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Angina symptoms or something else?

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Angina symptoms or something else?

Old 03-09-20, 08:35 PM
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Wattsup
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Angina symptoms or something else?

I did my usual 20 mile ride today, and rather than hop on the train with the bike and head home like I usually do, I decided to turn the bike around and ride the 20 miles home. 40 miles is no problem for me. The only issue was that I had my normal 12 inch Subway meatball sandwich before deciding to ride the 20 miles home. I knew that wasn’t a great idea, but I planned on taking it easy all the way home. I never eat a meal before riding, but today I did.



On the way home, I discovered that a little bridge was out, so I had to detour. I asked an elderly biker for directions, and he said, “Go up this hill, make the 2nd left, and you’ll be back on track. Well, it was a hill all right. It was about a mile long, and I had to stop and walk about two thirds of the way up. That didn’t surprise me, as it was long steep hill, beyond my current ability. Here’s the thing though. Towards the end of my climb, I started getting a strange tightness in my throat. It kind of reminded me of the exercise induced asthma I would get when I was very young, (I’m 60 yrs old now). The humidity was very low today, brush fire warnings.The sensation stopped about two minutes after I got off the bike and started walking. I got to the top of the hill and proceeded home another 15 miles without incident. Do you think this was angina? I had no chest pain, but I was in the weeds, right up against my fitness limit. Here’s the thing. I’m up against that limit often with no similar symptoms. I do VO2 max intervals in Trainerroad and get my heart within just a few beats of my maximum. Not a calculated maximum, but my proven maximum. I never have any issue, no pain. Just today, after I ate a foot long sandwich, something I never ordinarily do. I’ll usually have a small snack no less than 90 minutes before biking.



So what do you think? Anyone here ever have diagnosed angina with just this one symptom, a throat tightness?

edit: Could this be vocal cord disfunction? I have noticed myself clearing my throat alot lately, my voice sounds soft, almost hoarse sometimes. To me, from my experience, that's likely GERD. I started taking prilosec again a few days ago.

Last edited by Wattsup; 03-09-20 at 08:56 PM.
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Old 03-09-20, 09:08 PM
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Go to the ER. Don't panic, just go. Seriously. I love it when people ask here about different pains. Don't screw with what may be your heart. Just go.
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Old 03-09-20, 09:15 PM
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As the proud wearer of seven coronary stents I have a little bit of experience in this matter.

​​​Bassmanbob said it best. Don’t panic and go to the ER. Barring that, go and see your PCP as soon as possible. I would not do streneous exercise until you have been cleared by a doctor.

It could be nothing or it could be an early warning sign.

Don’t do like I did and keep riding. I was stupid and careless...don’t be me.
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Old 03-09-20, 09:32 PM
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Totally not your heart. It's GERD, as you suspect, also known colloquially as heartburn for obvious reasons. Don't worry too much about it. If you're taking prilosec, follow the package directions. If this happens more than say, every 2 months, you might want to take famotidine every day. If it gets bad, you definitely need to see a doctor.
https://www.rxlist.com/gerd_remedies...rn/article.htm
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Old 03-09-20, 09:43 PM
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Yeah, please go see your doctor.
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Old 03-09-20, 10:29 PM
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Originally Posted by Carbonfiberboy View Post
Totally not your heart. It's GERD, as you suspect, also known colloquially as heartburn for obvious reasons. Don't worry too much about it. If you're taking prilosec, follow the package directions. If this happens more than say, every 2 months, you might want to take famotidine every day. If it gets bad, you definitely need to see a doctor.
https://www.rxlist.com/gerd_remedies...rn/article.htm
You sound pretty certain about that, that it's GERD. I'll take the diagnosis. It's a little better than a clogged artery, right? I will see the PCP soon though, but no ER for me. It's a $500 deductible, and I feel fine.

