Trach Posted February 10, 2012 Report Share Posted February 10, 2012 I read this post last year on another site (dysautonomiaconnection) thought it may be helpful...Re: Having recurring chest pain, ( NEW INFO )by tmackinn » Fri Jan 14, 2011 2:38 amSo sorry to hear you are having such a terrible time. I hope you can find some relief soon.I often have bad chest pain. Sometimes it is so bad, I grab my chest and double over. I, too, get pain down my left arm, up my neck to my face and into a severe migraine. I have LOTS of EKGs done, all of which are relatively normal. I have been given nitroglycerin which does get rid of my chest pain. I have not experienced bad tachycardia with nitro. My POTS is not associated with low BP. I usually have high BP. Do you get low BP with your POTS? If so, the below explanation of how nitro works might explain your tachy reactionPerhaps some useful insight:Nitroglycerin is a nitrate. Nitrates are converted to nitric oxide. Nitric oxide causes vasodilation of blood vessels (aka, it lowers blood pressure). So, if you experience low BP with your POTS, I hypothesize that when you take nitro and your BP drops through the floor, it will trigger a POTS episode including tachycardia. So why does it relieve your chest pain? Because the cause of your chest pain may be either spasms of your cardiac blood vessels or a decrease of blood flow to your heart. Nitro will open up your coronary arteries (the arteries which supply your heart muscle with blood). Once adequate blood flow nourishes your heart muscle with oxygen, your chest pain will most likely cease. My cardiologist has told me numerous times POTS patients often have spasms of their coronary arteries or a decrease of blood to the heart muscle. Why? No one knows; however, it is hypothesized the the blood is mis-distributed like it is in other parts of the body. The spasms or mis-distribution of blood to the heart is not detrimental (i.e., it will not cause damage to the heart) and will not show up on the normal cardio work-up.The things I do to help with chest pain include lying completely flat, drinking fluids and consuming potassium (either in tablet form or drinking some V8 which has a good dose of bother sodium and potassium). Some of my worst chest pain has been associated with low potassium levels. So, when I feel the onslaught of a bad chest pain attack coming, I try to make sure I up my potassium (and magnesium) consumption. (Research shows that for an unknown reason, when potassium levels are low, magnesium is often low too. Potassium needs magnesium and magnesium needs potassium for proper absorption and utilization by your body.) I still develop chest pain, but it often is not as severe.I hope you have some relief soon from the chest pain. Quote Link to comment Share on other sites More sharing options...
Guest Alex Posted February 10, 2012 Report Share Posted February 10, 2012 Trach,thank you for the info.I've tried lying down (actually sometimes my chest pain episodes start when I'm lying down, rarely/never during effort), I'm drinking plenty of fluids as well, taking magnesium supplements, but I never considered potassium. I will try that starting today. I hope it helps. Alex Quote Link to comment Share on other sites More sharing options...
Trach Posted February 10, 2012 Report Share Posted February 10, 2012 I hope it helps. If i remember correctly, the person who wrote the post, tmackinn, was in the middle of medical school when POTS hit . Her posts were always insightful and helpful - like Rama. Quote Link to comment Share on other sites More sharing options...
Serbo Posted February 10, 2012 Report Share Posted February 10, 2012 Hello allThe coronary spasms mentioned is called variant angina or prinzmental angina. If you do a search here there are a few members who are diagnosed with this. It would be misleading to say that this condition is benign, from what I have read it seems to depend if you also have blocked arteries with it. If one does, it is more problematic.When POTS first struck me I had a lot of chest pain, much of it relieved by lying down, i even fainted with it once. I did not know i had POTS at this stage so i think this was a low blood pressure pain if there is such a thing! Variant angina seems to produce high blood pressure during an attack as the artery's spasm. Quote Link to comment Share on other sites More sharing options...
Guest Alex Posted February 11, 2012 Report Share Posted February 11, 2012 Serbo, would this kind of angina pain be picked up by an ecg, or blood work done during an episode? It sounds kind of scary. One thing I know is that my arteries aren't blocked (or shouldn't be based on the blood work I had done). Do you happen to know how is it diagnosed?.... I guess that's going to be one more research topic. Quote Link to comment Share on other sites More sharing options...
Serbo Posted February 11, 2012 Report Share Posted February 11, 2012 Hi - Re. the ECG i don't know, probably could be picked up on a 12 lead if you were in spasm @ the time.Gold standard diagnosis is cadiac cath with a an agent introduced to try and induce spasm. If you search on here for variant angina or prizmental there's lots of info on people who have been for tests and diagnosed etcNot had any work up for this myself Quote Link to comment Share on other sites More sharing options...
Guest Alex Posted February 11, 2012 Report Share Posted February 11, 2012 From what i just read a 12 lead ecg should pick it up. I've been in the ER many times during my chest pain episodes, plus I recorded several episodes on a loop monitor I wore. I always got "normal sinus rhythm" or "sinus tachycardia but otherwise normal ecg". Never had an angiogram.Thanks for the info once again. Quote Link to comment Share on other sites More sharing options...
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