Rene S.

Hi Potsgirl, You are always in my thoughts and prayers. I will be praying for you and your mom. Hang in there honey. I'm here for you whenever you want to talk. With love, Rene

Hi Michelle, You are such a doll. I owe youa long ovedue email. I did try the ditiazem cd (cardizem Cd) and still had wicked heart palps and rapid heart rate. My body just doesn't seem to like ccbs. I was ok on the betas but now they are contraindicated and it is upsetting to say the least. There must be a drug out that works on both lowering b/p and heart rate. Grrr. So frustrating especially when I get conflicting info from drs. I think that pharmicists know more! Hope you are doing ok. So sorry that I didn't get a chance to PM you back. You are so sweet to always come to my aid. Hugs, Rene

Hi. I'm in a state of confusion. I have extreme labile hypertension, which seems to be getting worse. If I'm laying in the bed and not moving, my b/p is normal. As soon as I move, it goes up. I can go from 120/70 to 180/90 in a matter of minutes. Then if I lay back down again it will drop but it's been averagin about 155/80. I also have elevated heart rate. Walking up stairs can leave me breathless and a h/r of 140. I can't stay in bed forever. I can tell when my pressure is up. I get a wicked headache and I shake all over. I've seen several cardiologists and they suggest different treatments, but none are in agreement and I'm confused. To make matters worse, I may also have prinzmetal's angina. I'm so scared. The other day my b/p was 200/100 for about 10 mins then went back to about 140/77. Still too high. Then it went back up again and was high most of the day because I was upright at the computer. I was on beta blockers which worked great but then was told that I shouldn't be on them if i had prinzmetal's. Also, I had some pauses on a cardionet monitor. Here is what I've tried: Most of the beta blockers, including a small dose of Coreg which seemed to aggravate my pvcs. The best for me was the metoprolol but seemed to lead to coronary spasms. Cardizem CD 120mg - made my heart race even more and I felt anxious and jittery. Norvasc (started the other day) - extreme palpitations and tachycardia. I called my family dr who put me on the Norvasc and she said that my case was too difficult for her and that I should call my cardio. He in turn said it's a matter for the family dr. It can't be good for your heart to have such amazing fluctuations in both b/p and h/r. at such quck intervals. One of the dysautonomic specialists recommended either trying Bystolic which is a beta and should be contraindicated with prinzmetal's or go back on the Coreg. So now I'm on nothing because I just don't know which I should be taking. I don't want to stroke out or have a heart attack. I have a headache and some numbness in my fingers. This has been ongoing. I even went to a new dr. last week who sent me to the ER and they basically treated me like someone with anxiety and dismissed me.That was the second time this had happened. I'm just about ready to pop a metoprolol in my mouth and chance the spasms. Plus I have always had PVCs. I was wondering if there was a drug that you could take that reduces both h/r and b/p but wouldn't cause spasms. Thanks for any advice! Rene

Pat, which beta did she put you on? Was your pressure high? I know what you mean. I can only stay flat if I want my pressure down. Going up stairs raises it to like 180/80 then I freak which I should know better by now! and it drops slightly. Today's been a bad day for my pressure. I wonder if it has to do with the rain????? Rene

Thanks, Pat. My cardio is done with me. No one wants to take my b/p seriously. They're all afraid that it will crash. Grrr. Betas helped me too but now that they think I have coronary spasms and had a few pauses on the cardionet monitor they don't want to give them to me. My pressure has been high for awhile, only low in the am and night and I'm just scared. But thanks for the name of your dr. I will look her up and make an appt. I appreciate it very much! Rene

