Angina or gastro?

[Pum67]

My husband recently started getting chest pains on exertion. Sometimes it will be after the exertion (like 5 minutes after lifting something heavy he will get it) and when walking uphill if he keeps going it passes. Also, drinking a glass of water can alleviate the pain sometimes. He had it last night and I noticed he was sweaty.
He has visited the doctor and is scheduled for a treadmill test. His resting ekg was normal, his blood pressure was 120/80, his cholesterol was "exemplorary" according to the doctor. He has no family history of heart issues and is normal weight, never smoked and is active. No diabetes and he's 45yrs.

I know this is a hard question to answer but I am worried about him and was interested in opinions. We will definitely be getting this checked out fully.

[ed34]

There is no guarantee that further blockages will not form, BUT, he will now recognise the symptoms and Doctors will listen more now. If he had just one blockage, he is in great shape and I wish you both all the very best :)
Oddly enough he will be very sensitive to his own body for a few weeks, constantly on the look out for those symptoms again, waiting for them to appear. It's like we get used to them being there. This will pass.

[Pum67]

Hey Ed he had his procedure today and they found a 90% blockage in one vessel? and put in a stent. All others were clear. He's on a few pills for the rest of his life but we're so glad we went into A&E to get this all done before something permanent happened.

Thanks for your help. It did help a lot and I hope to have his around for many years to come.

[ed34]

He could be suffering from Vasospasm in a coronary artery, which will restrict blood flow. It's called unstable because it isn't always possible to predict when it will occur, when stable angina is always associated with exertion. Saying that, there can be triggers for Vasospasm, such as exertion or caffeine, but finding the cause isn't always possible. Taking Nitro spray will stop the spasm in many cases, or in my case, I had to go onto calcium channel blockers. I took these for just a few weeks and the spasm stopped, no longer requiring the medication. If isn't a serious constriction of his artery, or he would be in much worse shape. They can see a spasm during an angiogram, but he obviously needs to be having one at the time. I do believe that even a plaque build up can cause spasms, and when stented, it usually stops it. Much more will be known after the Angiogram, but I wouldn't worry. At least they are now going to get inside his arteries and have a good look around.
Please let us know what they find, if anything, and again, don't worry.

[Pum67]

Hey Ed, his treadmill test was abnormal so they are proceeding to angiogram tomorrow. I'm so worried about him. It is such a shock. The specialist says it sounds like unstable angina but he could be wrong. The tropomol (sp?) tests were negative.
His bp was 120/80 to 150/70 during the treadmill but he got the pain and one trace did something funny.

[ed34]

If the discomforts last 10 minutes if standing still or seated, then I very much doubt if this is coronary artery disease. As the heart increases in work load, and artery disease exists, the amount of oxygen is insufficient, giving discomfort. Once you relax, the heart very quickly slows down and the discomforts go away. If the blockage in the artery is severe enough, then you would feel discomfort at rest and during exertion.

[Pum67]

Thanks very much Ed. The discomfort lasts up to 10 minutes and is often relieved by drinking water. Definitely longer than 40 seconds most times.

[ed34]

Very difficult to form an opinion, he definitely needs a treadmill test. However, there are many factors which can affect Angina if that's what he's experiencing. For example, walking in cold weather can make it worse. Walking in warm weather may bring no symptoms at all. Walking soon after eating a meal makes it worse too, whereas walking on an empty stomach produces far less symptoms.
I don't think you can determine if it's gastric or cardiac simply by relating to exertion. I had something similar in 2007 when diagnosed with CAD, and the key was the timing. If I was lifting something or walking and had discomforts, the key was how long the discomforts lasted when I stood still or sat down. If cardiac, the symptoms will go away quite quickly, usually within a couple of minutes. If gastric the discomforts will last much much longer. As soon as I said the discomforts subsided in around 40 seconds if I stood still, the Gastroenterologist sent me straight to a Cardiologist.

Please let us know how he gets on and the diagnosis.