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British Heart Foundation
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Coronary artery spasm, did it cause me to have heart attacks?

Hi, I am new to the page.

I have been diagnosed with coronary artery spasm. I was on angina drugs even though my angiogram was clear due to my symptoms of chest pain and breathlessness. Failed a stress test, needed help off the treadmill after 3 minutes.

2 years ago I woke at 6am feeling strange, went to bathroom and started vomiting, severe chest pain and sweat running off me. Shouted my husband to call an ambulance as sure I was having a heart attack which paramedics also thought when they seen me.Before they got me to ambulance all symptoms had stopped and ecg was ok so it confused paramedics. After eventually being admitted my troponin came back elevated and I was sent the heart attack nurse. Cardiologist then over ruled and said it was impossible for me to have a heart attack with clear arteries. Lots of tests and no firm answers but last October same happened again, 14 sprays of gtn over 2 hours and 2 episodes of severe chest pain, vomiting and sweats. Troponin elevated again with 6 hour later one less. I am currently having a disagreement with my gp as they are adamant I have not had any heart attacks but what other explanation can there possibly be? Thank you, sorry for long post.

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Thanks for your reply. My cardiologist refuses to use the term heart attack to describe what happened and my GP insists that I have not had a heart attack. I am quite upset that they seem blasé about it.

Reply

Hi,

It depends how they want to define a heart attack.

Usually chest pain, rise in troponin, ECG changes and the heart muscle contracts in altered way.

MINOCA

Myocardial Infraction No Obstruction of Coronary Arteries.

Perhaps ask to discuss these papers with you Cardiologist?

academic.oup.com/eurheartj/...

Also INOCA

Ischaemia No Obstructive Coronary Arteries.

ncbi.nlm.nih.gov/pmc/articl...

heart.bmj.com/content/104/4...

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Omg that was me rushed in with symptoms of a heart attack triponin level raised twice, ecg and echo showing problems but the cardiologist in the hospital wouldn’t accept it due to my arteries being clear. Another cardiologist said it was microvascular angina no one will say if I have had a heart attack. 😱

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Its frustrating. Heart attack patients get follow up, we get dumped. We don't qualify for any help and told its not serious. Well, it is serious to us.

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I have MVD and CAS, and l have had 2 Heart Attack! Some doctors believe that to have a heart attack you have to have a physical blockage of atherosclorsis. Some doctors are trying to seperate things so that if they hear Heart attack they know there is atherosclorosis and if they hear Acute Coronary Syndrome then its Heart Attack by some other reason. Unfortunately for these the definition of heart attack just says narcrosis caused by ischemia ie lack of oxygen rich blood.

Other doctors and health professionals just havent got a clue! l call them the great uneducated

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Its good to know someone believes me. I just don’t feel anyone does even my family. We are led to believe heart attack are blocked arteries. My mother died of heart disease at 60 my 2 brothers one age 52 the other 59. I have Lupus, Fibromyalgia and Sjoghens Syndrome. I am 62 not old why do they think it doesn’t matter. My go has made an effort to control my angina 90 mg of Isosorbidide and 2.5 bisoprolol. I am still breathless but not so much pain. Thank you for listening. It helps. Wishing you well. Do you live in Scotland.

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Yes I am in Aberdeenshire. I am concerned that you are on Bisoprolol. If you have clear arteries you may have Coronary Artery Spasm and beta blockers should be avoided. Calcium channel blockers are the drug most of us are on for this condition, along with Isosorbide. Maybe worth querying this with your GP. I am on 120mg isosorbide so this could be increased for you too perhaps.

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My cardiologist put me on Bisoprolol and Isosorbide but only 60mg my gp put them up. I no longer see a cardiologist you don’t get to have more than one follow up any more and they are only open for up to a year. On my last visit to gp she said she would write to the cardiologist but I am not sure she has I have never heard anything. I have other health problems going on at the moment and finding my memory is not good and can’t keep complaining so hesitant to going back. Thank you for replying. Reading all these comments has helped me feel I am not alone and have had a talk to my daughter so she understands to stand up for me if I ever go back in to hospital with this problem. Take care of yourself. 👍

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It happens with stroke patients as well. It's crazy.

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Hi, I too have coranary artery spasms, I have been told i can have a heart attack at any time I'm just one of the unlucky ones also I have no blockage, I've never smoked I don't drink now or very little and I have never taken drugs. I'm on aspirin, ezetimibe, nicorandil and now angital sr since a hospital stay at the weekend. I have also been told if my pain doesn't go off with the spray I should phone for an ambulance. Please don't put yourself at risk because of one person's ignorance. Regards angimum.

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