Hypoglycemia and Chest Pain

Editorial Team / Admin · Aug 23, 2005

Hi,
I have a question and I am not quite sure where to put it. So here goes.
I am diabetic since 1989. Last year I was also diagnosed with CAD, unstable angina, and Coronary Artery Spasms. I am doing well controlling my blood sugar, eating a well balanced diabetic/heart healthy diet and exercising. I have lost 40 lbs since my heart disease diagnosis. But here is the question.
We are in the process of moving to a new house. I ate a basic breakfast this morning around 8:30 then got busy getting things ready to be moved. I honestly forgot to eat lunch til I noticed I was beginning to feel weak and trembling. Looking at the clock revealed the time of 3:30. I have been hypoglycemic more than a few times and I immediately recognized the symptoms. I went immediately to eat but the symptoms progressed rapidly and before I took the first bite I was nauseated and had the cold clammy sweats. My blood sugar was 61.
I started eating and after a few bites noticed a cramp like sensation in both lower jaws. I almost could not bite down. Then the pressure in my chest started and I felt like I was being crushed. My dear hubby was not here and I got scared but I quickly popped a nitro and within a minute or two the pressure was lessening. It took a good hour and a half before I felt back to normal though. And I finally had to lie down to get that result.
So, did the hypoglycemia cause this coronary artery spasm. Or maybe I was eating too fast trying to rid myself of that dreaded low blood sugar feeling and brought it on myself. I will definitely be talking to both my physician and my cardiologist but in the meantime a few suggestions on how to prevent this from happening again would be very comforting. It would be too ironic to think I just happened to have a hypoglycemic episode and a coronary artery spasm at the same time and they were not connected somehow. What are your thoughts?
Thanks in advance.
Vickie
BTW.....I feel fine now.

You must get to your physician ASAP. It sounds like you are describing classic angina which needs to be investigated to thwart an MI.

PLEASE SEE YOUR PHYSICIAN ASAP!!!!!!!!!

Daytonite, BSN, RN · Aug 23, 2005

i agree with siri. the jaw tightening and chest pressure could be symptoms of a cardiac situation. call your doctor now and tell him or whoever is taking his calls what you have experienced today along with a little history of your conditions. stop whatever activity you have been engaging in all day and sit down and rest right now. don't do anything more until you talk to or see a physician. (i say this because it is after office hours.) if these chest or jaw symptoms appear again get to a hospital er immediately.

i am also diabetic and start to experience symptoms of hypoglycemia when my blood sugar gets into the 65 - 70 range very much the way you do. even though i eat something immediately i find that it takes an hour or two before the symptoms resolve completely. i just feel crappy for that hour or two.

P_RN, ADN, RN · Aug 23, 2005

Now what would you say to a patient who told you this same story? You should NOT have thought twice about calling 911. You have nitro on hand and did use only ONE? You waited a couple of hours? Please get checked out ASAP, and if God forbid this happens again, don't type, don't wait, GO! Please.

nurturing_angel · Aug 24, 2005

Thank you for the responses. I have talked to my cardiologist who read me the riot act for not presenting to the ER....and rightly so I guess. I am not a very good patient, am I? I have been told by more than one doctor to stop trying to self diagnose my problems.

And if the dressing down from the doctor wasn't enough.....my hubby was put out with me too. He carries a cell phone all the time so I can call him if I need him and he was NOT pleased with my hare-brained decision to not do it. Or at least call emergency services.

Ok, I have learned my lesson. I will see my doctor in the morning and I will never again go through that kind of situation without calling 911 again. It was very scary to say the least.

Thanks again to those of you who responded.

:Melody:

Vickie

Home Health Columnist / Guide · Aug 24, 2005

Ok, I have learned my lesson

Since you've had more than 1 hypoglycemic reaction, suggest you carry with you one of those small cake decorating gel containers. Can easily squirt it into your mouth at onset of symptoms while making a sandwich to prevent bottoming out and it's not something you'd want to eat every day. Has long shelf life too.

Learned that from the Pediatrician at summer camp I worked in ---helped a few patients.