Hi. Totally frustrated once again. Hoping someone out there can be of some help. I'm in Bucks County, PA (Southampton) and need a GOOD primary care dr. Or a great cardio for that matter! Before I got sick a year ago, I had a good primary care dr. Once I developed my symptoms and was confirmed as having dysautonomia, Gastroparesis, extreme labile hypertension (had fibro and cfs already), she said she wouldn't continue my care. Tried two more drs and neiher one of them knew anything about my conditon. Even my EP cardio has washed his hands of me. Everyone is afraid to treat me. Especially the b/p issues. I swear I just have hypertension, since just walking brings my b/p up to 160/80 and then it goes down to maybe 130/70 with a standing heart rate of 118), but yet if I lay in bed at night, my b/p is 115/68. The slightest movement, however, will raise it as well as my heart rate. Did well on beta blockers for awhile (Thank you Dr. Goodkin) but now that they think I have coronary spasms, I can't take them anymore. I spoke with Dr. Goodkin (POTS dr) and he had me try calcium channel blockers, but it made my heart rate higher and I felt even worse. To top it off, I was scheduled to see a nephrologist/hypertensive specialist today and I called ahead to see if he knew about Autonomic dysfunction and he hadn't a clue and basically told me to cancel my appt. I'm so frustrated. I just want what we all do - some semi normal balance of b/p and h/r. It's to the point where every day gets worse. The extreme ups and downs of the pressure are incapacitating me. I've given up driving for almost passing out at the wheel. Sorry I digressed off the original subject. I thought if I had a really good primary he/she could direct me. Right now I'm trying to find all of these drs myself and it's most frustrating. Thank you so much! Rene

I'm just glad that she's not my opthamologist but the oncall dr. Funny, she seemed so sweet and nice in the office. Very young, in her white shorts and tank top. But to say that she's been patient with me when Ihad a real problem and not just an eyelash in my eye and then to lash out at me like that and saying that she's with her family when all Iwanted to know what she had put in my eyes (still dilated 8 1/2 hrs later!) what uncalled for. And she kept reminding me it was a holiday weekend and she should be with her family! Hey, she's the one making the big bucks - not me. She signed up to be oncall so deal with it. Thanks guys! Rene

Of course being a holiday weekend, something would have to happen to me. Yesterday I woke with loss of vision in my right eye. Called the dr. on call. She said lubricate the eyes and call back tomorrow. Well, today wasn't different, so she agreed to see me. I was cautious when she said she was going to use eye drops. I think it was here that someone posted about reactions. She didn't use one in the epinephrine family but rather in the atropine family called mydricyl. They were administered at 1 and I noticed a bit of a racey heart. Now it's almost 5 pupils are still fully dialated, feeling strange and my heart rate is still up a bit. I called the dr, who reminded me that it was a holiday weekend and I shouldn't be bothering her, that she is with her family. I told her that I felt weird and that my heart was racing a bit and that my pupils were still dilated and I don't feel right. Almost like a speedy aggitated feeling. She screamed at me and said if it's that bad, call 911 and hung up! All I did was ask a question. She's the one getting paid. Was I out of line for calling? So my question, any weird experiences with dilating drops since being diagnosed with dysautonomia? Never had a previous problem. Oh, I was diagnosed with a swollen retina and she wants me to see a retina specialist this week. I'm just livid at the moment. Talk about lack of professionalism. Hope the weekend is going well for all. Rene

Hi Ramakentesh, The weird thing is that my b/p is high once I sit down from standing up or walking the steps. The only way it is normal is laying. As soon as I move around even if it's just to lift my head or turn around, wham, pressure goes up. And it's not like I'm taking it every 5 mins. I can feel it and how my body responds. Also my resting h/r is getting higher and higher. Very frustrating. Thanks so much for your advice. I love reading your postings. Take care, Rene

Hi. No, I'm not trying to drive my anxiety up. My very high b/p readings have only been going on since Sun. and I can definitely feel that my pressure is up. Headache, dizziness, etc, and it's scary. It's scary that the only way I seem to feel ok is to lay down. I have no expectations when it comes to this ailment. We're all in the same boat. We want to be back to our normal selves and every time another whammy comes along, it is scary, at least for me. And I haven't had the best luck with drs because most don't know about the condition and even some of the specialists that I have seen disagree on treatment. It's most frustrating. Just seems that it can't be normal (even for us) to have such a fluctuation in such a short period of time and that a leisurely walk up the steps would bring up a b/p so high. I was only looking for some advice and perhaps some views on how others manage to get their b/p somewhat stabilized if they can't take beta blockers. Thank you. Rene

Hi lina, Not on anything currently for b/p. I know that something has to be found. Thanks! Rene

Angela, sorry to hear about your ordeal. Unfortunately, ERS just don't seem to care. They know nothing about our condition. When I was there a few weeks ago, my b/p skyrocketed along with major tachycardia. They sent me home and of course the diagnosis was anxiety! So frustrating. Let them see what it's like to have your heart skipping and beating out of your chest. Just once, I wish I could find a compassionate ER dr. Why aren't they taught about autonomic dysfunction is what I want to know? I'm so tired of hearing "oh calm down and stop being so anxious. I wish I had a dime for everytime I heard that. I hope you are doing better now. Rene

