Concerns about Nitro patch and Nitro Spray

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Submitted by Dr T on February 8, 2014 – 10:17am

As brief as can be history   I am writing this out of concern for my husband
Male age 54  heart attack 1 year 4 months ago  right side arteries blockages had 3 stents inserted, there was some percentage blockage on left side but not enough for surgery.  Has family history of heart disease from mother and father side. Been on cholesterol and blood pressure meds for 10 years after heart attack he was Put on plavax for 1 year, asprin daily  cholesterol meds, blood pressure meds, Metoprolol and given nitro spray for use as needed. Ever since heart attack in Oct 2013 health has never been close to feeling as good as prior to heart attack. 
Always been dealing with chest pain off and on gone to emerg 3 times since heart attack with minimal resolve, and have had regular followup visit with cardiologist.  Have had various heart test  EKG, medically induced stress test, echo cardiogram with nothing out of ordinary found. Gets hot and cold sweating episodes off and on, nausea and vomiting, dizziness  all seems to go in episodes fine for a week or two then all the above symptoms seem to reappear for a week or two  been off and on like this since in recovery stages. 2 weeks ago after cardiologist followup appt has been prescribed .02 mg/hour nitro patch to wear 12 hours a day. This immediately has helped with all symptoms but now have new problems.
Feeling good well wearing patch but gets tightness in chest not long after patch is removed then in the morning upon waking has even more chest tightness. This pass week even well patch is on chest tightness get more dominate and has also used nitro spray sparingly. the last 2 nights he is awaken with chest tightness and pain takes a nitro spray and gets relief. I am concern with using the nitro spray in addition to the patch but it does help. yesterday patch was worn for 12 hours used spray once during the day patch was removed at 830pm. within 4 hours (12:30am) of removing patch had the tightness with pain used spray was ok, then was awaken at 3am with the same issues used spray again and got better.  Then again awaken at 530am same issues a shot of spray and ok. each episode pain seemed to be worse. Awoke at 8 am some tightness put on patch tightness subsided but nausea and vomiting has returned. It appears to me that the nitro is definitely helping but seeming to be needed 24/7   I also concerned that this is perhaps an onset to another heart attack, as with the 1st heart attack it seemed after the fact of us knowing that had had a heart attack, for 3 days leading up to it the signs were there we just were not aware of them.
He is a man and is stubborn which is also inherited from his father. I have asked him to call the cardiologist he just says lets just wait and see, I am also tying to get him to go to emerg but as i said a stubborn man. Wondering perhaps if i can get some knowledge from this posting that would help me convince him if needed to get to a hospital before it is too late. I thank you for your professional advise and knowledge

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    You just described me to a T.Im 53 will hopefully be 54 in 2 days.I had a heart attack 4 years ago 3 stents put in a year later another stent put in.Its now 2 years later and I’m getting the same symptoms as I got prior to my last stent.I was in The ER last night Sept 14 2022.I have a drug induced stress test booked for Oct 19.ER doctor and the cardiologist on call are trying to speed up the stress test date.I forgot to mention I’m in a small northern Ontario town and I’m 3 hours away from a cardiologist and cath lab.I was sent by plane the night of my heart attack. Im From Kirkland lake to Sudbury .I’m getting symptoms again tonight with nitro patch and spray. The only way to find out if you arteries are blocked is an angioplasty. I will be having one soon I promise you that. Tell your husband to insist on getting an angio before he’s dead.tell your husband to stop being a dick.If you have chest pain go to the hospital NOW.

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