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Women And Heart Disease Prinzmetal Variant Angina/vasospasms

I am a 48 year old woman and have recently been diagnosed with a heart condition I have never heard of. I talked to a couple of registered nurses at my insurance company, one at the ssi office and none of them had heard of the condition. I know it is out there and others have it but the coverage on this disease and getting the word out to women especially (it tends to affect many more women) is just not right and my concern is that there many be other women out there suffering like I did and being told that it is their nerves, menopause, gerd, bad habits, etc. And not getting the proper testing, and in that I mean that is it not the same test that will show up heart disease in men. Our vessels are apparently something else about us that is very different.


Because of what I have been though, I plan on starting a way to get information from women all across the country on their symptoms when they have finally gotten the diagnosis I did and see if something can be put together to correlate these and possibly have a questionnaire that can be used by doctors, nurses, and emergency rooms to better know if this disease is a possibility. This will also help get the word out to those who are suffering symptoms and have no idea what they may be dealing with or may be sent home not properly treated or feeling guilty that it possibly is just nerves or menopause related.


It took me demanding that they do a heart cath. And the first one showed a 75% blockage in the left side of my heart. I was sent home with medicine and told to change my diet and quit smoking, which I had already done. I ended up back in the hospital 3 weeks later and all I remember was in the ambulance they hollered, we're loosing her! I got stabilized at the hospital and one partners of the cardiologist said he was going to go ahead and do the balloon and put a stent in. I ask why that wasn't already done and he said, well my associate is only allowed to do that test, not to use any drugs or procedures. That is something that needs to be asked before you go under the knife also. He got the cath in, shot the dye in and low and behold, I still had a 75% blockage, but this time it was in the right side of my heart! He gave me 10 mg of nitro and again, low and behold it opened up!!! What that means is that it is not a true blockage. I was having sever and intense vasospasms that were so strong they were actually shutting off the vessels of my heart. He also tested my leg while he had the cath in, it was also blocked from a spasm shutting down my vessels.


I have been put on a whole new set of medicines and have a whole different life ahead of me, partly because it took so long to listen and diagnosis me. I do not know what the future holds for me, but I know that in the present I want to help others so they don't suffer like I did and also so they don't think they are alone and going crazy.


My goal is to get as much information gathered about this disease as possible, mainly from ones who suffer from it and find out what their beginning symptoms were and then get the word out through advertising, internet, american heart association, washington, what ever it takes. I guess it upsets me that for so long the only testing for heart disease was done on men and lab rats, lets you know where you rank when you go for help doesn't it? :?

If any of you have any information or have been diagnosed with prinzmetal let me know what your symptoms were, your age, and yes, it does seem like what is going on in your life as far as nerves does play into this stress wise so that is important. Lets join together as the strong women we are who have always been the caretakers but realize that we must take care of ourselves if we are to take care of others. :idea:

take care dear hearts
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replied March 31st, 2009
Does hair loss come with this condition? I can't find any information connecting Prinzmetal and hair loss.

I'm 49 years old. and otherwise basically healthy. My cholesteral levels are all within normal levels, I don't have any heart artery blockages that restrict blood flow. I exercise 5 times a week and and I'm a vegitarian.