Hi Kayjay, Could it possibly be from the betas you were put on or the catapress? I know you said that Dr. Hernandez started you on them. Any coorelation? I hate them too. And like you, the only thing I can take is tylenol. I hope things ease up a bit. How about gettting someone to massage your neck and shoulders? Or one of those heat packs? Wishing you better day. Hugs, Rene

I've always run a bit on the high side of normal for my b/p. But it was pretty much within range. Now, there's no holds bar. Don't know how to deal with it. Going up steps today for instance, I walked at a leisurely pace, and my b/p was 191/76, h/r 88 (that was sitting). I got so scared. It's been doing this all week and just walking around my h/r is over 110. Just the slightest movement seems to make my b/p and hr jumpl I'm not sleeping well and haven't been for awhile and wonderiing if this may be the cause. My body is worn out from the fluctuations. I can also tell when my b/p rises because my body starts shaking. Some of my reading today: 146/81, hr 106 118/72/101 150/79/ 86 191/76/88. When supine, it's perfect 115/69/ hr/80 117/65/ hr/ 85 113/68/ hr 83 I keep getting headsaches, I guess from the fluctuations. This started Sunday night, after I had to take nitro for a possible prinzmetal episode I'm frustrated and just want my pressure to be normalized. I used to take a beta which kept everything on an even keel. I was only taking 6.25mg of metoprolol once or twice a day and that brought it right down. Infact, at night, my diastolic was too low. I can't win. I spoke to Dr. Goodkin who has tried Calcium channel blockers (made my heart race and gave me palps!), he's thinking of trying Lisinopril (ace inhibitor) but he's afraid it will crash my b/p big time. I just want my heart rate down and sitting in bed all day is not the answer for keeping my b/p down. Any suggestions? Firewatcher told me about melatonin and Butcher's Broom as natural alternatives. The weird thing is that on Sat. I was pretty much in the normal range. This has me scared. It can't be good for the heart to go from 191/76 and then to 113/69. I can't figure out what is triggering this and why a simple act of stair climbing is making me so short of breath and racing my heart and raising my b/p. No one seems concerned, but me! Just sitting here typing I can feel my heart pounding. I want the days back when my b/p was 90/60 and heart rate was 60 consistently before I developed this DD. Of course if I were to go to the hospital, I would be laying down and my numbers would be totally normal. Grrr. I asked my cardio about doing a 24 hr ambulatory b/p monitoring but his answer was we know your pressure is labile. I've seen on the boards that some of you walk around with high readings and they eventually go down. I'm just scared of damaging my heart. Also, my gastroparesis has been acting up, I have no appetite and i'm not getting nearly as many calories as I should. Just trying to get a handle on all of this. I don't want to stroke out! Thanks for listening and any thoughts would be appreciate. You guys are the best! Hugs, Rene

Hi. My choices were supposed to be between Paxil, zoloft and celexa. I've been on all except the celexa. In the past I've been on Lexapro. I was to start Celexa, but since they don't have the brand only generic, the pysch said we'll do the paxil. I told her how much I hated it, but she said she's giving me such small amts to start. But I have a diary of when I used it the last time and it was horrid. I lasted about 2 weeks with the worst side effects. I'm more anxious than depressed and do take klonopin. The zoloft pooped out on me last year. Great for depression not so great for anxiety Bit, which beta are on you? Is is Coreg? I tried that in the past and it gave me palps but maybe I should try it again. Did try Cardizem CD (Calcium channel blocker) but found it increased my heart rate. Thanks Nina, but the article mentioned that these were women with no heart disease. I have a horrible family history. My dad was the oldest living male, and he died at 66. Mom died at 72 - bothof heart attacks. My younger brother just died and he was 48. Autopsy concluded CAD. I feel doomed, even though I had a clean cath. I know that stress and worrying only increases my heart rate, but I hate having it go up so high when walking up steps. I know, it's part of the dysautonomia. Doctors here in to me seem not to know what they are doing, unless I keep getting the worst of the bunch. There must be life after being diagnosed with dsyautonomia! I should just go back on the betas and not fear the Prinzmetal's because the pain from my heart beating so fast is horrible. And yes, I've had every cardiac test done. They all keep telling me it's anxiety! Grrr. So tomorrow I will stare blindly at the bottles of antidepressants and be paralyzed. The article mentions arrythmias and when I was on Lexapro (which I thought was a great drug) I had one incident of non sustained V-tach for 9 beats (captured on a cardionet monitor). They made me come off of it. Zoloft worked great for depression, nothing for anxiety. Any imput would be appreciated. Can you tell that I'm just a wee bit frazzled????? Oh last but not least - yes researching again - women with h/r of over 76 at rest (that's me!) were more likely to have heart attacks. Geez, prior to last Oct. my heart rate at rest was 60a and b/p was 90/60. What I wouldn't give to have those days back. Thank you all. I'm so glad you are here. And Cat Lady, I have two wonderful cats that I wouldn't trade for the world! Hugs to all! Rene

