Two days ago, I called a friend I had not spoken with in a while just to catch up. During the conversation I learned that his wife had had another episode of chest pain that was severe, radiated to her teeth, caused her to feel weak, and lasted about fifteen minutes. It was relieved by nitroglycerin. She had been having more frequent chest pains several months ago but has been on optimal medical therapy for coronary artery disease and the pains have calmed down. This episode was brought on by a stressful episode.
This is another example of how chest pain in women is different. It was not brought on by exercise, but by stress. One in three women who die of heart artery disease do not have significant blockage of the vessel prior to the heart attack. Microvascular disease of the heart seems to play a bigger role in these individuals. This process may also damage other organs of the body. Microvascular disease is also associated with endothelial dysfunction which is a medical term that means the inner lining of these tiny arteries produces reduced amounts of nitric oxide. Nitric oxide is the active ingredient in the nitroglycerin pill that patients with chest pain put under their tongues to relieve it. Decreased nitric oxide production leads to spasm in these tiny arteries and results in decreased blood flow. Emotional stress aggravates the spasm. Nitroglycerin relieves the pain and opens the artery. It solves the problem and relieves the pain.
Here is a very practical piece of advice. If are a woman with repeated chest pain, always keep nitroglycerin on hand. Once you have opened the bottle, the little pills are only effective for two months. Make sure they are no older than that or they are much less effective. Some find it easier to get nitroglycerin spray which is more expensive but retains its potency much longer. Decreased blood flow does not just cause pain, it also may cause dangerous heart rhythm disturbances. It is very important to take nitroglycerin that works.
I have written about Jean, my neighbor, and now another close friend. It seems this problem is pretty common. If you have a female friend with repeated chest pain, help her understand how she can protect herself. Heart disease is the leading cause of death in women.
Bravo, Dr. Bestermann - great work. When is Amy Spahic coming back to Greenville?
So good to know Im not alone. Thanks for sharing! Hope she is doing better.