Here are a few interesting extras. When I first started exercising five years ago, I had similar symptoms every once in a while. At the time I was running on the treadmill (biking now that the hip is screwed up). I could be doing the most brutal HIIT, getting my heart rate in the stratosphere and would feel fine. Occasionally though, when running a little longer distance, at a very moderate heart rate, I would get a slight sensation in my throat, a twinge that would pulse about once a second, a sensation that felt similar to what I felt today (today was stronger though.) So I went to the PCP, and I said, "Do I have angina?" He said."You might. If you feel pain, dial it back a bit." So I said, "Well, I was hoping to get a stress test. He said,"We can do that." If I hadn't brought up the stress test, that would have been it, just a recommendation to dial it back. Managed Care! I got the nuclear stress test, and it was negative. That was that. I've been biking for a few years now, indoors and out, and I have rung out my heart many many times. Never had a pain. Today I had the funky throat sensation for the first time in years. Even as write this, I can feel little *tiny* twinges right in my voice box, like little tiny spasms. Tiny! And I know the GERD is acting up. The question is, is it the same thing, just smaller amplitude, of what I was having today?

Another tidbit. I had GERD for many years, was on prilosec, but then I cured myself. What happened was that I was trying to eat better. No meat,(I love meat) little saturated fat, and I was scarfing down high fiber bars, (a source of inulin) and also cheap store brand yogurt, the kind they load up with guar gum and the like to make it feel smooth and creamy. Both inulin and these gums are known as prebiotics. They're actually food for the bugs in your stomach. You can't digest it, but the bugs can. So, after doing that for a few months, I ran out of prilosec one day, but was lazy, didn't get the script refilled. Ordinarily I would have the stomach pain, the persistent heart burn within two weeks of stopping the prilosec. Guess what? I never took prilosec again, and never had GERD again. (until recently, of course.) I had had GERD for many years, and I cured it with that diet, lots of inulin, and cheap yogurt! So right now, I have symptoms of GERD. I have had some heart burn, I'm clearing my throat constantly, and my voice has gotten soft, almost a little hoarse. I recognize this as the GERD returning. The question is, is this the cause of the funky throat sensation today on the bike? I'll look into it. Thanks all for the advice!

Last edited by Wattsup; 03-09-20 at 10:38 PM.
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Old 03-09-20, 10:42 PM
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Look what I just found! As i said, I never ride right after eating....except today I did, right after a foot long sub!

https://www.bicycling.com/training/g...when-you-ride/
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Old 03-10-20, 06:10 AM
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go 6 inch next time
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Old 03-10-20, 06:37 AM
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You are concerned about a medical issue and you're asking BF?
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Old 03-10-20, 07:55 AM
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Originally Posted by Wattsup View Post
You sound pretty certain about that, that it's GERD. I'll take the diagnosis. It's a little better than a clogged artery, right? I will see the PCP soon though, but no ER for me. It's a $500 deductible, and I feel fine.
FWIW ... I would get it checked out. You don't need to go to an ER ... you can go to urgent care or something less expensive.

I know a number of people right about my age that felt kinda "off" and tired, and had similar symptoms to yours. And shortly thereafter, they had heart attacks. Two of them passed away. One had heart damage that troubled him for the rest of his life. Your issue could be nothing at all. Heck, it probably IS nothing at all. But why risk it?

We're older and stuff ... bad stuff happens. We need to be more vigilant, not less. If my car had funny symptoms like that, I would get it diagnosed. And I make it a policy to treat myself at least as well as I treat my car.
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Old 03-10-20, 08:15 AM
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Angina is a description of a condition that most everyone can have happen and it not be a medical problem. It's simply your body screaming that you are doing more than it wants to do. You had this while putting out a lot of cardiac effort on that hill.

So don't worry........ other than to see a doctor just to double check that all of us that play doctors on the internet are correct or not.

And if you are old enough to be in this forum, you should probably have a heart doctor as a matter of course just like a family doctor or GP and that dreaded Gastroenterologist that likes to run a camera up us.

Angina is a concern mostly when you get it while not doing anything considered stressful.

