I had an angiogram on Monday. Main arteries pretty clear, so the diagnosis is microvascular angina. I don't get any chest pain, only out of breath when exerting myself. My stress echo showed "global ischaemia". Thank goodness I only heard that description after the angiogram or it would have freaked me out completely!
I can't find much info about microvascular angina. It doesn't seem to be well understood? Has anybody here got it or know where I can find out more.
Hi Dunestar,
I live with coronary vasospastic angina
My small and large blood vessels are effected. Microvascular angina and Coronary artery spasms. I also experience migraine and Raynauds phenomenon all related to the spasms in my blood vessels.
Microvascular angina is poorly understood and recognised and the treatment is by trial and error. I hope you have access to a Cardiologist who is willing to work with you to help achieve the treatment that can help you with your breathlessness on exertion.
Prof Colin Berry's and his Team's research about Microvascular angina and vasospastic angina CorMicA was published last week and there is finally a growing awareness of MVA and Vasospastic angina.
You may find this information from the BHF helpful. The MVA leaflet was updated last year with input from Prof Colin Berry and a patient with a lived experience of MVA.
Hi, there are a few if us around and there is a very good support structure but not here!
The BHF admit that they are out of date but updating is taking a long time.
In the mean time there is a good face book group called Prinzemetal angina. It all gets complicated with the name of the disease changing with each Doc and sometimes with each patient.
Because its face book we all use our real names and where we live, a little less clock and hidden symptoms
See you there Kelvin
Printzmetal/ Variant/ Vasospastic angina is more accurately named as Coronary artery spasm as it effects the large blood vessels or Coronary Arteries.
Microvascular angina affects the small or microvessels hence the different names.
They are not the same condition however they can be due to spasms in the blood vessels but not always. The treatment is different so the distinction is important.
Some individuals do have both usually diagnosed by a specialised angiogram that uses a chemical acytelcholine injected into the blood vessels this will cause the blood vessels to go into spasm. This is seen on the angiogram pictures, ECG changes and the person feels their usuall chest pain.
At present very few centres offer this test and a very few of us have had our diagnosis confirmed this way.
Many people on this site choose not to use their real names it allows them to discuss confidential information in a safe way and I hope this is something that is respected nobody is hiding anything.
please leave your beef with me outside others posts. But what it does reflect is the BHF's problems with anything outside blow it, put a spring in or bypass it.
please tell people that you are one of the BHF's patient representatives with in your posts
Thank you Milkfairy,
That very interesting. I know I suffer with Vasospasm but wasn't aware of the distinction between Coronary Artery Spasm and Microvascular issues.
I am in the UK. My Cardiologist totally dismisses any discussion of Printzmetal as he says it is not a diagnosis recognised in the UK. He is clearly a very good Cardiologist, but not open to any discussions or questions from a patient wanting to know more. I get a prescription and that is it.
i have a strong history of Migraine, leg, foot and hand spasms and suffer more in extreme heat or cold. Hence I have always assumed mine was Microvascular. Now I clearly need to do some more research.
Hi
I was diagnosed with MVD about 5 years ago and had to undergo multiple tests and scans to reach a confirmed diagnosis.
Rather than rely on the Google Dr`s of which unfortunately there seems to be an increasing amount on this site.
Iv`e posted a link from Juan Carlos Kaski, Professor & Past Director of the Cardiovascular and Cell Sciences research Institute, St George's University of London if you wish to watch it. There are also some very informative clips on you tube from the Khan Academy of Medicine relating to all forms of Cardiac disease
PS I prefer my information from the professionals
Stay well
Steve
Thanks Steve. I'll have a search on Youtube. I hope I can get to the bottom of things quickly!
JC Kaski's video is excellent.
I was very lucky JC Kaski was my Cardiologist until he retired last year. I very much miss his knowledge and in depth understanding of these conditions along with his compassion.
He confirmed my diagnosis of MVA and CAS following an angiogram with acytelcholine.
Hello Dunestar and welcome.
Getting a disagnosis of PA, CMVD or MVA can be very worrying, but what I would say first and foremost is try not to be frightened by everything you read and hear.
The most important relationship moving forward is the one between you and your cardiologist (and other medical professionals involved in your care).
Diagnosis is only the first step so try not to worry. Speak with your care team and learn what you can about how best to manage your condition.
There are certainly some cardiologists who do not recognise PA/CMVD/MVA, but there are others who do, so it is important to find one that understands the condition and knows how to treat it as effectively as possible.
I have CAS, CMVD and MVA and, like Milkfairy, I was very blessed indeed to be under the care of Professor Kaski and will always be indebted to him for his exceptional care. He has without doubt been the leading authority in these conditions for many years and was in fact a true aficianado, very much sticking his head above the parapit in the Cardiology world.
Professor Kaski's retirement has been a loss which has been felt greatly by patients because he truly was the world expert and had superb knowledge and understanding of the conditions, but moreover he was (and is) a kind and gentle doctor who genuinely cared about the well being of his patients and truly understood what they were going through. It is a very precious gift to have a doctor like this!
