Hello
Saw cardiologist yesterday outpatient follow up appointment after A&E admission with angina in September. Cardiologist will be monitoring me regularly and treating Micro vascular angina brought on by spasm of smaller arteries. Will be trying different medications to manage symptoms of breathlessness, chest tightness and fatigue. Had stents put in 3 years ago but have had ongoing symptoms, which are now being taken seriously by cardiologist and I'm feeling positive for the future.
Great to hear that your Microvascular angina has been recognised and you are getting the care you need. Hooray😊
Finally the awareness is growing amongst Cardiologists about microvascular and vasospastic angina.
Keeping my fingers crossed for you that the medication helps
That’s very interesting they got onto your microvascular angina. Some here mention that it can take ages! What drugs are they giving you?
It did take a while it's 3 years since having stents put in one of my main arteries, which should have made me better! MVA was suspected because I continued to have symptoms after the stents. I was in A & E in September and was seen by a new consultant having been discharged by the previous one who did the stents. I was diagnosed then with artery spasm in my microvessels and this consultant was reassuring and willing to work with me to find the right treatment, and medication. so it's been a long haul but there is more awareness of the condition now and I've found this site to be helpful too. Believe me I've felt frustrated and very down at times because I've had pain and they haven't known why when the ECG is fine troponin only slightly raised and angiograms clear with no extra narrowings, but now I have a consultant who is taking me seriously I'm very hopeful.
At the moment I take nitrates, amlodopine, nebivolol, aspirin, statins, lansoprosol, and ranolazine has just been added. I also have GNT spray which I use only when the chest pain is really bad.
Thanks for the details? Have you had any investigations that confirm the diagnosis! Or is it more because you still have angina, in spite of having had the ‘usual’ interventions?......if you see what I mean!
Hi Kristin1812
There several different possible causes of Microvascular angina.
Microvascular angina is not the same condition as coronary artery spasms . Though some people like me do live with both.
Causes are either the failure of the small blood vessels to dilate in response to exercise .
Microvascular dysfunction which can be detected by a perfusion MRI with adenosine.
A team at St Thomas hospital has recently developed a new way to diagnose Microvascular dysfunction using adenosine during a routine angiogram.
Some types of MVA are due to a temporary narrowing of the blood vessels. You can also have temporary constrictions in your coronary arteries leading to vasospastic angina (coronary artery spasms) too. Then its lots of pain at rest that wakes you at night.
Sometimes a person will have spontaneous coronary artery spasms during a normal angiogram and then they are diagnosed with Vasospastic angina. You cannot ' see' spasms taking place in the small coronary blood vessels.
However they can detect microvascular resistance to diagnose microvascular dysfunction.
My coronary vasospastic angina - microvascular angina and coronary artery spasms was diagnosed when they injected acetylcholine into my coronary arteries.
Normal blood vessels should relax mine didn't. My coronary blood flow fell as all my blood vessels narrowed in spasm.
I had vasospasms in my arteries, chest pain and ST elevations, ST depressions and spasms in my microvessels.
Result lots of chest pain, an excited cardiologist and a dose of IV morphine for me.
There is no one standard treatment for MVA or vasospastic angina.
Calcium channel blockers such as Diltiaziem can help with vasospastic angina
Beta blockers can help with microvascular dysfunction but can make coronary vasospastic angina worse.
There is no one size fits all. It takes time and patience to find which combination of medication works best for each individual patient.
MVA and vasospastic angina are complex and challenging conditions to diagnose, treat and live with for sure😊
Thank you. Really interesting. Lots I wasn’t aware of..
You are in very good company with many Cardiologists too😊
I haven't had a specific test for MVA it's on the ongoing symptoms.
You have a good Cardiologist as well who is using their knowledge and skills to look beyond the usual causes of angina.
The awareness of MVA has grown which is very encouraging for us all.
Coronary artery spasm
Micro vascular angina
Micro vascular angina
Micro vascular angina 
