Similarly, I usually don't want to know how serious my medical condition is. I know, that's completely ridiculous and irresponsible. But when I was told I had Angina Pectoris I only knew one thing: it was some serious shit. So, this morning I googled it and this is what I found:
Angina pectoris is the medical term for chest pain or discomfort due to coronary heart disease. Angina is a symptom of a condition called myocardial ischemia. It occurs when the heart muscle (myocardium) doesn't get as much blood (hence as much oxygen) as it needs. This usually happens because one or more of the heart's arteries (coronary blood vessels that supply blood to the heart muscle) is narrowed or blocked. Insufficient blood supply is called ischemia.
Angina also can occur in people with valvular heart disease, hypertrophic cardiomyopathy (this is an enlarged heart due to disease) or uncontrolled high blood pressure. These cases are rare, though.
Typical angina is uncomfortable pressure, fullness, squeezing or pain in the center of the chest. The discomfort also may be felt in the neck, jaw, shoulder, back or arm. Many types of chest discomfort aren't related to angina. Acid reflux (heartburn) and lung infection or inflammation are examples.
When does angina pectoris occur?
Angina often occurs when the heart needs more blood. For example, running to catch a bus could trigger an attack of angina while walking might not. Angina may happen during exercise, strong emotions or extreme temperatures. Some people, such as those who experience coronary artery spasm, may have angina when they're resting. (See below, unstable angina, Prinzmetal's or variant angina pectoris.)
Angina is a sign that someone is at increased risk of heart attack, cardiac arrest and sudden cardiac death.
What is stable angina?
People with stable angina (or chronic stable angina) have episodes of chest discomfort that are usually predictable. They occur on exertion (such as running to catch a bus) or under mental or emotional stress. Normally the chest discomfort is relieved with rest, nitroglycerin or both.
People with episodes of chest discomfort should see their physician for an evaluation. The doctor will evaluate the person's medical history and risk factors, conduct a physical exam, order a chest X-ray and take an electrocardiogram (ECG). Some people will also need an exercise ECG (stress test), an echocardiogram or other tests to complete the diagnosis.
What is unstable angina?
In people with unstable angina, the chest pain is unexpected and usually occurs while at rest. The discomfort may be more severe and prolonged than typical angina or be the first time a person has angina. The most common cause is reduced blood flow to the heart muscle because the coronary arteries are narrowed by fatty buildups (atherosclerosis). An artery may be abnormally constricted or partially blocked by a blood clot. Inflammation, infection and secondary causes also can lead to unstable angina. In a form of unstable angina called variant or Prinzmetal's angina, the cause is coronary artery spasm.
[b]Unstable angina is an acute coronary syndrome and should be treated as an emergency. People with new, worsening or persistent chest discomfort should be evaluated in a hospital emergency department or "chest pain unit" and monitored carefully. They're at increased risk for:
* acute myocardial infarction (heart attack).
* severe cardiac arrhythmias. These may include ventricular tachycardia and fibrillation.
* cardiac arrest leading to sudden death./b]
What is variant angina pectoris (Prinzmetal's angina)?
Variant angina pectoris is also called Prinzmetal's angina. It usually occurs spontaneously, and unlike typical angina, it nearly always occurs when a person is at rest. It doesn't follow physical exertion or emotional stress, either. Attacks can be very painful and usually occur between midnight and 8 a.m.
Variant angina is due to transient coronary artery spasm. About two-thirds of people with it have severe coronary atherosclerosis in at least one major vessel. The spasm usually occurs very close to the blockage.
Just to read those words makes me feel weak and slightly nauseous. It is the "unstable" kind that I have, and I think the occurrence Thursday night may have been triggered by something I did earlier that day:
I have always been of the opinion that crying is a healthy emotional catharsis. My depression had become so bad, or I should say that the anger and despair were at such a serious level that I felt I had to do something, so I decided to make myself cry (no small feat).
I dragged out some letters that my grandmother (who passed away in 86 at 89 years of age) had written to me while I was in the Naval Hospital. That was in 1985, at the time when I was first diagnosed with bipolar. I have always cherished those letters. I don't get them out very often because I don't like to think about the period in my life when they were written.
I read them very carefully, thinking of how much I loved her and missed her, about how I was so doped up on Thorazine when she died that I really didn't have the opportunity to say a proper "goodbye"...I guess I shouldn't go into much more detail, huh?
But it worked. Within minutes I was bawling like a baby. A part of me, some kind of demon in the back of my mind maybe, mocked me and taunted me with the thought that these weren't real tears, only manufactured, seeing as how I had forced them with a specific purpose. I mentally denied that, believing that regardless of any personal benefit I might receive, the bottom line was still the same, the emotions were still the same as they had always been, the tears were as real as they ever were...and it was like a struggle between two opposing sides. I was winning, though. And I kept on for as long as I thought I could stand.
I was in the moment when it was all done. "A moment of clarity", as they call it. In that state I realized what a bastard I'd been to my wife and, indirectly, to my son, all these years that I've let my anger and hatefulness (among other things) fuel my depression. It may be a cliche, the whole concept of Pink Floyd's "The Wall", but it is so true...I had built up a wall that my real self had been hiding behind. This experience opened a little chink in it, and I seized upon the moment to write a letter to my wife, trying to explain that beneath all the bullshit that had built up, there was still real love in my heart for her. I told her I was sorry for the way things had turned out, whether they were my fault or the bipolar. And I told her she didn't need to respond to the letter, that I would just as soon she didn't acknowledge it. But something inside of me didn't want me to give it to her in person. So I hid it in one of the drawers in her chest of drawers, underneath a stack of clothes, and figured she'd find it eventually.
Long story short, in writing the letter I became even more rattled than I was reading grandma's letters. I don't know how it is with "normal" people, but when you suffer serious depression this kind of emotional overload is wonderful and there is a real feeling of contentment and almost bliss when it's all over with.
I felt pretty good afterward, as is the case with a good cathartic experience. I felt at peace. I felt more "in the moment", though I was sure it would be temporary and there were still some negative, pessimistic feelings hovering about in my spirit (once again, for lack of a better term).
If anything could be considered "strong emotions", that was it. I don't think I was shaken that bad even at my father's funeral back in 99.
And it wasn't until I lay down in bed, settling in before going to sleep that the thing hit me. The only thing that doesn't absolutely convince me that this is the main cause is that it was several hours between the emotional upheaval and the angina attack (I guess that would be what it's called). It does make sense, though.
I can actually feel my upper body tense up just thinking about all this, so I suppose it would be advisable to stop for now.
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