Prinzmetal's Angina Sypmtoms,Diagnosis, and Treatment

by Jackie D. Kimball

I've been thinking about old Fred Sanford today  and how he would grab his chest, look to the heavens, and call to his deceased wife, "Elizabeth, I'm comin'. This is the "big one" Elizabeth!"

Fred Sanford may not have been such a put on after all about those "big ones". That's right. I said maybe not. Maybe, just maybe, old Fred was not always trying to get sympathy. Maybe he was having acute chest pains ! I know, I know, it's a broad stretch. Here's how I got there .

 

It Happened to Me. Now I Understand, Fred!

Do I look sick? OF course not. But you should see this face when a "big one" happens!
Do I look sick? OF course not. But you should see this face when a "big one" happens!

Promise Me!

Fred, I understand! I do! Sometimes I stumble and reel and grab my heart just like you did. It always feels like the" big one"!

Okay readers ,here is the clip.

If I let you watch this, will you promise to finish reading my article?Okay,then.......watch this! Then (you promised) back to my story!

Chest Pain is Frightening

If you want just the facts on Prinzmetal's  angina , skip this part and scroll down, as I wax eloquent about my mysterious ailment.

I was still in my twenties when my first prinzmetal attack struck me as I was walking into the new Sears store for the grand opening. I was in a good mood. It was Saturday, and like most of us, I love a good deal. Free hotdogs, chips, and a coke meant not having to fix lunch, and the paper announced loads of bargains. Suddenly I was feeling the most acute pain in my chest,to the left just under my breast. I literally stopped in the middle of the street near collapse . I tried to sit down on the street, but half way down I couldn't move another inch!

My (then) husband was unaware that I had bent over and finally crouched on the street, and I was unable to move or speak. Nausea flooded over me in waves, and I thought I was going to die right then. My dad had a serious heart condition and had an attack once on a railroad track with us kids in the car. He couldn't move or speak, so Mama steered the car across the tracks and stopped the car. Oh,yeah. I had seen a heart attack close up....and this was it! I was having a heart attack at my young age.

Only......maybe not. As my husband came running back to me ,I begin to get just a small amount of relief. The pain was subsiding, albiet slowly.We made it back to the car. We were less than a mile from the hospital, but I decided not to go. Ten or so minutes later, I felt fine and concluded that that was the worse trapped gas in my chest cavity that I had ever felt.

We went in and browsed Sears for a few minutes, but I neither wanted a hotdog or wanted to shop. The only way I can describe this is that I felt no pain, but an overwhelming feeling of impending doom came over me. I just wanted to go home. I felt fine. For a short while.

After a few more days of more eposides of some sort of frightening chest pains, I went to my family doctor. This was 1969 and medicine was nowhere near what it is today.My doctor concluded that I had heartburn, and put me on a bland diet which really didn't help.Of course he or the next few doctors really didn't believe me as to how debilitating the pain was, especially after the new doctor in town just starting his practice had hospitalized me and found nothing . Nothing in my upper and lower GI report showed any problem, so at least I got off the nasty bland diet! My heart was not the problem I was told, though no tests were done to verify that.

Women with heart complaints were not taken very seriously in that time. I gave up my quest to find the problem. I diagnosed my self with an "unknown heart condition" and just learned to live with it, expecting like old Fred Sanford, that the "big one" would eventually happen. I'd show them. I was right all along!

 

Prinzmetal 's Angina

Finally in my forties(yes,twenty years later!) after a heart cath,a wonder cardiologist at Saint Francis Medical Center diagnosed my problem. I had Prinzmetal's angina. I was given a beta blocker, nitroglycerine tablets, and a pamphlet about this type of angina. From my doctors,the pamphlets, library, internet, and personal experience I have learned much about Prinzmetal's angina. I am no expert, but I have dealt with this condition most of my life and I , by experience , have learned the symptoms, causes of onset, and treatment options.

There are basically two types of angina:

Stable angina- Mainly occurs when the person is experiencing emotional or physical stress. Other triggers are smoking, consuming a large meal, intense physical activity especially not in the regular daily pattern,and cold weather.

Unstable angina-Occurs at unexpected times during sleep, at rest, exposure to cold,or with even light activity. A doctor should be consulted immediatlely if pain or discomfort lasts more than more than a few minutes.

Prinzmetal's angina is unstable angina and the patient should be under the care of a cardiologist.

Symptoms and Diagnosis

SYMPTOMS

Prinzmetal angina is most often described as a very often severe painful tightness with squeezing, pressure, or a crushing sensation. The pain may sometimes radiate to the neck, and jaw, shoulder, or down one or both arms.

Though not sure of all of the causes for prinzmetal angina episodes, doctors know that extreme stress, being exposed to harsh cold temperatures, and activity can bring on the angina. For me, winter is a doozy as the cold causes many episodes at the most inconvenient times, such as recess duty outside.

It happens without warning, and may occur about the same time each day.(Though mine is sporadic.) It is said to often occur at night while resting. One study showed that the most common times were between midnight and eight A.M, though mine is more often in the morning.

While it lasts, it is painful, but the usual duration is five to thirty minutes. Occasionally prinzmetal angina can cause fainting. There is about a 2% chance of sudden death. It sounds bad, but that means there is a 98% chance that you will quickly recover. The episodes are most often occuring in clusters meaning that they may continue for a few days or months followed by long or short periods with no occurences.

DIAGNOSING PRINZMETAL'S ANGINA

After examining you , the doctor will take your complete medical history and even your family's medical history. Your doctor will ask questions about your lifestyle. It is important for the doctor to know if you smoke, drink, and even how much sleep you usually get a night.

There are tests that might be ordered to see if you have coronary artery disease and you may need more than one.

The first test that is usually done in the doctor's office is the EKG , which is an electrocardiogram to record your heart rhythm and rate. This may or may not show important information. A normal EKG does not mean that there is no problem.

Usually what follows the EKG will be a scheduled stress test. There are two types. One test involves monitoring your heart while walking on a treadmill. If it is felt that you should not or can not walk on the treadmill, you will be given a nuclear stress test. This test uses an injection of medication that will stimulate your heart. The dye will help indicate blockages. ( This is what I had, and I found the sensation to be a feeling of flushed skin and tiredness .)

After this test, if a blockage is suspected,you will probably be scheduled for an angiogram, more commonly called a heart cath.The doctor uses a camera . A catheter is inserted into the groin and guided using the camera to the heart.Upon reaching the heart, a dye is injected so that any blockages, blood flow, or other problems can be observed. To determine Prinzmetal's angina , this is considered so called "gold stndard" . ( I slept during the whole thing, I guess, because all I remember is seeing the monitor and hearing my doctor say,"That's a wrap.")

TREATMENT and LIFESTYLE

Your doctor may prescribe medications such as nitrates, calcium channel blockers,beta-blockers and an aspirin regimen.

You will probably be directed to change ceratin lifestyle behaviour that are risk factors.

Once you are prescribed your medications, you can take your nitroglycerin at the onset, and get much quicker relief. I have a very small stainless steel medicine cylinder on my keychain, and therefore my nitroglycerine is always available when I am out without taking the whole bottle.

So, what do you think?

Do you think Fred Sanford had Prinzmetal's angina?

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Comments 32 comments

50 Caliber profile image

50 Caliber 6 years ago from Arizona

A very good and thorough coverage of a serious topic. I tote nitro every where I go, and use it monthly, the American Heart Association has more one should be aware of. Good job, 50


Pamela99 profile image

Pamela99 6 years ago from United States

bayoylady, I have seen patients with this type of angina as a nurse. You wrote an excellent hub as to the symptoms and treatments of this type of angina and stable angina. Hub rated up!


fred allen profile image

fred allen 6 years ago from Myrtle Beach SC

Forget about Fred Sanford, my concern is for you sweet lady. I pray that you will be free from this pain and the fear it brings. Lord, protect Your child. You can do all things. Free her from this enemy! In Jesus name! Amen


bayoulady profile image

bayoulady 6 years ago from Northern Louisiana,USA Author

50caliber, Hi and thanks for commenting. Funny, the American Heart Assc. used to have much more presence on TV.