I have had a crushing chest pain about twice a year for atleast 10 years, as long as I have had migraines. As my migraines increased in frequency and intensity, my chest pain also increased. I have had stress tests over the years that ofcourse showed nothing since I was not having an attack at the time. All of my symptoms including cold hands and feet were ignored and I was put on imatrex and xanax and told it was all stress and perimenapausal. Last Sept I began having cluster migraines and the chest crushing began in ernest. I was put on three rounds of presnodone, Topomax, beta blocker, and vicodine. I was not in any kind of functioning state and had to leave my full time teaching position and my part time exercise coach position. In December my attacks worsened to 5 to 7 attacks per day lasting up to 2 hours each. I felt like I was dying (I think I actually was)and my Dr. basically blew me off. I went to the ER and they also blew me off. Finally, In January I went to a headache specialest who got my migraines and meds undercontrol and sent me to cardiologest who after an angiogram diagnosed me with Prinzmetal. I am now on a medley of meds that are helping and I have quality of life back, but I still get strong vasospasms about once or twice a week when I have to use atleast 2 nitros to releave the pain. I get some chest tightening but I figure I have to live that, since it'a a delicate balance between the vasospasms and the migraines. I'm learning to adjust and gently live with this very serious condition, but I am perplexed about my hair loss and I can't seem to get an answer.
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replied April 8th, 2012
I too have variant angina and was put on beta blockers, I noticed I was losing a lot of hair, I was then put on channel blockers and this has no effect on my hair, so my conclusion was it was the use of the beta blockers that was making me lose hair, I was told by my consultant that I should not have been on beta blockers as the treatment for variant angina is channel blockers, hope this helps.
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replied March 31st, 2009
Community Volunteer
According to every website I have visited, Prinzmetal's Angina affects more MEN than women. I called my Cardiologist (I have heart problems related to Vascular Ehler's Danlos)and asked about it, she said it is very rare and yes, it affects more men than women, yet it affects more caucasion women than caucasion men.

How common is Prinzmetal's Angina and who is likely to have it?

Prinzmetal’s angina is relatively rare and the actual number of cases is not well documented. Some estimate that 4 out of every 100,000 Americans have it, or about 2% to 3% of people with chest pain who undergo an X-ray of the heart called a cardiac catheterization (also known as an angiogram). Men are more likely to suffer Prinzmetal’s angina than women: about 70% to 90% of patients are male. It also seems to be more common among Japanese people than Caucasians. However, Caucasian women are more likely than Japanese women to have Prinzmetal’s angina. People with Prinzmetal’s angina are generally younger than those with stable angina; the average Prinzmetal’s angina patient is between 51 and 57 years old. They also have fewer risk factors for heart disease with the exception of smoking, which is the most significant risk factor for coronary artery spasm.

The majority of people with Prinzmetal’s angina also have coronary artery disease, characterized by atherosclerosis (“hardening of the arteries”). This means there is a buildup of fatty plaque in the arteries of the heart, making the arteries stiffer, thus making it more difficult for blood and oxygen to reach the heart. Prinzmetal’s angina alone rarely causes a heart attack, but heart attacks may occur more often in patients with severe underlying heart disease. There is also a very slight risk of sudden death (about 2%) in people with Prinzmetal’s angina. Coronary artery spasms can also be “silent” – meaning they occur without any symptoms.

What are the symptoms of Prinzmetal’s angina?
The chest pain from Prinzmetal’s angina often has the following characteristics:

•Located under the chest bone
•Described as squeezing, constricting, tightness, pressure, or crushing, which is usually severe and may radiate to the neck, jaw, shoulder, or arm
•Often occurs at rest
•May occur at the same time each day, usually between 12:00 midnight and 8:00 AM
•Lasts from 5 to 30 minutes
•Relieved by nitroglycerin
•Can cause fainting or loss of consciousness
What causes coronary spasms?
It is not known exactly what causes coronary spasms. They may be due to problems with the thin lining of the blood vessels called the endothelium. Usually the artery lining produces a chemical (nitric oxide) that widens the blood vessel allowing blood to flow through with ease. If the artery lining is damaged or isn’t working properly, the blood vessels may narrow more easily, which may cause a coronary spasm. This idea is supported by research done in women. Levels of the artery-widening chemical are higher when estrogen levels are also high at certain stages of the menstrual cycle. Studies have shown that during these times when estrogen levels are high, women have fewer chest pain attacks. In addition, smokers tend to have lower levels of nitric oxide in their blood vessels than nonsmokers, and smoking is a major risk factor for coronary spasm.

However, there is also research suggesting that the nitric oxide theory doesn’t fully explain Prinzmetal’s angina. Atherosclerosis, the hardening of the arteries caused by the buildup of fatty plaque, impairs the release of the artery-widening nitric oxide, but not everyone with atherosclerosis develops coronary artery spasms. Other suggested causes include problems in part of the nervous system (brain and spinal cord) or the muscle tissue involved in making the arteries narrow and widen. Another possibility is that injuries to the lining of the arteries expose the muscle to chemicals that cause the blood vessels to narrow.
How is Prinzmetal’s angina diagnosed?

Prinzmetal’s angina is often diagnosed with an ECG (electrocardiogram or EKG) during an episode of chest pain. The ECG may show a particular pattern called ST-segment elevation—a bump on a graph of the heart’s electrical activity that shows up in a telltale place. The pattern will disappear when the chest pain resolves. If you do not have heart disease (meaning an X-ray of your heart shows no major blockages in the arteries of your heart) or have only mild heart disease, and this pattern appears during ECG testing, you will probably be diagnosed with a Prinzmetal’s angina. If you have heart disease, this particular ECG pattern is may indicate that you are having a heart attack.

The gold standard for confirming a diagnosis of Prinzmetal’s angina is the coronary angiogram, a test that produces an X-ray of the heart’s arteries on a monitor. The physician will give you medication to see if it induces a spasm (the spasm will be visible on the monitor). If a focal spasm (a spasm at just one spot, rather than all over) occurs and you have ST-segment elevation on an ECG, you have Prinzmetal’s angina.

How is Prinzmetal’s angina treated?

Prinzmetal’s angina is treated with medications, specifically nitroglycerin (NTG), long-acting nitrates, and calcium channel blockers — all of which widen or open the blood vessels and improve blood and oxygen flow to the heart muscle. Calcium channel blockers are generally prescribed first. If you continue to experience episodes of chest pain, then a different class of calcium channel blocker or a long-acting nitrate may be given. For people who do not respond well to either of these drugs, alpha blockers can be prescribed. Alpha blockers lower blood pressure and reduce blood vessel narrowing by blocking the action of stress hormones. Nitroglycerin is used when you are experiencing a spasm to stop it, thereby alleviating pain; it is not used as a preventive medication. Nitroglycerin is usually given as a spray that you use in your mouth or a tablet that you place under your tongue.

Risk factor modification is also important because most people with Prinzmetal’s angina also have heart disease and are therefore at risk for a heart attack. It is especially important to stop smoking because smoking increases the likelihood of coronary artery spasms. By lowering your risk factors, you will reduce your chances of developing atherosclerosis. In addition, people diagnosed with Prinzmetal’s angina should avoid exposure to cold and high stress situations since these can trigger spasms.

What is the prognosis for people with Prinzmetal’s angina?

With medication, the prognosis is very good for people with Prinzmetal’s angina, and their chest pain can be treated successfully. One study found that 97% of patients survived 5 years after being diagnosed with Prinzmetal’s angina, and 83% survived without having a heart attack. Another study of 202 patients (18% female) who were diagnosed with variant angina between 1991 and 2002 found that 80% survived without a heart attack, and that most negative events happened within a month of when the patient first started having symptoms.