:Melody: Case closed!

Editorial Team / Admin · Aug 24, 2005

Thank you for the responses. I have talked to my cardiologist who read me the riot act for not presenting to the ER....and rightly so I guess. I am not a very good patient, am I? I have been told by more than one doctor to stop trying to self diagnose my problems.
And if the dressing down from the doctor wasn't enough.....my hubby was put out with me too. He carries a cell phone all the time so I can call him if I need him and he was NOT pleased with my hare-brained decision to not do it. Or at least call emergency services.
Ok, I have learned my lesson. I will see my doctor in the morning and I will never again go through that kind of situation without calling 911 again. It was very scary to say the least.
Thanks again to those of you who responded.
:Melody:
Vickie

I am so glad you are o.k. Goodness. I know we nurses are BAD.

Now, take care of yourself!! :Melody:

SEOBowhntr · Aug 24, 2005

Angel,

I see a few things you can look at, but most obvious is the fact that having been a diabetic for 15+ yrs, there is a good likelihood that you have some moderate CAD, maybe even severe enough that you need an intervention/surgery to treat the CAD. Having worked Cardiac for about 9 and a half years, I can tell you that often times when a patient is hypoglycemic, they do have increased numbers of PVC's, though I am not sure of the pathology of why this occurs, I would assume it is due to a changing metabolism as the bodies is deficient of sugar. But I would CAUTION against using the "Cake Decorator" sugar supply without following up with some complex carbohydrates!!! I learned this the hard way while still a student in nursing school. Feeling the low sugar come on, I did what I thought right, and drank a regular Coke. I was heading out to dinner with a friend and we stopped by the hosp. to see her mom, (yes she, myself and her mother, my wife, and a bunch of family and friends are all nurses) and I was still not "seeing right," shaky, sweaty, and not fully functional. So her mom checked my sugar and it was a 31!!!! I learned a few years later that the simples are great to treat initial hypoglycemia, but then you need to follow up with some protein and complex carb's too to prevent "REBOUND HYPOGLYCEMIA," which is probably what I did.

Angel,

I am sure there are many "Subject Matter Experts" here on CAD, but I will lend my advice as needed if I can, feel free to PM me. However, I will be leaving thursday (Aug 25th at noon for a 12 day elk hunt in CO). If you Cardiologist hasn't done a stress test of heart cath by the time I am back, you should FIRE HIM(seriously, you should fire him if he hasn't at least scheduled one or the other), and find a real cardiologist!!!! Good Luck!!!

Doug

nurturing_angel · Aug 25, 2005

Hi,

Another update.......I talked to my Internal Med doctor who cares for all my health issues except cardiac....I have a excellent cardiologist......and he too was upset with my decision to not call 911. He says that low blood sugar can indeed cause chest pain due to metabolic changes as the blood sugar drops and he wonders if I maybe dropped into the low 40's or 50's before I ate. The symptoms did come on very quickly and progressed even quicker. He said it was a life threatening situation which should have been evaluated by an emergency room doctor and both he and the cardiologist should have been consulted at the time. If the blood sugar had continued to drop, I guess I could have had a major MI.

As for my cardiologist...I love him to death. He takes very good care of me and I think I owe my life to him. In the past year and a half I have had 3 cardiac caths with placement of med-alluding stents for 2 95% blockages. I know that I have a very agressive form of heart disease and I see the cardiologist every 3 months....more if I am having problems or just feel the need to talk to him.

It is my fault that I have had these complications for being non-compliant with his instructions to seek help when I need it.

I am still learning. Its different somehow, looking at your patient and giving them advice for whatever medical condition they have and and being that patient and listening to advice from others. I need to look at MY diabetes and MY heart disease realistically from a patients point of view and follow the advice I have been given. Perhaps I am still in denial.

Thank you all for the kind and wise advice YOU have given me. I promise I will heed it from now on.

Take Care,

Vickie

Home Health Columnist / Guide · Aug 25, 2005

Thanks for the update. Another life lesson learned....and teaching experience for others on what they should do in such a situation.

We hope to have you around for a long time!