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Taking amlodipine for blood pressure. On colsprin. Angiography normal. Reason for chest pain?

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Practicing since : 1966
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One and a half year ago I went through angiography to rule out TMT positive test. Angiography
results were normal. However , my doctor continued me on medication of colsprin etc for another seven months.
I am not diabitic however family history exist.

From last year onwards I have increased by physical activity and am presently doing average 100km walk plus around 50km cycling per month.

Offlate when I start my morning brisk walk ( avg 8min 40sec for a Km) I get a throbbing pain in the top part of
left chest which subsides after few minutes. However sometimes a very mild sensation remains throughout the
period. Of the 7.35 Km walk/jog that I do nearly everyday thesedays I do interval jogging after the first 2.25 Kms walk.

Why do I get these pains ? I am an vegetarian and eat fruits in the morning , salad in the afternoon mixed with
cooked veg and in normal cooked dinner.

I am taking 1.25mg amlodipin for Blood pressure daily which I do miss sometime. I have also been
diagonesed for prostate (BPH)
Posted Sun, 5 May 2013 in Hypertension and Heart Disease
Answered by Dr. Anantharamakrishnan 2 hours later
Welcome to Health Care Magic

A negative angiography in a situation of positive TMT and symptoms is Micro-vascular Disease...
The pain is angina despite good effort tolerance and walk through phenomenon.
You have excellent life style – diet and exercise...

Resting ECG shows Inferior wall ischemia / markedly positive Infero-Lateral changes on exercise
LDL is a bit high for this situation – 70 or below will be ideal.

The dose of amlodipine is rather small / you can double it to 2.5 mg.
You can add a small dose of beta-blocker- extended release Metoprolol
You can add long acting nitroglycerine
You can add clopidogrel to aspirin.
You should a statin – it has benefits beyond cholesterol too (anti-oxidant)

Repeat the stress test with thallium

Take care
Wishing speedy recovery
God bless
Good luck
Above answer was peer-reviewed by
Follow-up: Taking amlodipine for blood pressure. On colsprin. Angiography normal. Reason for chest pain? 16 minutes later
Why does the pain only starts at the begining and subsides after a few minutes in the workout. During the rest of workout there is no pain or just mild sensatation.

I was already on extended release Metoprolol
and clopidogrel and aspirin for for 6 to 7 months after angio.

Should I continue to only walk or continue with my walk + jog activity.
What care needs to be taken if I do not want to add your recommended medicine

Answered by Dr. Anantharamakrishnan 55 minutes later
That is called walk-through phenomenon - due to recruitment of collateral vessels and some temporory restoration of blood supply
It is better to take clopidogrel and aspirin for life.../ preferable with Metoprolol too
Walking is safer than jogging...
No more specific area of care to recommend except to have regular follow up and/or another opinion
Above answer was peer-reviewed by
Follow-up: Taking amlodipine for blood pressure. On colsprin. Angiography normal. Reason for chest pain? 20 hours later
I do intermittent cycling also,
However, the starting pain does not seem to occur (walk-through phenomenon ) in case of cycling.
I did a 7.35 Kms cycling today at the speed of approx 1 Km per 2mins 50sec.
( WWW.WWWW.WW ) . I did not have
the pain as discussed above. On 7th of this month I did a 51.76 Kms cycling ibn 3 hrs 05 mins and did not feel the pain. Normally the pain/cramp is on the back of chest near the shoulder blades.

On few days I also have mild pain on right side of the chest. Am I overdoing the excecise bit because on some days I do 5 to 6 suryanamaskar and 5BX 4 minutes plan. The total duration of workout comes to approx 1 hr 20 mins.

On days of 7.3 Kms walk plus jog I measure my pulse and find it to be in the range of 110 +/- 5 ( full 1 min count) having done the last 250m as walk only.

Morning BP today was 126/72 with 67 pulse (electronic device).

However I do have mild headache on left side on some days like today also. I wear glasses and have dry eye syndrome.

How threatening is the situation. My next review with my local doctor ( not the Apollo) is 3 months down the line. What lifestyle should I follow because I like to jog as soon as I am walking in the morning breeze just like a dog cannot stop its urge to pee on a pole.

I have uploaded my angio report also

Answered by Dr. Anantharamakrishnan 2 hours later

In fixed obstructive lesions, the amount of effort bringing on the symptom is also fixed and predictable. Here, it is not predictable / it is variable - it depends on the speed and amount of collaterals recruited..

Angio report is OK / ...except LDL above 100

The situation is stable
Barring accidents, there is no obvious immediate threat...

Exercise has addictive potential! / Several neuro-endocrine hormones - endorphins in particular - are responsible, causing a sensation of happiness...
Anything in moderation is OK. You may reduce the speed / split the duration

Good luck
Above answer was peer-reviewed by
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