Thanks fellow cat lover! I went through the article again and it though it gives the amt of women that were studied it doesn't actually say how many of them died. I plan on emailing the author of this article. I need more specifics. Such as was it a particular anti-depressant? Or do they all carry the same risk?

Hi. I need major hugs and am scared. I've been through **** in the past year and don't mind admitting to being depressed and anxious with the dysautonomia, divorce, moving, etc, not to mention that my ex is getting married on Sunday. I'm working with a psychiatrist who is driving me crazy. Actually telling me to pick the med and then changing her mind. Grrr. I'm to pick one and start it tomorrow. Now, after reading this article, I don't know what to do. I live alone as many of you know, and have much fear about the article below. My b/p is labile, borderline hypertensive but then at times it's normal. However, my heart rate at rest is never under 80, which I hate. Beta blockers helped but now that they think I have prinzmetal's angina, I'm not supposed to take them. Do I start the antidepressant? My psych told me to stop reading so much but this is my life we're talking about. Sorry I just found this and it has me majorly spooked! So, I was researching and this popped up: Public release date: 9-Mar-2009 [ Print Article | E-mail Article | Close Window ] Contact: Amanda Jekowsky ajekowsk@acc.org 202-375-6645 American College of Cardiology Feeling down and out could break your heart, literally Research links depression to cardiac death in women without known heart disease New data published in the March 17, 2009, issue of the Journal of the American College of Cardiology suggest that relatively healthy women with severe depression are at increased risk of cardiac events, including sudden cardiac death (SCD) and fatal coronary heart disease (CHD). Researchers found that much of the relationship between depressive symptoms and cardiac events was mediated by cardiovascular disease risk factors, such as high blood pressure, high cholesterol and smoking. "It's important for women with depression to be aware of the possible association between depression and heart disease, and work with their health care providers to manage their risk for coronary heart disease," says William Whang, M.D., M.S., Division of Cardiology, Columbia University Medical Center, and lead investigator of the study. "A significant part of the heightened risk for cardiac events seems to be explained by the fact that coronary heart disease risk factors such as high blood pressure, diabetes, elevated cholesterol, and smoking were more common among women with more severe depressive symptoms." Dr. Whang and his colleagues prospectively studied 63,469 women from the Nurses Health Study who had no evidence of prior heart disease or stroke during follow-up between 1992 and 2004. Self-reported symptoms of depression and use of antidepressant medication were used as measures of depression. To best identify those with clinical depression, researchers specifically examined women with the most severe symptoms defined by a validated 5-point mental health index score of less than 53 or regular antidepressant use. The study found that women with more severe depressive symptoms or those who reported taking antidepressants were at higher risk for SCD and fatal CHD. In particular, women with clinical depression were more than twice as likely to experience sudden cardiac death. Surprisingly, this risk was associated more strongly with antidepressant use than with depressive symptoms. "These data indicate the link between depression and serious heart rhythm problems may be more complex than previously thought," says Sanjiv M. Narayan, M.D., F.A.C.C., University of California, San Diego, who co-authored the accompanying editorial with colleague, Murray Stein, M.D. "It raises the question of whether this association may have something to do with the antidepressant drugs used to treat depression." Both Drs. Whang and Narayan stress that although the relationship between antidepressant medicines and SCD merits further investigation to determine whether antidepressant medications directly increase the risk for heart rhythm disorders, at present the benefits of appropriately prescribed antidepressants outweigh the risk of sudden cardiac death. There was no relationship between antidepressant use and fatal CHD or nonfatal heart attack. "We can't say antidepressant medications were the cause of higher risk of sudden cardiac death. It may well be that use of antidepressants is a marker for worse depression," adds Dr. Whang. "Our data raise more questions about the mechanisms by which depression is associated with arrhythmia and cardiac death." Plausible explanations for the link between depression and SCD may include autonomic dysfunction, higher resting heart rates and reduced heart rate variability, according to Dr. Whang. Researchers also found an association with nonfatal MI, but this became borderline non-significant when adjusted for multiple other CHD risk factors. Still, these study findings reinforce the need for patients with depression to be monitored closely for risk factors for coronary heart disease, since management of these risk factors can reduce the risk for mortality from coronary heart disease and sudden cardiac death. ### Dr. Whang reports no conflict of interest. The American College of Cardiology is leading the way to optimal cardiovascular care and disease prevention. The College is a 36,000-member nonprofit medical society and bestows the credential Fellow of the American College of Cardiology upon physicians who meet its stringent qualifications. The College is a leader in the formulation of health policy, standards and guidelines, and is a staunch supporter of cardiovascular research. The ACC provides professional education and operates national registries for the measurement and improvement of quality care. More information about the association is available online at www.acc.org . The American College of Cardiology (ACC) provides these news reports of clinical studies published in the Journal of the American College of Cardiology as a service to physicians, the media, the public and other interested parties. However, statements or opinions expressed in these reports reflect the view of the author(s) and do not represent official policy of the ACC unless stated so. Video feed contains footage and soundbites of William Whang, M.D., and B-roll. A suggested script is attached. Galaxy 3C Transponder 4 Analogue U/L Freq. 6005 Horizontal D/L Freq. 3780 Vertical Monday, March 9th ? 2:00 pm-2:15 pm ET Tuesday, March 10th ? 10:30 am -10:45 am ET Please contact Amanda Jekowsky at (202) 375-6645 for more information Disclaimer: Content based on new reports from the Journal of the American College of Cardiology. Unrestricted content provided by the American College of Cardiology.

Angela, That's about what I was taking of the metoprolol 6.25 mg once or twice a day. And you didn't have break through spasms. Thanks! Rene

Hi Michelle, I just spoke to the dysautonomic sp. who said Norvasc would be ok. He's ordering 2.5 What were some of your side effects besides the swelling? I was told I could take it with a beta blocker since Norvasc does nothing to decrease hr and mine lately has been so high. They look at me like I have two heads in the ER. They know nothing about Prinzmetal's and probably think I'm looney tune. I think the answer is to find a female cardio! Nitro sometimes helps and others I tried to force myself to go sleep and pray that I get up!

Angela, thank you so much for validating what I was feeling on the Cardizem. Increased h/r and palps. The PA said there is no way that it could be a side effect. Wanna bet? What do you take now?

Hi Tearose, yes, they are horrible aren't they? Nitro I take is a very small amt. Your heart rate speeds up a bit and it can lower your pressure, but the other night I took one and it actually increased my pressure maybe because I was terrified since I was alone! I do believe this all started when I moved into my townhouse. My next door neighbor smokes, and I can smell it right through my bedroom wall and the whole house. And cigarette smoke is known to be a trigger. Never had this before. Grrr. What do you take for the spasms?

I'm at my witt's end. I can't catch a break. Ever since my diagnosis almost a year ago, my b/p has been in disarray. Lately, however, it has been high. Going up the steps, I'm out of breath, my h/r is 125 and my b/p goes as high as 174/85. It does drop after sitting a bit, but not that much. I'm averaging around 145/75. Not good. I was doing the betas which kept my hr nice and calm and my b/p around 120/65. (my disastolyic is usually very low on betas and I'm talking 6.25 mg of metoprolol. Well, for the fast few months with more frequency, I've had what I believe to be prinzmetal's angina or variant spasms. At rest, like someone is squeezing my heart and spasms in my shoulder blades into my jaw. I have nitro on hand. Last week, I wound up in the hospital for 2 days since my pressure was high. They put me on a calcium channel blocker, Cardizem CD. I took it for 2 days and hated it. My h/r was faster and I had palps not to mention another spasm. Ok, I admit I cheated the other day and took the beta blocker. I felt almost normal. Nice steady b/p and my heart rate was back down in the 70's. However that night, I had a spasm that was pretty intense and wound up taking the nitro. Last night, with nothing on board, I had yet another spasm that was letting up. I think it's Michelle that said she went every time to the ER. So off I went last night. Nothing showed on EKG and I had to beg to have cardiac enzymes drawn. The ER dr said my case was too complicated (really???) and didn't want to give me anything for my high b/p. I was clutching my head it hurt so much. My b/p in the ER was 180/80 and he said that with those numbers I shouldn't be having symptoms. Easy for him to say. He offered Percocet which I turned down. I was dismissed and told to follow up with primary care dr. Called today and they said it's a cardiac issue and that's who I should be seeing. My only problem is that my original cardiologist won't see me because I won't take the advice of the quack dysautonomic dr. Just got off the phone with the PA from the cardiologist. She says stay on the metoprolol that there's no contraindication for it being used with Prinzmetal's but everything I read says different. She said to take the Cardizem CD 120 mg with it if I want and that Prinzmetal's never causes heart attacks in people with normal coronary arteries. There is a website for women with Prinzmetal's and it says the exact opposite. I asked her about Norvasc and she said it's never used for Prinzmetal's and everything I've read said it's the top drug for it. I'm lost. Now where to turn and what to do? The only decent thing she said was that I should have been kept last night or at least given something for the high b/p. How I wished elsewhere at this point. Thanks for any advice and for letting me vent. Rene

