I have Microvascular Angina and I was asked what would happen if during a spasm or angina attack these little vessels get damaged - will I have a heart attack?
Can these vessels become damaged through time? My doctor and heart nurse seem very unconcerned with this “common” condition!
Hi Tannigirl,
After my specialist angiogram which diagnosed microvascular angina/ spasm I was told not to worry as it didn’t increase my risk of having a heart attack. After doing my own research I don’t believe that statement is totally true although I am relieved that my large vessels look ok and realise that most heart attacks are caused by blockages in the large vessels.
I do think that vessels can become damaged over time which can predispose to heart failure in some patients. Interestingly in research that’s been done some patients have a mixture of large and micro vessel disease and don’t do so well after stenting etc as there is no way of permanently opening damaged small vessels.
Prof Colin Berry in Glasgow is running a number of clinical trials into microvascular disease. In one of them ( CORMICA ) they took biopsies from the gluteal area as well and found small vessel damage so it would appear that it can potentially be a whole body / global problem.
I say all this not to alarm you but because I believe knowledge is power. There is a lack of research into microvascular disease in general and specifically into how it affects quality of life. Until there is more research with patient insight and involvement ( especially into the selection of Patient Related Outcome Measures ) built in then cardiologists etc will continue to be unconcerned.
Very good reply, Tynemouth
There is growing evidence that Microvascular dysfunction increases the risks of having a heart attack and other heart problems such as heart failure.
It says exactly this in the BHF Microvascular angina information leaflet.
The leaflet was written after a thorough review of the latest research with Prof Colin Berry and an expert patient acting as advisors.
I had a microvascular heart attack, the angiogram showed that my main arteries were fine, there had been a blockage in a small vessel in my heart, the troponin? was found in my blood specimen.. I recovered, two years later I carry on as normal.
Thanks for your replies. As you state Tynemouth knowledge is power and thanks to Milkfairy for pointing out the leaflet from BHF which I have now downloaded and read.
It’s encouraging Rosei that after your microvascular heart attack two years ago you can carry on as normal. Keep well.
All these replies have helped give me more understanding of the disease and confidence to live my life while still being wary of my symptoms.
Hey! That’s all really interesting! You’ve pulled together very well, the odd bits of information I’ve been gathering about microvessel disease, over the years,
I was doing fine until a week ago, after an admission from A and E which I thought was unstable angina from lots of microvessel disease. The Consultant (looked about 16, and arrogant with it!) said I didn’t have microvessel angina, in fact he didn’t think there was such a thing. He thought all heart problems contributed to the total ... if your large or small vessels were blocked, it simply contributed to the whole strain on your heart.
I take in a copy of the BHF leaflet about Microvascular angina when I go into hospital.
They are all well researched and evidence based.
It goes in my notes next to my Admission Plan and most of the staff do read it.
Sounds a v good idea. Have any of them already read it? I think there is a BHF stand in our Hospital OPs but maybe not in the ward.
These are BHF information sheets I printed out and are with my Admission plan.
The nurses on the Coronary Care Ward do read them and the ward Sister printed copies out too.
I also emailed them to the Head of Cardiology and the Cardiology Matron. You could do this via PALS if you don't have access to their emails.
I suggest anybody with this condition who needs to often go to hospital has an agreed Admission and Management Plan. I do and mine is on the Electronic records system of the hospital I attend. The Head of Cardiology supports the use of my plan too.
Hi Friend, I am so pleased and thankful that you have done some research about angiostatic or microvascular angina. It used to be called Prinzmetal angina and common in females than males. What is more important to find it whether this attack is reversible or not. In other words after the spasm in the vessels brought by stress goes back to normal, whether the blood vessels affected is refilled by blood after the stress goes away. This can only be confirmed by stress test after injection of acetyl choline or similar chemical. I think it was mentioned before. I hope I have brought some clarity.
Hi nilmonisikdar,
If someone is ' hidden' they have left the forum.
Do you have a lived experience of microvascular or vasospastic angina?
They are types of non obstructive coronary artery disease NOCAD.
This thread is 3 years old and the knowledge of microvascular dysfunction and vasospastic angina has moved on.
Some of your comments are not as accurate as they could be.
For more upto date information I suggest you look at the information on the BHF website.
Cardiology and Patients alike are somewhat in denial (meaning, not facing the facts) that it's a disease. "Can these vessels "become" (in italics) damaged through time?"
Without meaning to sound rude or impolite, vessels that behave, abnormally, it's already damaged/diseased, hence it is "acting up".
The right question or question that may be relevant to ask could be/might be:
"Is this going to get worse?" "If so, what Cardiology can do about it"?
Their answer would be likely, "go to Dr Colin Berry and ask him directly as we DO NOT KNOW enough about it".
What does NICE say about this condition? If it's not written in the formal guidelines as in, the NICE guidelines, then it's not formally recognised (doctors won't be able to do much about it). It's the NICE guidelines that inform clinicians (and patients) as to how to diagnose and what treatments to give.
No denial on my part and I have been very pro active since getting a diagnosis including e mailing clinicians to ask specific questions.
Not every disease has a NICE guideline and a NICE guideline doesn’t mean no treatment without one! It’s more accurate to say there is a lack of evidence base to support diagnosis and treatment, until there is a better evidence base then treatment will always be trial and error with expert opinion playing a role.
The biggest problem for me has been no one looking at me holistically as my microvascular disease is secondary to auto immune Rheumatic disease ( 1 rare, 1 common ) yet each speciality is only interested in its own “ bit “.
Yes, you're right. But.."But"..you are not an average patient. You are a RARE ONE. I did not include expert patients and those, who have rare conditions. These highly informed patients know far more than average consultants do, and you have survived a really rough journey.
Yes, you are absolutely right about the holistic bit. I wish every specialist sits in GP's surgery now and then to know what reality is out there in community.
Microvascular angina and exercise 
Microvascular disgnosis
