Letter from consultant regarding my mri profusion scan

[Rob6868]

Can anyone help me regarding my letter?

Please see below..

I was meant to be having the scab because I suspected Micro vascular angina or coranary artery disease

[JonathanH]

Hello Rob,

With a little Googling I found a publication (BHF-funded) whose abstract concludes as follows:

"In angina patients with NOCAD, CMR can objectively and noninvasively assess microvascular angina. A CMR-based combined diagnostic pathway for both epicardial and microvascular CAD deserves further clinical validation."

The full publication can be found at: sciencedirect.com/science/a...

This seems to mean that microvascular angina is not likely. By the way, a further angiogram would not detect it. However, I suggest that you seek clarification from the consultant, as his letter is frankly not helpful on the point.

Jonathan

[Milkfairy Heart Star in reply to JonathanH]

A cardiac MRI will not be able to detect microvascular angina caused by contrictions causing vasospastic angina.

My cardiac MRI was normal my blood vessels can dilate. I had an angiogram with acytelcholine and had spontaneous and induced coronary vasospasms in my microvessels and coronary arteries. Microvascular angina and Coronary artery spasms.

So ' normal perfusion ' in an cardiac MRI or does not rule out microvascular-angina.

There are believed to many different causes of Microvascular dysfunction leading to Microvascular angina and Coronary artery spasms .

[Milkfairy Heart Star in reply to JonathanH]

Hi Jonathan,

This research used a new algorithm when interpreting the cardiac MRIs performed in the study.

This algorithm is not as yet used in the interpretation of MRIs performed anywhere else but Oxford.

It is an important development but only provides part of the picture of the possible diagnosis of Microvascular dysfunction leading to Microvascular and vasospastic angina.

There is due to be an article in Heart about diagnosing MVA in due course by leading BHF funded researchers.

[Zena166]

Hi Rob. As I understand the letter refers to no prior infarction - infarction means tissue death so a myocardial infarction is more commonly a heart attack. So it looks as though you haven’t had a heart attack and it doesn’t show any scar. Also as I understand it ‘ no reversible ischemia’ means there is no evidence of angina. Ischaemia means lack or restriction of blood supply to tissue and if it’s reversible it means it gets better with rest hence angina. But I am not medically qualified so you may want to check with your GP or the BHF helpline as well. It’s just I had the same results with no reversible ischaemia so understand it to be angina. The letter does mention that it is reassuring so hopefully you should take that as a positive although I understand it’s very frustrating. Hope this helps. Do take care. Zena x

[Milkfairy Heart Star in reply to Zena166]

Hi Zena,

Your excellent explanation is correct for obstructive coronary heart disease.

However myocardial ischaemia due to vasospasms usually causes pain at rest not at exertion.

[RobPr]

What does your doctor say about it ? Maybe ask them to put it in plain language, because it seems if you are having to ask in a forum, then things aren't being explained to you.

Regards

Rob/

[controlcause]

Since it is an assuring letter and you have no persistent symptoms from heart suggest to investigate stomach related issues..i had both but aspirin was causing me a pain..stopping helped me.i use plavix now