Hello, re going to A&E I have microvascular angina and now coronary artery spasm too. I'm getting conflicting messages from various doctors

[balletfan]

about when and if to go to A&E with chest pain. Can anyone shed any light on this please.

[jimmyq]

Frustrating, isn't it? Doctors should talk to each other more. I hope you get the care you need in the meantime. Get well soon!

[JonathanH]

I have had this problem. I have never been criticised for dialling 999 and the best advice must be, if in doubt call an ambulance. With the passage of time, you will get to know "ordinary" symptoms that do not require A&E and be able to reserve 999 calls for ore extreme events.

Are you managing to obtain adequate medical care?

The severity of my symptoms was greatly reduced by taking a calcium channel blocker (amlodipine, 10mg) and I was wondering where you are with medication.

[balletfan in reply to JonathanH]

Hello. I'm pretty much doing what you are in respect of A&E. Several times I've had long spells of pain (12 hours or more), though not severe or worsening pain. The cardiologist does not seem perturbed, but I've been told by GPs that I should have gone to hospital. On Monday I went to the Dr about another matter and he was horrified that I hadn't gone to A&E the day before, and insisted on sending me to be seen at the hospital. All tests were fine. I'm on the top dose of a calcium channel blocker, and two different vasodilators besides the GTN spray which is often ineffective.

[Hidden]

I'm currently mulling over what to do as well. I have seen a Cardio of late, but he didn't seem to see any urgency over the symptoms. A & E would be the last place I would like to end up in.

[balletfan in reply to Hidden]

Yes, I've had much the same response from the cardiologist, but the GPs at my practice are horrified when I've had long spells of pain (12 hours,not severe), and I've not gone to A&E. Mostly I don't tell them. I agree about A&E not being somewhere I'd want to be.

[Hidden]

Hi balletfan,

I have microvascular angina plus a thoracic ascending aortic aneurysm and really struggle with this as well. I can have chest pain for 3 days at a time, on the few occasions I have gone to A&E it’s been a waste of time. As my troponin and ECG are always negative they never know what to do with me.

Have you discussed this with your cardiologist? Sometimes it’s helpful to draw up a a management plan which details what symptoms should be investigated and what should be done. Microvascular disease is very much the poor relation in cardiology with little insight into how it affects quality of life.

[Hidden in reply to Hidden]

"Microvascular disease is very much the poor relation in cardiology with little insight into how it affects quality of life."

It essentially falls into "invisible condition".

This explains the attitude of the Cardiologist I had seen of late.

I have seen an article, commenting, "these patients are extra sensitive to pain".

He/these authors should try to give birth and see if it would hurt.

[Hidden in reply to Hidden]

Lol.😂

That’s part of the problem, medics like things that they can measure such as biomarkers ( troponin ) or ECG changes. It’s very difficult to measure pain, fatigue and shortness of breath, they are very subjective. Until we get more research and Patient Reported Outcome Measures that actually mean something to patients nothing will change.

That’s why I do a lot of Patient and Public Involvement in Research, lay review of grant applications etc, I am a woman with a mission!

[Hidden in reply to Hidden]

"That’s part of the problem, medics like things that they can measure such as biomarkers ( troponin ) or ECG changes. It’s very difficult to measure pain, fatigue and shortness of breath, they are very subjective."

They are somewhat similar to Neurologists. Has anybody been offered Cardiac PET? CPET must show microvascular damage.

[Milkfairy Heart Star]

My I share everyone's frustrations!

I have lived with vasospastic angina causing Microvascular angina and Coronary artery spasms for over 6 years.

I have an Admission Plan which is on my local hospital 's, a leading Heart Attack centre's electronic patient record system. It was co designed by myself, my local cardiologist, tertiary cardiologist and pain management team.

The BHF information leaflet about MVA makes reference to the importance of having a written care plan.

The NHS Constitution states that as a patient we have the legal right to be treated with respect and dignity.

I wrote to the Trust responsible for my care the following.

' Whenever a patient's pain is not acknowledged or reliably treated in an timely and appropriate manner they are not being treated with respect and dignity . There is no dignity being in pain. '

Those of us who live with Microvascular angina or Coronary artery spasms live with a Heart related pain condition and at present our pain is not being acknowledged nor how this can have a devastating effect on the quality of our lives.

I am also actively involved in patient involvement in research through my voluntary role at the BHF and other forums.

[Hidden in reply to Milkfairy]

Very useful advice, indeed.

"Those of us who live with Microvascular angina or Coronary artery spasms live with a Heart related pain condition and at present our pain is not being acknowledged nor how this can have a devastating effect on the quality of our lives.

I am also actively involved in patient involvement in research through my voluntary role at the BHF and other forums."

[Shuey]

Hi I suffer with similar ,I was put on a medication called ranexa ,it does help a lot , not sure if anyone else on it ,if not worth asking about as it has good reviews

[balletfan in reply to Shuey]

Hi, I have been on Ranexa a few weeks. So far it has helped a little.

[Shuey in reply to balletfan]

Hi ,

Yes ranexa I think comes in 3 different mg I’m on the 500 but can be upped to 750 mg if needed

Hope you soon feeling better with the ranexa

[Keep-it-ticking]

Can I ask how this was diagnosed ? Having un- diagnosed issues at the moment.

[Manhattan1]

hi.. i also have microvascular angina.. cardiologist advice if i experience pain... take one puff of gtn spray.. if pain still there after 10 mins take another gtn puff.. if pain persists after that.. call 999.. hope that helps

[balletfan in reply to Manhattan1]

Hi. Thank you. Your advice is the same as I was given by my GP. If I followed it I'd be at the hospital at least once a week, and sometimes oftener. During the last week it would have been four times. The cardiologist told me that I need not go to A&E unless I was having more symptoms eg breathlessness. I was seen by a consultant a few days ago.

[Manhattan1 in reply to balletfan]

was also advised by paramedics that chest pain that doesn’t go away should never be ignored.. and that they would rather come out even if it proved to be a false alarm.. than run the risk if someone suffering a heart attack.. hope that helps