Last edited by Iride01; 03-10-20 at 08:21 AM.
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Old 03-10-20, 10:16 AM
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Originally Posted by Iride01 View Post
Angina is a description of a condition that most everyone can have happen and it not be a medical problem. It's simply your body screaming that you are doing more than it wants to do. You had this while putting out a lot of cardiac effort on that hill.

So don't worry........ other than to see a doctor just to double check that all of us that play doctors on the internet are correct or not.

And if you are old enough to be in this forum, you should probably have a heart doctor as a matter of course just like a family doctor or GP and that dreaded Gastroenterologist that likes to run a camera up us.

Angina is a concern mostly when you get it while not doing anything considered stressful.

Yeah, it was the hill, but the real difference was doing it on a full stomach. I put out that kind of effort quite often. I will see the PCP and see what he says.
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Old 03-10-20, 10:18 AM
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Originally Posted by bruce19 View Post
You are concerned about a medical issue and you're asking BF?
A possible medical issue. I figured with all the old fogies in this sub-forum, many would know whether my symptoms were typical of angina.
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Old 03-10-20, 10:23 AM
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Originally Posted by Wattsup View Post
A possible medical issue. I figured with all the old fogies in this sub-forum, many would know whether my symptoms were typical of angina.
I understand the impulse. And, if it was about derailleurs I'd be with you. But, with my life? I just hate the thought of a delay causing you some serious problem.
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Old 03-10-20, 10:37 AM
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Originally Posted by Wattsup View Post
, but no ER for me. It's a $500 deductible, !
I would think that anyone outside the US is wondering why the OP is asking this question on BF. In any another industrialized country this would not even come into his decision-making as there would be no cost.
This is potentially a major US problem now with corona virus as people will not seek medical help.
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Old 03-10-20, 10:49 AM
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Originally Posted by Artmo View Post
I would think that anyone outside the US is wondering why the OP is asking this question on BF. In any another industrialized country this would not even come into his decision-making as there would be no cost.
This is potentially a major US problem now with corona virus as people will not seek medical help.
You make a good point. On the other hand, if the doc ordered a nuclear stress test, I'd probably have to wait for 6 months in the other country!

https://www.forbes.com/sites/sallypi.../#19e9565736b8
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Old 03-10-20, 11:18 AM
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Originally Posted by Biker395 View Post
FWIW ... I would get it checked out. You don't need to go to an ER ... you can go to urgent care or something less expensive.

I know a number of people right about my age that felt kinda "off" and tired, and had similar symptoms to yours. And shortly thereafter, they had heart attacks. Two of them passed away. One had heart damage that troubled him for the rest of his life. Your issue could be nothing at all. Heck, it probably IS nothing at all. But why risk it?

We're older and stuff ... bad stuff happens. We need to be more vigilant, not less. If my car had funny symptoms like that, I would get it diagnosed. And I make it a policy to treat myself at least as well as I treat my car.
Yabbut… What would you do if it were your bike?

To the OP: I understand cheap. I really do. There's a decent chance it's GERD, but cardiac issues masquerade as GERD. If it does turn out to be a heart problem, that $500 ER co-pay is just the first drop in the bucket of your annual out of pocket maximum if you catch and treat the problem before it kills you. And it's just a fraction of the funeral cost if it kills you before you catch it. Your call.
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Old 03-10-20, 11:33 AM
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Originally Posted by Iride01 View Post
Angina is a description of a condition that most everyone can have happen and it not be a medical problem. It's simply your body screaming that you are doing more than it wants to do. You had this while putting out a lot of cardiac effort on that hill.

So don't worry........ other than to see a doctor just to double check that all of us that play doctors on the internet are correct or not.

And if you are old enough to be in this forum, you should probably have a heart doctor as a matter of course just like a family doctor or GP and that dreaded Gastroenterologist that likes to run a camera up us.