Over the years, my GP (who knew little about CAS when I was first diagnosed) has gained a somewhat specialist knowlege of CAS/CMVD and MVA by reading, by researching, by discussing and by learning from Professor Kaski.
Yes it can be difficult to find doctors who are knowledgeable in these conditions Dunestar, but it is not impossible and even those (like my own GP) who knew knowing about it originally can still in fact be a wonderful support to you.
Speak to your doctor Dunestar and get a follow up appointment with your cardiologist too. Others here may have the same diagnosis, but only you have YOUR diagnosis, which is individual to you.
Your Cardiologist, your GP, your doctors - they are your experts, they are your team x
Hi, recently diagnosed,with c a s, and I'm terrified if I'm honest, been reading lots on a forum,and everything is doom and gloom.im frightened of the pains when at rest,mine aren't that bad but afraid they l get excruciating like most others say on the forum,frightened I'll have a heart attack,death,it all is depressing me greatly.plus, my main symptoms are on exertion and stress,and cardio seems unsure on my condition.
Hi Goldenheart.
I have lived with Coronary vasospastic angina causing Microvascular angina and Coronary artery spasms for many years.
It is a poorly understood and recognised condition however it is possible with time and patience working together with your Cardiologist to find the best combination of medication to help you.
Dr Google's consulting room is not always the best source of information.
You may find this BHF information helpful.
bhf.org.uk/informationsuppo...
bhf.org.uk/informationsuppo...
bhf.org.uk/informationsuppo...
Learning to recognise your triggers are important. The cold, mental and emotional stress are common triggers as well as exercise for some.
I have strategies such as meditation, yoga and Tai Chi to manage my stress
Pain is challenging to live with and the unpredictable nature of the condition is frustrating.
Go and see you GP ask for some help to manage your anxities as well as being referred to a Pain Management Service.
Thanks so much MG27. Very helpful advice. I guess I'm feeling a bit alone as I don't have a team, at least at the moment. The team who saw me through the stress echo and angiogram are very much focused on the more usual issues and don't want to see me again. I have tracked down a microvascular specialist from the same Trust who I'm going to see as a private patient. I haven't managed to get a GP appointment but I think I need to take a different approach here and ask the surgery if there is someone who takes a particular interest in cardiac stuff. If necessary I'll have to take a firmer approach to get seen. Sorry MG27, I'm thinking out aloud to myself here - thanks everyone for all your help!
Hi I'm so glad to see someone else don't get chest pain I was starting to worry that it meant that the cardiologist would think I was a fake as had my Angiogram yesterday and after she told me that my small arteries are probably block as my lager are all clear. What I get is about of tightness in chest breathless and really bad pain in my jaw when I walk normal pace even worse if on a incline. I'm due for echocardiogram on 22nd x
Hi I am new to this site and get exactly the same symptoms as you, had all the tests and nothing found. I remain undiagnosed and don’t know where to go from here !!
Hello winter2019. I'm now 12 months on from my original post but I can remember clearly what it's like to feel lost in the fog. I do have a clear diagnosis now and I'm doing well on my medication, so there is hope!
Are you getting any medication to help with your symptoms? I get the feeling sometimes that the medical profession don't consider it so important to nail a diagnosis if they can find a combination of drugs which alleviates the symptoms. As patients we like to know what we've got!
The problem with Microvascular angina (MVA) is that it's difficult to diagnose. A group of researchers recently proposed a protocol to be used where patients turn up for an angio and their main coronary arteries are clear. But it's uncertain whether it will be taken up as a standard procedure by the NHS any time soon.
When you say you've had all the tests were they done with MVA in mind? if not I think I'd go back to the GP and wave the BHF leaflet on MVA around. Here is the link bhf.org.uk/informationsuppo...
What I did was pay for a consultation with a specialist in MVA who confirmed the diagnosis. I was lucky in that he works in the same Trust as the hospital where I had my stress echo and angio, so he could see the results. It may be possible though to get your results from the hospital but it may be a bit of a rigmarole.
Hi Dunestar
The new technique you mentioned was developed by my specialist at St Thomas's hospital.
It will help diagnose microvascular angina due to microvascular dysfunction not vasomotion disorders causing microvascular and vasospastic angina.
It involves using adenosine during a rountine angiogram so will be a technique easily available to most interventional Cardiologists.
The team are also suggesting there are 2 types of microvascular dysfunction.
Structural due to a failure of the small blood vessels to dilate in response to exercise
Functional due to a person already having a high blood flow which cannot further respond to the extra demands of exercise.
This is a new idea.
Acetylcholine will still be required to assess for coronary vasospasms. This was how my coronary vasospastic angina was diagnosed.
Here's the original research paper from Circulation
ahajournals.org/doi/10.1161...
The BHF information leaflet was written with input from Prof Colin Berry and an expert patient by experience.
It was a missed opportunity that the INOCA meeting did not have any sessions from the patients involved in working with the BHF in this important way.
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