I was driving locally for awhile, but that all ended 3 weeks ago, when I was driving and everything seemed to be blacking out and my heart rate was 148 (I was on the cardionet monitor at the time). Also, my b/p was so high that I couldn't see or swallow and had to pull over. I had my cuff with me and it was 174/114. This happened right outside of a hospital and I went in and the nurse looked at me and said it was a panick attack and sent me on my way. No one should have a b/p that high and h/r as well and be told it's panic. It took about an hr for everything to return to normal but that did me in on the driving front! Rene

Don't even know where to start. I've never been more confused in my life. I saw a new Dysautonomic Specialist (EP Cardiologist) recommended by my cardio (also EP). This Dr claims he can cure dysautonomia. Right away I'm skeptical. Ok I go in and have what's called an ANSAR test. Hooked up to ekg, b/p and told to sit and relax for 5 mins. Vitals being taken. Then I'm told to breath in, hold and let go. Then, the bearing down test. Sit and squeeze and hold it. Lastly, stand for 5 mins. End of test. Ushered into a room where I meet with the dr. Says that dysautonomia is a result of a childhood trauma. Oy! Tells me I have the autonomic function of a 90 year old. Yes, I probably do have Prinzmetal's angina. I know I have the gastroparesis - he says it can all be cured with his method. Here we go: Coreg 3.125 mg BID (hello, this ia beta blocker and I thought it was contraindicated if you have variant/prinzmetal's. Also, I took it once in the past and had wicked heart palps. It also says that if you have skipped beats this is not a drug for you. Amitriptyline (Elavil) 10mg to be taken twice a day. The alternative would be Cymbalta 20mg once a day. He says it's a guaranteed cure. Meanwhile, my b/p has been rising and not lowering so I probably also have hypertension. This is where it gets tricky. I had seen Dr. Michael Goodkin (on the list of recommended drs on this site). He thinks I should be on Cardizem for the h/b/p and possible Prinzmetals. Also, to complicate matters even further, my psych. wants me back on the zoloft at a small dose to start out on. So this morning was when I was going to begin the zoloft and get the cardizem. However, I got a very irritated called from my original cardiologist who said that if I didn't follow the advice from this doctor, that he was going to dismiss me as his patient. I'm scared to death. I've taken nothing today out of not knowing what to do. Is there anyone who has ever heard of this protocol? The scary part is that every one of his patients is on the same protocol. I would ask to speak to some of his patients, but his nurse is one of his patients, currently on the coreg/cymbalta protocol and swears by it. Due to a few heart problems, my psych thinks that SSRI's such as the zoloft is the way to go and prior to this visit to this doctor, my own cardio also felt SSRI was the safest and that because my heart pauses, he didn't want me on the betas. I tried telling him this morning that the Coreg made me sick and that it's contraindicated for Prinzmetal's but he wouldn't let me get a word in edgewise. Does anyone have any info or suggestions? I thought this guy was not on the up and up and didn't want to go with his recommendations. I'm so utterly confused that I've been on the computer all night and day trying to figure this out. Thank you so much for listening and for any advice/insight you might have. Rene