinzmetal's Angina, the symptoms can be similar in some ways to heart failure and heart attack.  They just aren't usually permanent and they intermittently come and go, such as the shortness of breath.  In fact, it becomes unstable angina as it progresses.  However, I am always on alert to stop the chest pain as quickly as possible which is why I carry my nitro.  It will usually relieve the chest pain by dilating the arteries.  

The reason that I ended up with the first stent is to stop the coronary artery spasms as it was causing a second heart attack.  They couldn't find a reason for the first heart attack but now believe it to be coronary artery spasms as the plaque in my arteries was minimal.  The next two stents were due to 99% blockage that occurred after I quit taking plavix following the first stent implant.  I didn't have hardly any plaque buildup before that.  I also don't feel like I did when I had blockage as the symptoms are not constant nor continually progressive.  Some days I feel great and have absolutely no pain or heart symptoms.

I am just really concerned that if I keep having the chest pain from the spasms that it is going to weaken other parts of my heart and I will progressively become sicker and end up with  chronic / dibilitating heart issues.  Not that these aren't enough...but I am talking like cardiomyopathy or heart failure.      

[jrbon]

I do not know if the prinzmetal can produce additional problems, but definitely the 2 MI can do.

Some of your symptoms indicates a possible heart failure, or perhaps the some way that in the past you need the stents, some other arteries are  closing..

If I were you, I would take and appointment with the cardiologist.

Jesus