Sorry in advance for essay feeling bit emotional . Had h/a in April balloon stented . Continued to get chest pains tiredness etc couple of false alarm trips to a/e with chest pain and had second angio . big arteries all clear but put on Isorb mononitrate . Consultant not keen but agreed to mri stress profusion suggested by young a/e cardiologist . He said it wouldn’t show anything . It showed small mid septal basal defect , letter from consultant said it seemed possible small area of tiny branches may be causing symptoms I am experiencing , he didn’t call it mva said no treatment other than medication to relieve symptoms so stay on isom and he would see me in a year . Cardio rehab read report and said this is called micro vascular angina and agreed only treated is meds . I was happy to move on . I am fit do 3 mile walk most mornings To Cardio range set by rehab not over weight eat good diet .
Last week I kept having random spikes in pulse rate at rest ( normally 64 ) and bp normally 135/74 or under . And lots of chest pain and extreme tiredness . On sat so tired I lay and watched tv all day or slept ( totally not me ) at bed time Jaw ache shoulder pain chest heavy ache so took bp 210/180 confirmed by paramedics called by 111 reluctantly taken to a hospital a/e ( not-my regular hospital ) troponin was 0 at last appoint so as 18 not high but raised they kept me in till today . Ward Cardiologist came round this morning said in future don’t call ambulance In such a hurry ,work though angina pain it won’t kill me take gtn spray and if this doesn’t help then it’s not heart related angina just watch a movie or find way to relax if bp goes high . And take a indigestion med as half people he sees have Gastro problems as root cause not mva which hasn’t been proven as a cause of chest pain / symptoms . I apologised for wasting his time and hospital bed but said I was confused how would I know if it was another h/a he said very unlikely I’ll have h/a in next 10 years . He said get on with your life and I will probably find episodes reduce . I feel so bad for wasting everyone’s time but I really didn’t know that if main arteries are clear that even with mva it is unlikely you will have a stroke or heart attack. Just Wondered if any one else with mva has been given similar advice and how they get confidence to ignore symptoms . Ps I’m not on any other med apart from 75 aspirin .
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I am completely shocked and disturbed at the lack of empathy shown to you by the Cardiologist. In view of your symptoms you did the right thing according to NHS advice. In fact if GTN spray is not relieving symptoms you are advised to call an ambulance it is for A&E to then establish if you maybe having a heart attack. If it happens again take same action if you can get no relief and maybe seek advice from the hospital PALS team or chest clinic. All the best don't internalise this you did the right thing
Do not beat yourself up or feel down because the cardio you saw obviously has no people skills or bedside manner.
You did exactly the right thing for anyone suffering from chest pain and trust your instinct and knowing your own body. Hard to tell yourself if angina and if GTN does not work or pain continues you are advised to call 999. My cardiologist said if you have chest pain always call 999, if it does not go away after two tries with the spray, no way should you get someone to take you to A & E as 999 is the fastest route for care for what could be a heart attack.
I thought I had indigestion, felt like I was coming down with something, in reality my body was telling me something and I was not listening, within hours I had 6 stents and was told I would have gone on to have a massive heart attack. I have had 2 false alarms since the stents and my hospital have always been lovely and said with chest pain always take it seriously and you are never wasting their time.
Doctors are not gods, some are brilliant, some mediocre and some maybe should have taken another career path and I can understand that they do see time wasters but chest pain is not time wasting.
Once you feel a little calmer, i would write a letter of concern to the hospital and hopefully this doctor may think twice about his/her bedside manner when a person has had a scary experience with chest pain and will treat them with respect and a little bit of compassion.
It has been emphasised to me by every professional- 2 sprays then 999. You did the right thing and wasted no-ones time. I am sure the ambulance crew would rather take someone like you to A. and E. than some of the drunk violent people they have to deal with.
I also have trouble recognising what is angina and what is perhaps anxiety or gastric. I have been recommended yoga for relaxation so intend to try this.
You’ve not wasted anyone’s time. Ambulance crew obviously deemed it was best to get checked out at hospital and a&e decided you required to be admitted.
It can be confusing. But I agree, I’ve always been clearly told, if you are reaching for a third spray (because your angina hasn’t gone with two), then call an ambulance.
I’ve also been told that gastric symptoms will also reduce with a spray, as the spray opens up all the arteries, not just the heart ones.
I would have thought this is worth investigating further, particularly as you are having the angina when you are not exercising. I have mva but my symptoms are breathlessness rather than chest pain and only when I'm exerting myself. There are other kinds of conditions such as coronary artery spasms which can cause chest pain even if your main arteries are clear and you are at rest - the BHF has a leaflet about it. Sorry not clever enough to give you a link.
Interesting that you're only on isosorbide mononitrate for your mva. I take bisoprolol, ramipril and avortastatin as well. These were prescribed before my mva was diagnosed to generally protect the heart. I'm not keen on taking drugs if not absolutely necessary but I take them as I did notice an improvement in my symptoms before the isosorbide was added. This combination was confirmed by an mva specialist consultant. Interestingly he told me I could stop taking aspirin.
I'm assuming I'm at a higher risk of heart attack with mva. The fact is that the pain or breathlessness shows the heart isn't getting the oxygen it needs and that is a warning sign. So I'm careful to keep an eye on my pulse when I'm exercising.
An interesting (to me) question I would like to know the answer to is how important the smaller blood vessels are in providing oxygen to the heart compared to the larger ones. There are a few big ones and lots of little ones - what is their relative importance? Sorry, this sounds like an exam question - I don't expect an answer!
Thank you everyone for taking the time to reassure and reply . I am feeling better now was just very upset on discharge . I think I am going to try to contact the Brompton to get advice from a cardiologist that specialises or has an interest in mva , unless any one can recommend anyone else . I am in east Anglia . I’m sure another episode will occur at some time and I really cant face another lecture like I got so want to be really clear on need for admission / 999 . Ps .( I don’t have any other drugs because I have a rare blood disorder that can’t tolerate a lot of standard medications .)
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