Hi, I saw my cardiologist for second time (last visit as was discharged). I was put on bisprolol at first visit for high heart rate he agreed I have heart pain with high heart rate but during the consultation he only wanted to discuss my echo and abnormal ecg. The last 6 weeks of breathing changes & chest pain on & off after cold, increased activity etc he wasn’t interested in as he was looking into my ‘heart rate’ and my heart scan was fine. I suffered the last few weeks thinking I’d cope as I was seeing a cardiologist and so was surprised when he wasn’t interested in my presentation just my results. He basically said I’d probably stay on the beta blockers for life and that was it. I’m now left feeling ill exhausted by mid afternoon/evening having chest pain several days a week and unsure if should be trying to live with it or seek out more support? I thought chest pain would always be taken seriously but am I wrong? Should I go back to my GP, don’t want to see another dismissive cardiologist but I’m only 44 with 2 children I’m I’m struggling physically, thank you for reading.
Chest pain dismissed by cardiologist - British Heart Fou...
Chest pain dismissed by cardiologist
Definitely demand further help, Cardiologists are very good at ignoring and dismissing patients, particularly women !
Many of us have been and are still in your shoes, you have to be persistent.
I am with Bantam - you have to keep badgering to get another consultation. Cardiologists are very varied in ability. That said I can be formidable but I got absolutely nowhere with my lovely GP trying to get a referral. In desperation I went privately. I should have had an annual scan (aortic aneurysm within 1mm of size they operate, bicuspid valve etc) four months ago and no sign of an appointment despite cardiologist, registrar and GP all putting in letters trying to get one booked. The system is broken and it is only the persistent who get anywhere. It;s really hard to concede that and when you feel rough even harder to show persistence - but keep at it. You may be in an area of less demand. It is a real lottery. Take care.
I found the consultant at Southmead very good Mr Walker helpful an older guy and he listens to you, The arrogant ones come from the surgeons there bedside manner could do with a bit off brushing up They need to rember that we are frightened /scarred human beings and not a slab of meat
Thank you for your replies, I was feeling like that was it I had my appointment so tough but actually it’s ok to say it’s not enough as it’s affecting my quality of life. I will make an appointment with my GP, he was very good and he requested my tests and then the cardiologist ‘took over’ but he did listen and hopefully will again.
As frustrating as it is badgering medics seems to be the way forward in such circumstances. We know our own bodies and when something is wrong we know it. Sometimes they spend too much time looking at results and too little time looking at and examining the patient. Modern technology is wonderful but not a substitute entirely for looking at the patient sat in front of them.
Be demanding sadly it's seemingly all you can do to get the thorough attention you deserve.
There may well be a legion of mainly women who have had their heart conditions overlooked. Some are accused of being demanding and hysterical women who perhaps need to see a psychologist. Many made to feel their pain is in their heads. This is a reflection of a Cardiologist's lack of understanding of women and how heart disease effects them differently.
Women are more likely to live with non obstructive coronary heart disease causing their chest pain.
bhf.org.uk/informationsuppo...
Unfortunately some doctors have also lost the vital skill of listening actively to their patients and treat the test results rather than the patient in front of them.
I have a less common type of angina, coronary vasospastic angina causes microvascular angina and coronary artery spasms.
Only problem all the conventional tests I had done came back normal. Conventional tests are designed to detect the more common cause of angina due to permanent blockages. I usually only have subtle ECG and troponin changes.
I still had my pain so I persisted. I saw and expert who sent me for a very specialised angiogram and my diagnosis was confirmed.
I suggest you go back to your GP and ask to be referred to a more sympathetic Cardiologist.
Your chest pain does need to be investigated properly.
I cannot take beta blockers as they make my vasospastic angina worse.
Good luck.
That’s really interesting, my concerns starts with spasms/flutters and when my high heart rate on an ecg took everyone’s attention from my concerns and onto the high hr, since the bisprolol my spasms stronger & more frequent but I’ve not mentioned it, I had a 24hr ecg and I saw them on the results but he just focused on my rate going to 148 but it’s up & down not constant, normal most the time, the chest pain & breathing changes also since beta blockers. I also have undiagnosed Raynaud's, awful circulation and I feel my issues might relate to small arteries as I have no risk factors, apart from grandma angina/ heart condition from her 40’s fatal heart attach and my dad mini heart attack, my blood pressure low so he can’t increase beta blockers.
Thank you again, really helpful
All my blood vessels are effected.
I also have Raynauds Phenomenon and migraine. Beta blockers can make these conditions worse too.
My biggest triggers for chest pain are the cold , emotional and mental stress.
Most of my pain is at rest in the evening and in the night
I have no conventional risk factors. My BMI is 21.
You may find this information from the BHF website helpful too.
bhf.org.uk/informationsuppo...
bhf.org.uk/informationsuppo...
bhf.org.uk/informationsuppo...
I suggest you print these out and give them to your GP and discuss the contents.