Prognosis is closely tied to the extent of coronary artery disease, and people with more severe heart disease have worse outcomes than those with less severe or no heart disease. The severity of the spasm, and how completely it blocks blood flow to the heart, may also predict outcomes: in one study, people who had ST-elevation on an ECG were 3 times as likely to die or have a heart attack than those who did not, independent of the extent of their coronary artery disease. Variant angina also increases the risk of developing a cardiac arrhythmia (heart rhythm disorder), and there is a small but significant risk of sudden cardiac death. Sudden cardiac death occurs most often in people who have spasm in multiple arteries and have experienced an arrhythmia before during a chest pain attack.
(excerpt from HeartHealthyWomen.Org...no caps if you copy/paste, change all caps to lowercase letters or link will not work)
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replied March 31st, 2009
Prinzmetal and hair loss
Thank you for the lesson but I have read all that information. My question again is: Is there any connection between Prinzmetal and hair loss?
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replied April 1st, 2009
Community Volunteer
No. And all that information was for the original poster. Many things can cause hair loss, lack of proper nutrition, menopause, getting older, stress, etc. If you are having chest pains of any type, seek the advice of your doctor asap. But I have never seem anything about hair loss and Prinzemetal's Angina.
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replied June 18th, 2009
Prinzmetals Angina
No one has actually given you what their symptoms are.. I also want to know what are the symptoms
I have chest pain upon waking in the morning its sharp stabbing pain and it takes my breath away. I fell hot and I have pain down my left arm. This has been going on for several years but EKGs always come out fine. I have never has an attack during an EKG. I have also done a heart stress test and that came out fine my primary dr thinks I may have Prinzemetals angina. Anyone else have similar symptoms
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replied July 16th, 2011
Your tests will always be normal unless you are having an event during the test. Your dr. can do a cath through the groin, There is a medicine given during the cath that if you really do have prinzmetals your heart will spasm during the cath. It's accurate confirmation of prinzmetals. good luck
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replied December 26th, 2009
prinzmetal's angina
This sounds like the same symptoms my woman friend had, and it took a long time for the best doctors to diagnose. Finally she had an attack while in the hospital and they got to view it on the machines. She finally was diagnosed with Prinzmetal's, after being told she was having panic attacks, GERD, and a host of other minor issues. It took a full blown heart attack to get anyone to pay attention.
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replied July 16th, 2011
Prinzemetals
48 yo female w/ moderate chest pain, cardiologist did every test EXCEPT cath. This went on for about 6 months. It became more severe over time. STRESS PLAYS A HUGE ROLE IN ATTACKS and attacks are almost always during periods of rest. Cardiologist told me I had an insignificant blockage in the LAD. On April 4 this year the same cardiologist told me the blockage had disappeared. One month and 2 days later I was taken by ambulance to the hospital where a different cardiologist did a cath and found a 95% blockage in the LAD. I had immediate open heart surgery, double by pass. (Up to this point I had NOT had a heart attack). After open heart surgery, the 2nd day in ICU my heart spasmed again, and sadly this time I did have a heart attack. When they went back in they were suprised to find the 95% blockage was gone. That's when they knew it was Prinzmetals. I never needed the open heart surgery. Here is my advice to anyone w/ chest pain. BE DEMANDING OF YOUR DOCTOR! Prinzmetal is very hard to diagnose, it doesn't show on stress test, EKG, etc. unless you are in the middle of an event. There is a chemical the cardiologist can give you during the cath that will make your heart spasm (thereby confirming Prinzmetals)and medications to control the spasms. Don't let doctors blow you off. Best of luck to you all.
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replied September 12th, 2011
It took me a year to be diagnosed with Prinzmetals Angina. My first one was Jan. 6, 2009. Second one was about 3-4 months later. It progressed to every month, week, then 5-6 times everyday. I was diagnosed during catherization after nuclear stress test that showed I had a complete blockage the day before, (I didn't). I take slow release nitroglycerin and sublingual as needed. I also take beta blocker for uncontrolled hbp from Prinzmetals. I have had problems ever since 2009 with nerve damage, fatigue and memory problems which I believe are from Prinzmetals. Right before 2009 I was diagnosed with Hashimoto's Thyroiditis, which I had hair loss on my scalp, legs, armpits and other areas. Thyroid treatment has helped with my hair loss. I do not have any plaque in my arteries, or hardening and have been given a clean bill of health, in regards to my heart (except for the vasospasms). I am 41 and still experience vasospasms almost daily and have chest tightening feeling a lot.
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replied December 3rd, 2011
I had s spasm while wearing a halter monitor. Immediately my cardiologist had me go in for a heart cath and I had a spasm during the her cath and was told I have Prinzemetal. I have been suffering for over 2 years and normally have 1 to 3 attacks daily for 2 weeks out of a month.

Recently, I went to Baptist hospital in cincinnati Ohio. The doctor told me to take L-Arginaid. This is supplement that can be bought through the Nestle company or amazon. I have been taking it for almost a month now and I have not had any spasms. What this product does is produce nitric oxide, which is believed that is what a person with Prinzemetal is lacking. I am thrilled by the results, especially because for a year I have been on several medications and getting no results.

