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Internist
Internist, Doctor
Category: Medical
Satisfied Customers: 1066
Experience:  MD,MBBS, Diplomate American Board of Internal Medicine
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I had a heart attack 5 years ago on my 40th birthday & I

Customer Question

Hi there, I had a heart attack 5 years ago on my 40th birthday & I have disrythmia & a leaky mitral valve. I had only had 2 glasses of low alcohol wine & I got terrible chest & arm pains that only went away when I took my nitras spray what wud that be?
Submitted: 1 year ago.
Category: Medical
Expert:  Internist replied 1 year ago.

Hi there,

I am online and will be happy to answer your questions.

I am sorry to hear about your problem.

thank you for your patience.

chest pain , arm pain going away with nitras spray and past history of heart attack is strongly suggestive of ischemic heart disease. and this episode was most likely anginal episode ( decreased blood supply to your heart )

I recommend you to take aspirin and visit emergency department. and do not do any exertional activity.

Expert:  Internist replied 1 year ago.

I am here to help you and I wish you best health,

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Expert:  Internist replied 1 year ago.

please let me know if you have questions. / if i can provide clarifications '

thanks

Customer: replied 1 year ago.
I am not satisfied with that answer
Expert:  Internist replied 1 year ago.

I am soryy to hear that.

please let me know what information you are looking for?

I am here to help you.

Expert:  Internist replied 1 year ago.

you asked for what could be the cause of your symptom?

my reply was it is most likely due to ischemia of heart.

please let me know if i can provide clarifications. thanks

I look forward to helping you.

Customer: replied 1 year ago.
I want to know why did the spray work so easily when i was told i don't have heart disease that my heart attack was from stress
Customer: replied 1 year ago.
Can u clarify please
Expert:  Internist replied 1 year ago.

i am sorry but you did not said that it was stress related and not heart attack. you said it was heart attack and you have history of arrythmia and mitral regurgitation.

pain relieved with nitrates are strongly suggestive of ischemic heart disease. with history of arrythmia and vulvular heart disease.

You should get ekg, cardiac enzymes and echocardiogram of heart.

please let me know if i am not clear

Expert:  Internist replied 1 year ago.

only other reason , esophageal spasm gets better with nitras spray.

esophageal spasm causes mid sternal chest pain and improves with nitras and calcium channel blocking drugs.

with your history, i recommend you seeing a cardiologist. arrythmia too can cause chest pain , becuase with poor rhythm , the blood supply to heart is compromised and can present with angina like chest pain.

i hope this helps.

Customer: replied 1 year ago.
OK i had a heart attack with damage left on my heart the doctor said it was caused from stress. I already had disrythmia then they found I had a leaky mitral valve after my heart attack. So I want to know why the spray worked when apparently I don't have heart disease
Expert:  Internist replied 1 year ago.

why do you say you do not have heart disease. you have leaky mitral valve and dysrhtyhmia and history of heart attack ( the cause may be stress , but you did have ischemia of heart , thats what heart attack means. )

nitras work by restroing blood supply to heart by dilating coronary arteries. and that is what happens in compromised blood supply to heart ( due to any reason, i.e blocking by cholesterol plaques, stress causing spasm of arteries, arrythmia )

Customer: replied 1 year ago.
OK well i have been to the doctors about this before & they said my heart was
OK so I don't know what was causing the pain as it
was almost unbearable
Expert:  Internist replied 1 year ago.

dear ,

why would one say a heart ok if there is leaky mitral valve and rhythm problem. that is heart disease.

you may not have acute heart attack at the time you visited your doctor.

but you do have heart disease and you do need to get ekg, echocardiogram and stress test ( stress test is best way to rule out compromised blood supply to heart

Customer: replied 1 year ago.
OK i say that cos the cardiologist said it wasn't heart disease it was just stress. But if it is heart disease then that's why the spray worked. Gosh different doctors sat different things it is very confusing. All i know is i had terrible chest pains.
Expert:  Internist replied 1 year ago.

dear

leaky miral valve and dysryhtmia means you have heart disease ( if ekg shows normal rhythm and echocardiogram shows normal heart valve , then you do not have heart disease. but you already said you do have rhythm problem and you have mitral valve which is leaky. )

please get EKG, Echocardiogram AND stress test ( to rule out / in ischemia of heart )

i hope this helps.

I am here to help you and I wish you best health,

if done for now, please leave positive rating above the chat box.

we only get credit for helping clients after positive feedback.

If you have any more questions, please feel free to ask anytime.

Please bookmark my profile for asking further questions!

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Customer: replied 1 year ago.
I have had a ekg & a stress test done 5 years ago & it showed my disrythmia &
& the leaky valve but they were happy with how it is & I'm on a asprin & simvastatin that's why I'm surprised I had such pains.
Expert:  Internist replied 1 year ago.

so you do have heart disease.

5 years is a lot of time. and with these chest pains i highly recommend you to repeat ekg, echo and stress test and adjust doses of your medicine/ or if you need to add any other medicine.

i hope this helps.

kindly click on accept when done with questioning.

feel free to ask any follow-up questions.

Expert:  Internist replied 1 year ago.

do you have any qeustions?

Expert:  Internist replied 1 year ago.

please let me know if you have questions.

kindly click on accept if this answered you query.

Regards.

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