Hi all you lovely people i am now 12 days post primary pci another stent . I have been trawling web and can’t find anything to answer my question so thought I’d try you . Does any one know how common it is to have a second mi stemi within 9 months of first mi that also required pic emergency angioplasty and stent in same artery ? I was constantly reassured during the last 9 months that all my big arteries were clear ( I had had a second angioplasty 8 weeks after first mi as chest pain and breathlessness continued to be a problem ) As anyone who has read my posts before know I was struggling with symptoms from day one after first mi , I’m not overweight was fit and back to speed walking everyday but was so so tired all the time with chest pain symptoms being diagnosed as mva ( after s profusion mri ) . i don’t have great relationship with the cardiology team I am under . I don’t seem to be able to get answer from them as to why this second one happened if in April last year all my big arteries were seen as clear and why mri didn’t show it . They did say it wasn’t from a clot . The discharging cardiologist said that it’s possible the block they treated 12 days ago was very hidden but he was young and didn’t appear comfortable talking about it .
I felt better after this pic until last Wednesday when I did go back to a/e las had pain in chest under arms was breathlessness and sweating low oxygen levels. trop was raised but as they said prob still ion it’s way down ecg must have been ok as I was discharged . Since Wednesday , I have had ongoing chest discomfort ( not pain ) and keep having very wet sweats . I think it is kinda angina because it gets better with rest and gtn and I have read angina pain is common in few weeks after emergency pci . At a/e I was told it is most likely stent settling but no advice how to move on while waiting for cardio rehab .
I tried ringing cardio rehab for advice about starting exercise as per book but got answer phone . I’m seeing them on the 14 th ( 3 weeks after mi )
As I have had the two mi ‘s that needed emergency pic in 9 months despite being told this wasn’t going to happen I think understandably I don’t feel very confidant . Ps I am my husbands carer so back to normal re house duties and his care but minus heavy stuff such as vacuuming , but I feel guilty I’m not doing the exercise the book tells you to do .
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Themcgeevers
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Vasospastic and Microvascular angina angina and MINOCA
Myocardial infarction non obstructive coronary arteries.
Vasospastic and Microvascular angina are poorly understood and recognised conditions. I suggest you get back in touch with the Cardiology team and ask to be referred to a Cardiologist who has some knowledge about Vasospastic and Microvascular angina or they are willing to work in partnership with you and do some research to provide the care you need.
This is the information on the BHF website about Microvascular angina.
Thank for replmilk fairy . The consultant I saw in a/e said he didn’t think I have any mva now ? I was taken off of the isorb monitrate slow release when this second mi happened and they started me in all the new drugs ? I think this is why I feel confused if big arteries are apparently clear why am I getting angina pain ?
I can understand your feeling of confusion and feeling let down.
Microvascular angina is a complex condition and I suggest you discuss what has happened with the Cardiology team caring for you.
Microvascular angina is thought to be due to the small vessels going into spasm or not being able to dilate.
Causing a lack of blood supply to your heart which you feel as angina pain.
Like Vasospastic angina, Microvascular angina can cause a heart attack.
Isosorbide mononitrate extended release helps to relax your blood vessels and are very helpful to relieve not only your pain but reduce complications.
Beta blockers can make vasospasms worse. So it is important for the Cardiologists to make the correct diagnosis.
Microvascular and Vasospastic angina unfortunately are poorly understood and recognised and as someone else remarked we are considered to be unicorns as some Cardiologists have difficulty looking beyond the blockages and believing that MVA or vasospastic angina exists at all!
I personally would ask to talk through this with your Cardiology team with a copy of your notes to hand.
Ask to be referred to a specialist in Microvascular and Vasospastic angina if necessary.
Perhaps print out the BHF information leaflet about MVA and take it to the appointment with your Cardiology team.
I have a written Admission Plan to guide the A&E staff and Cardiology team how to care for me when I am admitted. This is perhaps something you could request too.
The key is to establish a good relationship with your Cardiologist who is willing to work with you to find the best combination of medication that will work best for you. This can take time and patience.
Everybody now knows not to mess with my medication regime or IV GTN.
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Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
ICD or not ICD
Living for the moment 
Sorry to be leaving.