I have the same triggers and timings as yourself, can I ask what your spasms feel like, if anything? When I first talked about my flutters I kept being asked if they were palpitations but I would not describe them as that and they happen most at rest or when I’m in deep conversation (?).
Thank you so much for the links.
My bmi 19/20 too
Hi Leahetea,
I am unfortunately really badly affected by my vasospastic angina and over the now 7 years have despite seeing some of the best specialists still live with alot of pain.
I feel my pain at the bottom of my breast bone and just below my left collar bone it radiates into my left neck, jaw shoulder, upper back, lower ribs, kidneys and left arm.
I feel a band of pain like a cheese wire cutting through my upper chest.
My bra feels as though it is on too tight.
It feels like being in labour. Some spasms are brief lasting less than minute they then build in length and intensity over time peak and then lessen. This process can take upto an hour and if it keeps happening I go into hospital for further treatment.
My heart rate increases and I have palpitations which show up on my ECG.
They feel like a little flutter in my chest at the top of my breast bone.
I can also feel breathless and lightheaded.
Some people do not feel chest pain at all just as sense of unease, extreme tiredness, pressure or tightness.
Please bear in mind I am unusual and I hope you find a Cardiologist who is willing to try and find the effective treatment you need to get your symptoms sorted and so you can feel better.
Calcium channel blockers such as Diltiaziem along with nitrates are usually pretty good at treating vasospasms. Though not always so effective treating microvascular angina.
I’m sorry to hear you’re experience, thank you for answering my question, you have a lot to cope with.
I’m finding I’m getting worse over time and I’m getting much more tired more easily with everyday activity and with the chest pain across my chest (it’s like a belt has been strapped tight around the top of my chest & interestingly I keep thinking my bra strap too tight and go to undo it) it’s getting quite painful on some occasions with referred pain. I’ve been tired for years with young children and B12 deficiency (have b12 injections every 3 months) but this is a new kind of tired that I can’t bare the thought of living with for the ‘long term’ .
Thank you for listening and advice I’m going to try to get more answers, did you have a stress ecg? Does this help with MVA diagnosis?
I have as they say had quite a journey!
Awareness of MVA and VSA are growing. I have seen a change and my care has improved.
Most conventional tests detect coronary heart disease and are not so good at picking up MVA or Vasospastic angina.
The gold standard to diagnose MVA and VSA is an angiogram with acetylcholine which is available in only a few places in the UK.
Normal blood vessels should dilate when acetylcholine is injected into them if they constrict it shows the blood vessels are not working as they should. If the small vessels are affected Microvascular angina is diagnosed. If the larger coronary arteries constrict then Vasospastic angina aka coronary artery spasms/ Printzmetal/ variant angina.
Most people have one or the other the minority both.
There are thought to be several different causes of MVA. In people where the blood vessels fail to dilate then some of the newer MRI scans can pick this up.
However a clever Cardiologist who listens carefully will be able diagnose MVA or VSA.
I had an angiogram with acetylcholine and it confirmed that I have both MVA and VSA.
It is an emerging field and you may have to help your Cardiologist they can't always keep up to date with the research.
I regularly send the latest research paper to my Cardiologist before an appointment.
Everyone knows I am a bit of a research geek. It has helped me get the care I need especially when I go into hospital.
Thank you for posting this - I was feeling quite alone with almost the same scenario . I’ve had an eco test And a chest X-ray at the hospital and apparently that is all fine - however the hospital haven’t told me that , they have sent a letter to my dr who didn’t pass on this information - I rang today and the admin person said there was a letter but no further information . Apparently they are going to send me for a CT scan. I’m on beta blockers and aspirin and I have cycles of feeling bad but breathlessness doesn’t go away - the pains mainly come on during the night , last time I felt as if I had been speared in the chest right through to the bed .I also feel nauseous and my appetite is low . I feel like at a bit of a loss and don’t want to seem like a hypochondriac, silly middle age women. Any tips on how to not be dismissed / passed over would be gratefully received . Just to caveat - I do understand that Covid has slowed the systems down .
Hi Forgetfulme
I suggest you read the information on the BHF website about Microvascular and vasospastic angina. I have posted the links above.
Print them out , go and see your GP and ask to be referred to a Cardiologist who has some understanding of Non obstructive coronary artery disease/ Ischaemia non obstructive coronary arteries.
NOCAD/ INOCA
There is a lack of awareness of these conditions though there are some specialist heart centres that are now able to diagnose Microvascular dysfunction/ angina and vasospastic angina during an angiogram.
This is how my coronary vasospastic angina was diagnosed some years ago.
I see a specialist at St Thomas hospital in London who is actively researching into this type of angina.
Your pain is real and should be investigated appropriately.
Good luck
Thank you so much I will do this now . Really kind of you to get back so quickly
No problem it took quite a while for me to get my diagnosis and I acknowledge your sense of isolation.
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