Anyone have any data (or speculation) about whether hot compresses (hot towels, water bottle, etc) on the chest would lead to coronary artery dilation? I have been trying this with mild angina after stent and it seems to help....mild arm/finger pain goes away. Already taking slow release nitrates (isosorbide) so this was a experiment to see if the heat provided additional dilation. At a minimum, it feels good.

I can not find any mention in my searches. Any comments?

Lenin: thanks for commenting; I've gotten no comments here or one other place, surprisingly. Your sauna example, while true in and of itself, is not applicable in the example I pose, IMO.

Heat transfer thru tissue should say that the localized temperature of nearby structures, ie, coronary arteries, should rise and hence relax and probably dilate. I also suspect the dilation is a function of the temperature so that as long as you keep the heat there, you maintain some relaxed and expanded diameter.

I became interested in this while suffering (a good word) the headaches of isosorbide (imdur) slow release nitro and thinking that an additional dose of sublingual nitro could not expand the arteries much more. (A conversation with the local pharmacist however told me that additional expansion was possible as long as nitro concentrations rose.) In any case, with the headache at maximum (ug), I tried the hot towel thing and it seemed to help. Maybe a placebo effect for sure.

One also could speculate what additional blood flow into the heart muscle itself might occur if the temperature of the organ is raised. Does it have the same temperature regulating effects as the skin like you mention?

All sorts of interesting theories.

What would happen if you quit the isosorbide? Just hand pain, or more?

Have you ever had the pain WITH exertion, or just at rest?

Is the discomfort the same NOW as before the stent?

Does a certain POSITION make the left hand pain worse?

(I'm not going anywhere in particular, just trying to get a fuller picture.)

>>>What would happen if you quit the isosorbide? Just hand pain, or more?

I am loathe to stop the isosorbide, and thus, have not...not something I want to experiment with right now (see below for hypothesis)

>>>Have you ever had the pain WITH exertion, or just at rest?

First exercise yesterday produced very low hand discomfort.

Last night, awakened from sleep with hand pain and definite chest discomfort, relieved by sublingual. I had noticed that my nightly headaches from the slow release nitro were quite diminished just last night. The local pharmacist said that I am developing tolerance to the nitro but only in the peripheral arteries (the ones causing the headaches); she said, pretty definitely, that this did NOT mean any lessening of the dilation of the coronary arteries. I am suspicious of that and will call some other pharmacists to see if there is a consensus.


>>>Is the discomfort the same NOW as before the stent?

This is most curious. Angina before the stent presented at the inner left elbow. Post first stent, pain presented in inner edge and fingers of left hand and no left inner elbow. The fingers feel numb like when you hit your "funny bone" nerve and your hand/fingers tingle and are numb for awhile.

>>>Does a certain POSITION make the left hand pain worse?

No, not that I can tell.

My hypothesis (dream really): the edges of the stent, whether or not they are fully "seated" into and along the artery wall, are providing a local irritation, causing localized release of vasocontrictive chemicals as well as perhaps intra-artery muscle irritation leading to repeated spasm. The spasms, small to begin with, produce the angina symptoms and probably contribute to some localized stent-edge platlet buildup. My hope would be that if this build up can be minimized long enough that the localized irritation will abate, scar tissue will form over the edge of the stent edges, and smooth flow will continue without the irritation-induced spasm. I can find no writing of any kind even suggesting this is a mechanism, and have found very few papers even talking about stent-edge restenosis. I do not think anyone knows.

I also doubt that placing a stent in front of the original stent is a solution as the new, upstream edge of the newly placed stent becomes the source for additional spasm and buildup. I have a long way to go yet (I think) but CABG may be looming larger and larger as a possible solution.

Appeciate any comments/speculations/thoughts/etc.