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Ask Dr.S.A.Alam Your Own Question
Dr.S.A.Alam
Dr.S.A.Alam, Doctor
Category: Health
Satisfied Customers: 4454
Experience:  MBBS/FCPS(Internal medicine/cardiology) MRCP(R) U.K
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Customer Question

I HAVE EXCELLEN BP EXCEPT WHEN I EXERT MYSELF IT GETS VERY HIGH AND I MUST STOP WHAT I AM DOING IMMEDIATELY OR IT WILL GO OVER 220/130. THE PAIN IS IN MY LEFT CHEST AREA WITH PAIN RUNNING DOWN MY LEFT ARM. BAD PAIN AND HIGH B; GOES AWAY AFTER A WHILE BUTY A PAIN IN MY CHEST REMAINS FOR AN HOIUR OESO. SSOMETIMES EVEN A BRISK WALK STARTS IT. I HAD A HEART CATH 10 MONTHS AGO AND IT CAME OUT FINE. CAN THINGS GET THIS BAD IN JUSTY TEN MONTHS?. I NEVER SMOKED OR DRINK. I AM NOT OVERWEIGHT. WAS VERY ACTIVE TILL THIS STARTED WHICH KEEPS GETTING WORSE. IT HAS GOT SO BAD I CANNOT EVEN WALK AROUND THE MALL NOW WITHOUT GETTING BAD PAINS AND ILLREGULAR HEART BEATS. IN FACT SOME TIMES WHILE JUST WATCHING TV I GET L GET ILLREGULAR HEART BEATS.I AM 66 AND UNTIL NOW WAS IN PERFECT HEALTH. ALSO, TAKING OXYCODONE FOR SERIOUS GASTRIC PAINS I HAVE BEEN GETTING THEY ARE STARTNG TO TRY ANHD FIND OUT WHY NEXT WEEK.

ANY IDEAS WHAT THIS IS? THINK I WILL NEED A BYPASS ETC./
Submitted: 5 years ago.
Category: Health
Expert:  Dr.S.A.Alam replied 5 years ago.
Hello,
Thank you for your question,
This seems like prinzmetal angina, in such cases the heart cath are normal. Heart arteries are hyper responsive and get into spasm with with activity or stress, in most cases cause remains unknown, most people do have high cholesterol in such cases. Treatment option in such cases is high dose nitrates, calcium channel blockers to prevent the spasm of the heart arteries. Statins are also given to help lower the arterial wall thickening(METEOR trial supports use of statins to help lower or reduce the intimal thickening of heart arteries). So this should be your treatment plan. By pass surgery is indicated when we find some blockage in the heart arteries, stents can also be used but both these options are used when heart cath shows blockage of the heart arteries which in your case are normal. These medicine(nitrates/ calcium channel blockers) will also help to lower your blood pressure.
I hope this helps.