Have had chest pain intermittently throughout the past 10 years; diagnosed as anything from coronary spasm to right ventricular apical ischemia. Five years ago, however, had a negative angiogram. (There was mention on the report following the procedure regarding the fact that they had to administer nitro during the procedure because of spasms; my guess is that this is not particularly unusual or concerning.) Whatever the case, 99% of the time, nitro spray takes care of the problem quickly. Usually, withing 15 - 30 seconds I feel it release and the pain - which is like having someone with a cowboy boot stand on my breastbone with the heel of their boot - will diminish and disappear altogether. Occasionally, more than one spray is required.
In the past month there has been a new development, which is that when I go on walks (which I do year-round), I become breathless quickly. In fact, I usually walk when talking on my cell phone, but in the past month I have to gasp for breath while I do this.
This past Friday, I called my doctor while having one of these episodes to suggest that we schedule a stress test; however, by the time the nurse came on the line I was vomiting from the breathlessness - which progressed to pain AND breathlessness. I "hit" the nitro spray and it began to release, but they had me call 911 for (another) aggravating trip to the E/R. After being held overnight and having a negative stress test (confirming the lack of an apparent blockage), I was really frustrated, because I KNOW this is somehow heart-related, and don't have a firm diagnosis. The good news, however, is the cardiologist on call spoke with me and suggested that it could possibly be diastolic dysfunction. After looking that up on the internet, the pieces seemed to be falling into place for the first time. Past ultrasound (10 years ago) showed that the aortic valve is tricuspid, and I have always had a heart murmur (diagnosed as aortic). My question is this: if this IS eventually diagnosed as diastolic dysfunction, does that account for the chest pain as well as the breathlessness? And, what does the rapid onset (one month) of breathlessness mean? Does the fact that the aorta is a tri-leaflet make a difference? (My father had exactly the same aortic structure and I learned that it can cause the aorta to become less flexible more rapidly than a bi-cuspid valve, if I understood the cardiologist correctly). Is this diagnosis less concerning that having an actual heart attack? Should I skip the ride to the E/R next time?