I want to get the word out there to people who suffer with this condition. I am a 47 year old female that is healthy except for this condition. I have been told by my doctors that this a rare and hard for the health professionals to figure out. I am lucky to have found a doctor is doing a case study on this.
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replied October 24th, 2012
prinzmetals angina
Hi Im a 35 year old woman that is suffering from prinzmentals angina, micro vasculiaur angina and palpacations and heart failure all because doctors wouldnt listen to my symtoms when i came in the er or office visits this has been going on for years the doctors told me i was having panic attacks cause the found nothing other than high blood pressure and racing heart the wouldnt help me until now when i almost died. now i need a new heart becuase of doctors lack of education of the heart of women. i had shortness of breath, high pulse rates, low pulse rates, i was low oxygen, dizzy, clammy, chest pains, left arm numbness, fatigue, falling, coughing, swelling of the feet,hands and i turned blue now they see it cause it never stops im in clusters all the time it is worst at night then during the day its not as bad except when i get up and walk then it gets bad
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replied November 30th, 2012
I have tried to describe to my husband how the docs ignore symptomes in women. He thinks I'm nuts. It has gotten so ridiculous that I've quit mentioning my chest, arm, and jaw pain. With him, if he complains of feeling funny, they are admitting him to the hospital and running tests. Me, I told him the only way they will take me seriously is if I collapse in public and have to be moved out of the way so I'm not blooking the path for other people. It makes me so angry sometimes.
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replied November 2nd, 2012
I have a question. Have any of you had your magnesium levels checked. I have read of a link between low mag and unstable variant angina caused by muscle spasms as a result of low mag. I have been diagnosed with low mag and ended up in the ER last week with severe chest pains which sound like your type of angina. All the tests came up negative and I had a nuclear stress test with echo this week. I go for my results on Monday and I am expecting them to be negative too. I have had many of these pain attacks in the past and always thought they were indigestion, gallbladder(had my gallbladder removed and they continue) I am currently suffering with debilitating muscle spasms also so a cardiac spasm of some kind wouldn't surprise me. I just need to know how to approach this with the dr.
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replied March 21st, 2013
estrogen
I had severe prinzmetals only when I forgot to take my bhrt just 3 times in my life.

Pollution (xenoestrogenics) is screwing up everyones hormone levels---causing prinzmetals and all manner of diseases.
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replied July 25th, 2018
Experienced User
I was diagnosed with plantar fasciitis and was given some insoles by my podiatrist. The insoles did not work in all my shoes and I got blisters on my heels. I was in a lot of pain and could not exercise or even go for a walk. I saw an ad for orthofeet shoes online and I was interested. I was so excited to get my pair because of all the great reviews and I was hopeful that they would work for me also. From day 1 they were amazing, so comfortable, no pain when walking or exercising. My plantar fasciitis has even improved and now I am interested in trying different orthofeet styles not just for exercise.
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replied March 6th, 2019
I am a 47 year old female. I started getting heaviness on my chest followed by a sharp pain in the center of my chest that radiated to my back between my shoulder blades, up the right side of my neck, into my right jaw, my right side of my face went numb and my vision in my right eye went blurry. This lasted about 20 minutes. After it happened the 3rd time I went to the ER. Results, Gerd. In between I have had episodes where I get nauseous and dizzy and can't stand up for a day or more. I continued to go to a cardiologist. Everything he said was ok. But he prescribed nitro for my episodes which help and isosorbide. He tested me for lupus and the first result came back positive. But the second test that confirms it's lupus and not a false positive came back negative for lupus. I continue with both types of episodes. My right arm also hurts alot and my hand gets real cold. I am a runner but recently within one minute of running my heart beat is at 178 or more when it's shouldn't ho over 143. I went to a new cardiologist and she says coronary microvascular disease. I recently did a nuclear stress test and under the projection R short axis dly the stress extent shows a shade darker in an area and the rest extent shows a black blob in that same area. What is that? It also says chamber 38ml, wall 105ml, defect 3ml, extent 3%.
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