bayoulady profile image

bayoulady 6 years ago from Northern Louisiana,USA Author

pamela99,thanks for commenting and approving. I was wondering what you in the medical profession would think.


bayoulady profile image

bayoulady 6 years ago from Northern Louisiana,USA Author

Fred, Thanks for commenting and your prayers.Fred is jst so funny to me! You would not believe all the health problems I have,lol!PLUS I'm 60!Main ones are the angina,lymphedema,fibromyalgia,asthma,arthritis,diverticulitus,acid reflux and hypertension.See? If I regulary told people that, they would treat me like an invalid, and I'm having NONE of that!Most people I know don't know about most of it.......I try to be upbeat and keep it to myself.That is why I'm glad I just retired. I can take it easy when I need to. ;.) EASY LIVIN'!


LillyGrillzit profile image

LillyGrillzit 6 years ago from The River Valley, Arkansas

I know this is a serious topic, but genius adding the Funny Red Foxx! I loved Sanford & Son, and there have been times I too felt like this may be the "big one". I have adjusted my eating habits and lifestyle, so those moments will only come if I win the Lottery or a Hub Nugget Award! Thank you for an informative Hub that pulls you in from the start! Way to Go


bayoulady profile image

bayoulady 6 years ago from Northern Louisiana,USA Author

LillyGrillzit, thanks for the compliment! Yeah, I thought a bit of humor would soften the article, and make it more readable...'cause I made 'em promise to read it!LOL!

Eating and lifestyle may aggrevate Prinzmetal's angina, but are not the cause of it.I weighed 91 lbs and ate mostly from our garden at the time this happened. Go figure,huh?


akirchner profile image

akirchner 6 years ago from Central Oregon

Very well done - I'm no doctor but I am a medical transcriptionist and you nailed it!


bayoulady profile image

bayoulady 6 years ago from Northern Louisiana,USA Author

akirchner, thanks for the compliment!


NoRR4Me profile image

NoRR4Me 6 years ago

Bayoulady, I like your hub. I know you're just kidding by asking your question, but no I don't think Fred Sanford had Prinzmetal's angina because he could have one at will. I love the show though and still watch the re-runs on t.v.

On the serious side, there are some natural things to help heart conditions. Hawthorn Berry herb can be used in a capsule or drink as a tea. Also, cayenne pepper is excellent. It can also be taken in a capsule. Cayenne extract is also available. You can drop a few drops in a cup of herbal tea and enjoy.

Anyway, I hope you stay well. Take care.


bayoulady profile image

bayoulady 6 years ago from Northern Louisiana,USA Author

noRR4me, hi and thanks for stopping by. Yes I am just kidding by using Fred as an example, because he only used it during agitation, and stress sometimes brings on an episode. I eat a lot of jalepenos and LA hot sauce,too.I haven't tried cayenne extract. I'll look into that!


samiaali profile image

samiaali 6 years ago

Hi bayoulady, This is a very informative hubpage. This can truly help someone who is having similar symptoms and may be ignoring them. Thank you.


habee profile image

habee 6 years ago from Georgia

My dad had this. Sometimes the pain would wake him from a deep sleep. Great info!


bayoulady profile image

bayoulady 6 years ago from Northern Louisiana,USA Author

Samiaali, Thanks for reading and commenting on recognizing angina.Prinzmetal's is very frightening, even if you are popping a nitro and know what it is. However,until I knew what it was, I was a FRED SANFORD type saying ,'I'm dying!"Thankfully, 98% recovery is very good odds! I'll take that!


bayoulady profile image

bayoulady 6 years ago from Northern Louisiana,USA Author

habee,thanks for reading and commenting,even though you've seen it first hand. I'm sure you're glad that only about 2% is fatal. I know I am!


BkCreative profile image

BkCreative 6 years ago from Brooklyn, New York City

How well I remember Fred Sanford grabbing his heart. I've learned something new from you today. I'm glad you mentioned stable angina - we like to discount just how devastating stress is.

