Living With Angina: A Case Study
Four years ago, when he was in his late 50s, Geoff began to feel breathless and tight-chested on his daily walk to work. “It was just over a mile and I enjoyed the exercise, particularly in the nicer weather but in the spring of 2005, I just wasn’t feeling right,” he remembers. After a few days of discomfort, which wore off as soon as he sat down at his desk in the council offices where he worked, Geoff decided to see his doctor. “I actually thought I had a chest infection,” says Geoff.
Angina is DiagnosedGeoff’s doctor knew as soon as he listened to Geoff’s chest that he didn’t have any signs of an infection, but something was clearly wrong. He suspected that Geoff was experiencing the symptoms of angina, which seemed to be fairly mild, but definitely needed checking out.
“I was booked in at the local hospital the following week to have an ECG and the practice nurse took what seemed to be loads of blood to be sent away for testing. My blood count, blood lipid levels, cholesterol level and the quantity of cardiac enzymes in my system were all checked. While I was at the hospital for the ECG, they also did an ultrasound scan of my heart and two weeks later I also had an angiogram,” explains Geoff.
Until the test results came through, Geoff was told to rest if his chest began to feel tight and to call for help if he experienced any severe chest pain. “Things didn’t really get any worse, luckily, and I began to think it was all going to be a big fuss about nothing. However, when I went back, the GP confirmed that I definitely had angina – one of my coronary arteries was 30% blocked, the other 40% and one was nearly 70% blocked. I began to get very worried,” admits Geoff.
Treating AnginaGeoff was told about the various treatment options for angina and was told that, eventually, he might have to have a heart bypass operation. He was immediately started on daily aspirin treatment to thin his blood and prevent him having a heart attack if a blood clot got caught in the most narrowed coronary artery. “I was also given a drug called glyceryl trinitrate (GTN), which is delivered by spraying it into your mouth, like a breath freshener,” says Geoff.
GTN, taken during an angina attack, reduces the pain by acting on the coronary arteries to make them relax so that blood can flow through them more easily.
A Bad Angina AttackGeoff was also advised to take better care of his own health – he smoked 20 cigarettes a day and made a great effort to give up. “I was less successful with my diet – I was also supposed to lose some weight and eat a low fat diet but, with the stress of not smoking and the worry, I failed miserably,” says Geoff.
About three months later though, Geoff received a big wake up call that gave him fresh encouragement to improve his health. “I was rushing, late for work and on the way there I had an unbelievable pain in the middle of my chest and to the left, with sharp and aching pains all down my left arm. I half collapsed and a passing motorist stopped and called an ambulance and I ended up in A&E having another ECG,” says Geoff.
At first, the medical staff were concerned that Geoff had actually suffered a heart attack but tests showed that there was no heart damage. Although one of this arteries was still almost 70% blocked, the tests did reveal that the blockages in the other two arteries had got worse since his previous tests – all three arteries were now more than 50% blocked.
“I was given some longer-acting nitrates, which did help but I was constantly terrified that I was going to have a heart attack. I was supposed to be avoiding stress, but my illness was stressing me out more than anything,” says Geoff.