Pulse Rate/blood Pressure/heart Attack

[taichiperson]

I had a small heart attack in January last year which stumped the doctors for a while, as my arteries were found to be fine after an angiogram. After a scan I was told part of the heart muscle had been damaged and was 'sluggish'. They thought that it was most probably a small blood clot that had caused the damage. I'm now on ramipril, atorvasatin, brilique (ticagrelor), amlodipine and aspirin. I'm due a meds review next month.

My question is this - they have told me to watch out for breathlessness as a danger sign that things might be going wrong again, but what else should I watch for apart from chest pain (for me it was discomfort rather than pain)? In this hot weather my heart is a little 'fluttery' ie it doesn't feel as if the beat is as strong as normal (though I do get palpitations from time to time, which I also did before the HA) and I've felt a little light headed at times. I've maybe not kept up the exercise as they told me - getting into the cardio range is not easy to do regularly.

I monitor my pulse with a fitness band and have a blood pressure app that seems to be pretty accurate - if I was in trouble, would my pulse rate be slow or fast, and I presume high blood pressure would be bad - but would low blood pressure point to another HA? Thanks in advance.

[Sqad]

I am rather confused a little here.
You had a heart attack (small) and yet the angiogram was normal, so how was the heart attack diagnosed...one presumes on ECG and blood tests, but if they were normal, then i would have thought a heart attack would have been a unlikely diagnosis.

BUT...let us assume that the diagnosis is correct.....then the medication medication is correct foe someone who has had a heart attack and high BP (Amlodipine)
Watch out for chest pain, indigestion, tightness in the chest on exercise and weakness. Shortness of breath and tiredness are all features to look out for.
Palpitations and heart irregularities would point to another diagnosis which i will mention later.

A low pressure alone without other symptoms would be unlikely to point to another heart attack. A fast or slow pulse rate might be indicative of that other diagnosis which i am about to suggest:

Sick Sinus Syndrome.

Good luck.

[taichiperson]

Thanks Squad. They took a blood sample and discovered high levels of Troponin that indicated the HA - normal levels are around 20, mine was over 200, if I remember correctly - the level was still rising when I was on the ward later. I had chest pain (tightness) which spread into my shoulders, arms and neck. I'd been having symptoms that came and went over a week, very odd. I'd had an 'episode' a couple of months earlier with sweating, cold clammy skin, and I was told I went extremely pale at the time - I'd just felt a bit off - dizzy - and had to sit down at the time. My GP asked me to take my BP for a week after, but as it was a fortnight until a monitor was available, by which time I felt ok, he missed out on a diagnosis

[taichiperson]

PS I don't suffer from shortness of breath - at the time it just felt like I had to take a deeper breath every now and again, no worse than that. I most definitely got the tightness after exercising (I tried skipping!!) Tiredness makes me laugh, I have a lot of trouble getting to and remaining asleep due to feeling hot - not sweating, just needing to feel cool. When I am short of sleep I rarely feel tired or sleepy.

[bainbrig]

Taichi: not underestimating your problems for an instant, but do remember Corporal Jones' cry ('Don't panic!')

I have similar physical problems to you, but often the answer to my occasional breathlessness is just remembering to BREATH deeper and slower.

With all good wishes,

Bill B

[taichiperson]

Thanks Bill. I teach Tai Chi so breathing is not a problem. When I was recovering I found deep slow abdominal breathing allieved my symptoms just as well as or better than the spray they gave me. Have not needed to use it since

[Sqad]

taichi.........from you posts, I cannot in any way support your diagnosis of a heart attack based solely on high levels of Troponin.
If they were that high, then your ECG would have been abnormal and certainly your angiograms would have shown impairment.
I would suggest an MRI scan of your heart, but I cannot see how that would be abnormal.
There are other reasons for high troponin levels and certainly false readings have been identified.

My opinions remain the same that you have not had a heart attack, Sick Sinus Syndrome still remains in my mind a possibility.

I am not a Cardiologist.

[thesshhh]

Regular exercise is absolutely vital to your future wellbeing. If you’ve been given a cardio workout DVD to do, do it 5 mornings a week without fail. And eat healthy food as often as you can, especially green veg. If you get stressed, drink camomile tea (with just hot water, no milk or sugar) as it will calm you down

[taichiperson]

Squad, I had an MRI scan - it showed damage as I originally posted. They were rather puzzled I must say and while I was waiting to be discharged the ward nurse said 'They're trying to find something wrong with you'. Broken Heart Syndrome/Takostsubo was one possible diagnosis that they threw out. I do take on board that you are not a cardiologist! My Qigong (type of Tai Chi) teacher told me if I hadn't been practising Qigong that the attack would have happened sooner and been worse.