Great hub - rated up!


bayoulady profile image

bayoulady 6 years ago from Northern Louisiana,USA Author

Bkcreative, thanks for checking out this report! Yes, the effects of stress on major organs of the body has long been known, but ignored!


TheListLady profile image

TheListLady 6 years ago from New York City

I've learned something new today. And by being informed we can be our own good-health advocates. Thanks a lot for this information.

Oh and I remember Fred Sanford very well!


bayoulady profile image

bayoulady 6 years ago from Northern Louisiana,USA Author

List lady,hello. Sorry I'm late(been sick). Thanks for reading and commenting.Good ole Fred!


stars439 profile image

stars439 6 years ago from Louisiana, The Magnolia and Pelican State.

Dear bayoulady : My thoughts of you are always in my heart. Your hub is awesome. God Bless You Dear Heart.


bayoulady profile image

bayoulady 6 years ago from Northern Louisiana,USA Author

Stars439- thanks for reading and commenting, and of course your prayers are always welcome!


Becky Puetz profile image

Becky Puetz 6 years ago from Oklahoma

Excellent information. So sad that you had to live with terrible pain and fear of an attack so many years before you were diagnosed. Thanks for sharing your experience with us.


bayoulady profile image

bayoulady 6 years ago from Northern Louisiana,USA Author

Becky, I appreciate your comments. I keep nitro everywhere!lol! I even have a little stainless steel cylinder with nitro in it on my keychain! :D


Money Glitch profile image

Money Glitch 6 years ago from Texas

Thanks for sharing your experience in such detail bayoulady, I'm sure the info on Pinzmetals Angina will help someone else as well. Rating up!


bayoulady profile image

bayoulady 6 years ago from Northern Louisiana,USA Author

Thank you moneyglitch.I hope it will help someone! If I neverr make a dime off of it, I'm glad it's published, because of the rarity of the condition and misdiagnosed patients.


motherbeastly profile image

motherbeastly 6 years ago from Argyll and Albox

I don't know why this suddenly appeared in front of me, but it did and I found it very useful. I also liked your comment about your range of health problems and how they are not going to get you. I know that feeling! I will not let my health problems bring me down either. Good on you Ma'am, and I hope you are around have more 'big ones' for a long long time. rating up.


bayoulady profile image

bayoulady 6 years ago from Northern Louisiana,USA Author

hello motherbeastly!Thanks for your encouraging words and the rate up!


skye2day profile image

skye2day 5 years ago from Rocky Mountains

Thank YOU sweet bouylady for the wonderful information. I am grateful to know what to look for. I pray in HIS name that you are healed and never have another attack. I will stand in Faith for you. By HIS stripes I am going to claim healing for you. NO more attacks. My dad carried the nitro. He passed on after heart failure. Docs said alcohol damaged his heart.

I love you. bayoulady. You are a gem in the box of Jewell's. Precious child of God you are. Hugs Galore UP Awesome bookmarked

PS on your profile take out old woman you are a frisky love. I think you are quite young myself. Age is just a number one day new bodies. Think men of Bible lived to be 800 or so years. Moses must have thought 62? to be a very young babe in the woods when he was 150.

Fred was so cool, I watched him all the time growing up. He did love to keep his stash of stuff. I think maybe he had angina. He was great at acting it out so maybe he really understood the pain. I have not a clue just a wild guess. Be back soon.


mulberry1 profile image

mulberry1 5 years ago

What a frightening experience! I'm glad it was finally diagnosed, not only so that it's being addressed properly but that knowing would have to be better than the fear of NOT knowing. Great information!


Di 4 years ago

I know this was written a while ago, and very good job on describing the condition. You do have a very positive outlook. I'm a little more pessimistic as I have Prinzmetal and unfortunately for me it occurs in 2 coronary arteries with 100% occlusion. I actually had a heart attack due to the lack of blood flow from that episode. The purpose of this comment is this, I had episodes that I ignored without knowing what it was. They progressively got worse until I let it go too far. What a strange condition, and I'm glad you wrote about it.


bayoulady profile image

bayoulady 4 years ago from Northern Louisiana,USA Author

Di. Thank you for adding this information. Though risk of a fatal episode is small,it does happen.

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