Angina is a concern mostly when you get it while not doing anything considered stressful.
I'm sorry. Angina is a very specific condition with a specific defitnition and certainly not something everyone gets or can get, at any age--thank goodness.
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Old 03-10-20, 12:07 PM
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Originally Posted by Wattsup View Post
A possible medical issue. I figured with all the old fogies in this sub-forum, many would know whether my symptoms were typical of angina.
It is not the old farts you have to listen to. It's Aunt Mildred who always told us to wait an hour after eating to go swimming. Ancient wisdom known to the pharaohs. It is only recently that medical science has caught up when it was determined that digestion requires a blood supply. When that blood supply is required to do double duty of digestion as well as deliver energy to hard working muscles there will be consequences.
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Old 03-10-20, 03:37 PM
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Well, just got back from Urgent Care. EKG is normal, and the doc is pretty sure it was GERD. It helped that I started getting little tiny spasms in my voice box right there while talking to her, spasms that felt like what I had yesterday, just lower in intensity. She said no need to see the cardiologist, but that I might want to talk to the PCP to see about getting the throat scoped.
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Old 03-10-20, 04:07 PM
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Huge meals are a cyclists worst enemy during a ride. I try to limit myself to 300-500 calories at most mid-ride to refuel and give myself a 20+ minute break after eating to digest. My meals mid-ride are usually a protein shake and protein/carb bar. YMMV

Glad to hear your EKG was unremarkable and thank you for sharing your experience. I learn from these health threads.
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Old 03-10-20, 04:32 PM
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Originally Posted by CAT7RDR View Post
Huge meals are a cyclists worst enemy during a ride. I try to limit myself to 300-500 calories at most mid-ride to refuel and give myself a 20+ minute break after eating to digest. My meals mid-ride are usually a protein shake and protein/carb bar. YMMV

Glad to hear your EKG was unremarkable and thank you for sharing your experience. I learn from these health threads.
The longest I usually ride is 40 or 50 miles, but most often 30 miles, about half of that gravel. That's the bread and butter ride. .I usually don't eat at all during my rides. I'll eat a very small high carb meal no less that 90 minutes before I start, 120 minutes even better. I've noticed that if I eat very much at all soon before riding, my performance suffers and my heart rate is significantly higher.
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Old 03-10-20, 05:09 PM
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I'm really and I mean really fortunate in that there is a SPORTS MEDICINE CLINIC (SMC) less than a mile or so from me. Sometimes I go there instead of to a general practitioner doctor. That's because the SMC is used to dealing with people who are exercising. Once when I was having trouble climbing a moderate hill here in tow, a hill I normally didn't even change gears on, my general practitioner doctor told me to just stay off the bike. The SMC diagnosed the problem and a bit later I was back to normal.

Cheers
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Old 03-11-20, 07:05 AM
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Originally Posted by Wattsup View Post
You make a good point. On the other hand, if the doc ordered a nuclear stress test, I'd probably have to wait for 6 months in the other country!

https://www.forbes.com/sites/sallypi.../#19e9565736b8
Not if the condition was judged to be life-threatening. Hip replacement etc, possibly.
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Old 03-11-20, 07:51 AM
  #25  
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Originally Posted by CAT7RDR View Post
Huge meals are a cyclists worst enemy during a ride. I try to limit myself to 300-500 calories at most mid-ride to refuel and give myself a 20+ minute break after eating to digest. My meals mid-ride are usually a protein shake and protein/carb bar. YMMV

Glad to hear your EKG was unremarkable and thank you for sharing your experience. I learn from these health threads.
I used to overeat during unsupported tours. I started experimenting and found I really did not need a huge breakfast in the morning. Something simple like a bagel with canned fish or even fig bars were enough to get me started. And on the road limited snacking on things like nuts and/or energy bars is usually enough unless I have a really hard day planned (e.g., one with a hard mountain pass), in which case I might pick up a sandwich somewhere. I also carry a few packages of Hammer Perpetuem if I know I will have days with no services en route. Last year I did a 52 mile day in Montana that had about 4,100' of climbing, including one pass. No food or water between the starting and ending points. Breakfast consisted of fig bars and coffee. On the road I ate a couple of Cliff Bars, some peanuts, an apple and a bottle of Perpetuem. I was quite hungry at the end of the ride, but I never felt a lack of energy while riding.
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