cardiac microvascular ischaemia

[Mijnhart]

Hi all

Here an update....had my cMRI recently which suggested cardiac microvascular ischaemia. Am on ISMO 20mg twice daily already, with 17 hour interval to avoid tolerance, however this dosage has not really shown any improvements for me.

Just wondered the drugs and dosages others are on to ease the symptoms of this condition as there is no curative treatment as far as I understand it.

[Milkfairy Heart Star]

Hi Mijnhart

It can be trial an error to find the best treatment to suit you as an individual to treat microvascular dysfunction and microvascular angina ( microvascular disease)

There is no one size fits all. Do you have a good relationship with your Cardiologist?

It is important to be able to work in partnership with a Cardiologist who has the patience, knowledge, understanding and skills to help .

They are a special breed just like we are very special too 🙂

Do you also have coronary artery disease?

Here's some recent information see table 2.

heart.bmj.com/content/104/4...

MVA is a complex condition some people's problems are due to their blood vessels not being able to dilate.

In these cases beta blockers, statins and ACE inhibitors can help but not necessarily nitrates

Ranolazine is another option that works for some but not others.

The other cause of MVA is due to spasms in the small vessels then nitrates do usually help but definitely not beta blockers.

I have spasms in both my small and large blood vessels so even more of a challenge for everyone involved.

I take my 60mgs ( increased to 120mgs in the winter) of ISMO at 6pm with 20mg GTN patches. I remove them at 8am the following day. I have most of my pain at rest in the night . I have never become tolerant of nitrates on 7 years. I do also end up in hospital on IV GTN from time to time.

I am on 2 calcium channel blockers, nicorandil, statins and chlopidergrel.

I am on the extreme end of the spectrum and I truly hope you don't join me there.

I hope you are able to find the best treatment for you soon.

[Mijnhart in reply to Milkfairy]

Thanks Milkfairy for the information, sorry to read you are at the extreme end of MVA.

Will talk to my cardiologist to see if an increase on ISMO might help, I understand it will not be curative but some more relief of the symptoms would be great.

All the best to you

[Milkfairy Heart Star in reply to Mijnhart]

Thank you.

I hope you are able to get better control of your symptoms!