I know none of you can give me medical advice but I would appreciate any opinion on my symptoms. I’v been suffering with chest/shoulder/arm and jaw pain for a few years now but lately it’s been getting worse. I have been getting pain regularly in one area above my right breast, sometimes I feel I go lightheaded for a split second when it happens. It comes and goes and I’m usually at rest or doing light activity when it happens, the jaw pain is getting more frequent also. Over the years i’v had several ekgs, stress test, bloods, chest X-ray and 24 holter monitor, nothing has showed up. My lastest stress test and 24 hour holter were about 6 weeks ago, bloods and chest X-ray were about 8 months ago. The pain is driving me insane and freaking me out, I am in pain as I type! I am a 36 year old female, over weight (BMI 31) and not fit. I also have high cholesterol, not controlled with statins, gp just suggested to try get it down with diet and exercise. My resting heart rate is usually low 70’s and my blood pressure is always normal. I am insulin resistant with polycyclic ovarian syndrome but I’m not on any medication for it. Thanks in advance for any advice x
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Ckd123
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I am so sorry that you are having a really bad time without a diagnosis, as I know from experience that this is a difficult position to be in.
I have microvascular angina and I think it possible that you do as well - there is a regular flow of people on here with symptoms suggestive of this condition because it is fairly unusual and many doctors - including many cardiologists - don't know of the condition or even don't believe that it exists. I suffer more or less continual but highly variable pain in the same areas as you. Normally, the pain is on the left but it does occasionally appear in my right chest.
I typically have "attacks" when I am at rest, especially after exercise or at night. The effects of gentle exertion are variable in me: sometimes it reduces the pain, sometimes it increases it and sometimes it seems to make no difference. Like you, I suffer from transient light-headedness.
Microvascular angina (MVA) is caused by the small blood vessels to your heart being dysfunctional. It can be associated with vasospastic angina, which is angina caused by spasms in the blood vessels to your heart. It often doesn't show up in tests but, in principle, should produce indications in your ECGs of ischemia (poor blood flow causing oxygen deprivation). The changes are often subtle (e.g. ST-depression or T-wave flattening) and my experience is that hospital staff often overlook or ignore the changes, presumably because they are looking for the more dramatic changes associated with heart attacks etc. I strongly recommend that you keep all your ECGs in case you later have an opportunity to show them to a specialist who knows what to look for.
I am sure that Milkfairy on here will be in touch with you as she is a great expert on MVA. There are very few cardiologists expert in the disease, but two are mentioned on the BHF information, namely Prof Colin Berry (Glasgow) and Prof Juan-Carlos Kaski (London). Unfortunately, Prof Kaski is in the process of retiring and, whilst I believe he still has a private practice, he has retired from the NHS.
You don't need me to tell you that it would probably improve your health in the long term to lose weight - I know it's tough to do as I have been through the same thing. I would think that something should be done to control your cholesterol if possible and, in any event, a statin ought to help improve the functioning of the endothelium of your blood vessels, including inhibiting inflammation. A cardiologist should be able to advise if your GP is unwilling to help.
Needless to say, I am not a doctor and my suggestion of MVA may be wrong
Hi..what you are describing is exactly what I suffered with for some six years...I did find it seemed to be related in what I had been eating..doughnuts for instance...or being under stress....it was very similar to reflux...with the jaw ach...I was treated for reflux but nothing more...in 2016 I was given a heart scan due to feeling breathless...I had a triple bypass three months later..The damage was done...these signs were warnings..So I think you should get a scan..
Jonathan has given you a description of Microvascular angina (MVA).
which is a complex and poorly understood condition. It is under recognised partly as there are no simple tests to diagnose MVA at the moment.
MVA is thought to be due to the small blood vessels in the heart either being unable to dilate in response to the extra demands of exercise giving pain on exertion or narrowing in a spasm giving pain at rest.
Vasospastic angina also know as Coronary artery spasm / Printzmetal/ variant is due to spasms in the larger blood vessels of the heart. Typically the pain felt is at rest often at night and in the early morning.
Most people have either MVA or Vasospastic angina some people like me live with both.
MVA is more common in women and being overweight or diabetic increases the chances of having the condition.
Vasospastic angina effects both men and women.
It is important that whatever the cause of your pain that its cause is found so that it can be treated properly.
Living in pain can be very challenging and I acknowledge the anxiety that you may be feeling.
I suggest you go back to discuss the issues with your GP and perhaps take a printout of the BHF information about MVA with you. It is important to establish a good relationship with those responsible for your healthcare as they ultimately are professionally responsible to find the cause of your pain whatever the cause.
I have also attached another link about vasospastic angina which I hope helps
There is a growing awareness of the condition and whilst Prof Juan Carlos Kaski has retired there are other BHF funded Cardiologists researching into Microvascular dysfunction in London, Cambridge and Oxford.
Good luck. I hope you find the cause of your pain and the appropriate treatment soon.
I feel for you and hope that you can get the medics to actually act soon. I can only add one topic that may help you. You mentioned that you are insulin resistant, and this triggered a memory, vaguely, of something I read.
So I googled "insulin resistance and cardiovascular disease" and up came a long list of scholarly articles, but this reference seems to be more understandable
Basically, it seems insulin resistance and heart disease are linked and is an important topic for all readers of this website and really everyone else too.
I am not medically trained, and maybe there is something flawed in this and the many other articles that came up on Google, but .....what if insulin resistance is some sort of key to cardiovascular disease? I think its worth a few minutes to read and think about.
Hi, my Colin has angina. He has a spray and if that doesn’t work we call an ambulance. When at hospital they take a blood test to see if it is a small heart attack. Apparently they can tell by the numbers on this test, when he had a heart attack it was over 2000 but his angina attacks are usually at about 250 which they say is not a worry.
It is still best I think to get it properly checked out .
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