Vasospasms?
 

In the two weeks before this past christmas holiday I had severe vasospasms which were unbearable in my chest. They persisted practically nonstop for those 2 straight weeks leaving me with no sleep and extreme discomfort.

They've since caused some visible damage to my blood vessels.

Wondering if anyone else has experienced them and if should I expect for it to happen again if I have a chronic autonomic neuropathy?

That happens a lot with Autonomic Neuropathy. No way to know exactly what happened to you, but people with Dysautonomia talk about it a lot. Mine is much better now.

That type of chest discomfort can be cardiac vasospasms or even esophageal spasms. Have you had GI manometry to rule out the esophageal spasms? The treatment is basically the same for either...nitro if episodes are not frequent and long acting nitrates or calcium channel blockers for those with more frequent problems.

What "visible" damage have they caused and how is your doctor treating this?

They are a part of autonomic neuropathy, so you may have periodic problems when other AN issues arise. However, the treatments can relieve your chest pain.

I would have been inclined to think that they were esophageal spasms except I had too many other symptoms that pinpointed vasospams- ie. when I had a tight squeeze that lasted a long time in my chest just below my neck, my arms lost blood flow and became so heavy they felt paralyzed. I also had razor sharp fleeting pain that ran along the course of my blood vessels during this 2 week long episode. The "damage" that i mentioned, is that my blood vessels now during and now after that episode seem to be highly sensitive. They overreact to heat and cold. My blood vessels "blow up" huge with heat, my hands swell, and with cold they shrivel and hands "shrink" to where my ring starts falling off my finger and they turn white.

What treatment do you believe can alleviate the chest pain? That was horrible and if I experience it again, I'd like to be prepared. My doctor mentioned beta-blockers. I couldn't get nitro during the worst of the episode because the doctor said my blood pressure was too low.

Although autonomic function is usually behind vasospasms, the low blood pressure may be triggering or aggravating them. Of course, your low BP may be autonomic dysfunction/neuropathy as well. If you treat the BP, then you may avoid the vasospasms before they start. Something as simple as compression stockings may help your BP increase. There are also meds like florinef or midodrine increase BP. You need to be tested to see what is going on before being treated.

The other treatment for vasospasms (besides nitro) is as I mentioned before...calcium channel blockers. They can drop BP a little, but spasms can sometimes be controlled with just small doses.

Your doctor needs to be addressing all of this...even the blood vessel issues...I certainly hope you've brought it to his/her attention and that he's seen what you're describing.

What I don't understand is after 4 ER visits, why not a single doctor has prescribed calcium-channel blockers. My cardiologist just recently mentioned beta-blockers-

what is the difference? and why does it seem that none of the previous doctors were aware of how to treat them?

The ER is not the place for routine treatment. They are there to stabilize any life-threatening condition, then turn you over to the appropriate doctor for treatment. Your cardiologist needs to be addressing this. I'm not sure why he didn't discuss calcium channel blockers. If your heart rate is high (compensatory reaction to low BP) he may be trying to lower the heart rate with beta-blockers...when what you really need is to be properly diagnosed and treated for the low BP. Once the BP is treated, your spasms may improve. This other condition you mentioned with your blood vessels also needs to be addressed.

You say the cardio "mentioned" the beta-blockers, but you didn't say whether you were actually taking them (if they helped) or what the plan is. You haven't said what testing you've had to determine AN (tilt table, etc).

You should request to see an autonomic specialist...which may mean you might need to go to a teaching hospital or large medical center. Good autonomic specialists are not in run of the mill hospitals.