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On Metoprolol, Have Pain Radiating From Base Of Throat To Lower Jaw On Rapid Walking. Should I Start Imdur?

Posted on Tue, 21 May 2013

Question: I am a 65 yr old female currently taking 50 mg twice daily of metoprolol along with 25 mg daily of enalapril for high blood pressure. Recently began having some pain radiating from the base of my throat to my lower jaw when I engaged in certain activities, like bike riding or walking rapidly. It is not consistent, happens sometimes but not every time with exertion. Never had shortness of breath, dizziness, or sweating with the pain. cardiologist. I had a nuclear stress test, ECG, chest xray, carotid ultrasound, and CT angiography. All studies revealed no plaque build up in any vessels. However, following the tests, he prescribed Imdur, 15 mg daily to "determine" whether I have microvascular disease causing the intermittent pain. Reading all the horrific side effects, I am fearful of taking it. I truly feel the pain is related to GERD, for which I take Prilosec, 40 mg daily. As there is no "treatment" for microvascular disease according to my cardio, is it imperative that I begin the Imdur??

Answered by Dr. Prabhakar C Koregol (42 minutes later)

Thanks for detailed description. Superficially, your symptoms do appear like anginal. If you had so many tests and they being normal it’s unlikely to be angina. Even with microvascular lesion, we should have been able to pick up something on Stress Nuclear. Since that is, also it is less likely to be microvacular.

Even if it is Angina with kind of reports, you have excellent prognosis without treatment as well. If you have occasional symptoms you can just ignore them and should be fine.

If they are recurrent and troublesome then you should be able to take Nikorandil/Amlodepine without much side effect. However, you need to discuss this with your cardiologist before starting treatment.

Thanks and regards

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Prabhakar C Koregol (35 minutes later)

Thanks very much. That is what I was thinking.....just ignore/put up with the annoyance if it occasionally happens. Thank you for the suggestion of Nikorandil or Amlodepine with less side effects.

Answered by Dr. Prabhakar C Koregol (7 hours later)

Thanks and I happy that my answer helped you.

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj