Hi
I have been SOB and not able to do my usual exercise x 4 weekly. I have had chest pain and nausea and complete tiredness/ brain fog
Today saw a new Dr who suggested I have heart spasms. I had a pacemaker for SSS since 2017 /Angina 2019
But he was more concerned about my BP
I don’t feel listened to - I’m late 40s any suggestions pls x
SOB? SSS? My Bisoprolol induced brain-fog in action or I'd know these without having to ask.
New doctor and you don't feel listened to - I can so relate! Are you booked to see him again? If yes, the next time you do, he'll have had time to read your notes and will be more familiar with your case notes. My experience, any road. The first time I met my cardiologist I thought he didn't understand how unwell I was when my GP referred me. The second meeting proved me wrong. He's still a lot 'to the point' (reminds me of Doc Martin, actually) but wow is he a great cardiologist!
As for the BP - you don't list your reading that apparently caused him concern but it must have been remarkable one way or the other for him to make you feel he was more concerned about it than your actual heart condition. BP and heart conditions are so closely related it makes complete sense for a medic to be interested in it.
Hi Sunnie
I have sinus sick syndrome which my heart rapidly fluctuates. But they put pacemaker in for bradycardia as pulse was in 30s
Shortness of breath he feels is possibly heart spasms and high BP
My BP can’t go to high as previously had a stroke in my twenties but fully recovered
I’m awaiting an Ecco as he said my angiogram was clear in 2017 so feels this does not need looking at
Today my pain has gone but had chest pain most of yest and previous night
X
Thank-you for the SSS definition (and I've now added it to my abbreviations list on a word doc). What does SOB stand for?
The echocardiogram should provide definitive answers. Interesting about your angiogram showing clear arteries - I had the same result on 20 Nov 2019, left everyone scratching their heads as my chest pain presents as angina and they're all convinced angina is only caused by blocked arteries.
I'm on the list for cardiac MRI to see if I have microvascular angina (MVA, I don't know much about it despite reading everything on it I can get my hands on, but apparently it is a rare angina caused by microvascular spasms).
I have recurrent pericarditis (plus Rheumatic Heart Syndrome+aortic valve scarring+pericardial effusion+pericardial scarring and thickening), and have a constant 'dull ache' chest pain on my left side. On sudden exertion (or when it's hot and humid) I get a whomping increase in the dull ache chest pain+short stabbing pain - and it all 'radiates' from left centre breast up to neck-shoulder-left biceps. GTN spray relieves the pain and I've used it so often now I no longer get the unpleasant side effects.
What medications are you on?
I’ have GTN and that previously has relieved the pain but same as you I get pain in the central chest and left breast. Often accompanied by neck ache shoulder ache
I am only on ramipril for BP
At times I feel as though as I’m not in the reg age bracket they think it’s just minor but all my females on my dads side have died of heart or strokes by the age of 60
I explained to him this is unlike me as I’m putting weight back on from not going to the gym so often and just feel exhausted
SOB is shortness of breath xx
Thank-you for the SOB (which I really should have known!), now added to that growing list
I'm 63 but have been a cardiac patient since aged 7 (the RHS) and I think you are spot-on about age. Even with the RHS and then in my mid 40s the recurrent pericarditis (which went to the acute cardiac tamponade stage necessitating an emergency pericardiocentesis - not fun!), I don't think enough medics took me seriously until I hit my early 60s.
Medics were so casual about my RHS, for example, I was able to pass the physical for military service back in the 1970s - today I would be rejected immediately were I a 20something applying to join, and back then males with RHS were automatically rejected.
It's sort of a double whammy thing, I think - I was 'too young for (insert heart condition here)' and female, and being female with a heart condition is a bit tricky (she sez drily). Recent medical publications (and a few on the BHF site) discuss the difficulty women of all ages, even those with family history, have being taken as seriously as men are when presenting with the same/similar symptoms.
It sounds good to me, though, your new doctor is concerned about your BP, knows about your angio results from 2017, and is ordering an echo - these non-invasive investigations are incredibly useful (and woohoo, painless!) for 'getting a look in' and lead 99% of the time to an answer.
Er, eventually - depending on where you are, the wait for the echo, and then the follow-up consult, can be frustratingly lengthy. Weeks (if not months) to the echo then unless the tech sees something on the echo, more weeks (or months) to hear the results. During my wait periods I found reading and posting here on the forum most helpful.
Just to explain a bit about microvascular angina (MVA). The cause is not totally understood but it's a failure of the microvessels to expand and transport blood/oxygen to where it's needed in the heart muscle. Some people who have MVA also have vasospastic angina which is the spasms you mention. But the two don't necessarily go together. I have MVA but not spasms.
Thank-you!Trust me to get those confused, thank-you again for the clarification.
MVA as Dunestar mentions has more than one type of cause.
It is probably not rare just under diagnosed and recognised by Cardiologists.
One theory is that it is the inability of blood vessels to dilate in response to exercise microvascular dysfunction causing MVA which can be detected in some cases by a perfusion MRI.
This type is more common in menopausal women. You tend to get chest pain and other symptoms on exertion.
Then there is a group of patients whose small vessels constrict or go into spasm causing MVA. This group tends to get pain at rest and exertion.
Another group whose coronary arteries only go into spasm causing vasospastic angina. Then its pain at rest and in the night. Quite often the same time of night
The research suggests about 50% have only MVA, about 15% just vasospastic angina, 20% both MVA & VSA. The rest unknown cause.
I live with both MVA and Vasospastic angina as I my tests and symptoms suggest I have a vasomotion disorder of my all blood vessels. I get migraines and have Raynauds Phenomenon too.
My blood vessels can dilate so I don't have microvascular dysfunction like those people with MVA due to a failure of their blood vessels to dilate.
It's complicated😊
It is complicated! My cardiologist feels a cardiac MRI will tell us if I have MVA but he says it's unlikely as cold doesn't seem to bother me, and he's ruled out vasospastic angina completely. He's the one with the all honours training and sterling reputation so I don't argue with him - but I really do think all my chest pain is from my rather wonky pericardium. I've studied the images in my first edition and 2004 student edition of Gray's Anatomy and have no trouble understanding what I'm seeing and reading about the pericardium so it's disappointing my cardiologist insists pericardial effusion cannot cause chest pain.
I've been trying to understand MVA since the first time I read one of your posts but every time I think I 'get' it I realise I've no clue. I have come to realise most of my brain block on the condition is down to my fervent hope I don't have it.
I keep meaning to ask and now is as good a time as any - does using a GTN spray have any success when your angina strikes? It seems I've read some of your posts that you have been hospitalised on a GTN drip which makes me wonder about the spray being effective - I ask in part as my use of the GTN spray is quick and hugely effective.
Hi Sunnie2day.
GTN spray doesn't help me. It works briefly as it stops the vasospasm then as it wears off I have even worse rebound vasospasms. This is just me I have very fickle and temperamental blood vessels,
despite being on the top doses of isosorbide mononitrate and GTN patches also 2 Calcium channel blockers.
I go into hospital as my Cardiologist advises to have my ECG done and Troponin levels checked. There is always a possibility that my vasospastic angina could lead to acute coronary syndrome.
The IV GTN is the only thing that stops my vasospasms completely.
So, what helps your MVA?
Here's where I feel compelled to tell you I think you are dictionary definition awesome - I don't want to think about having one let alone both those angina types, I'd like to believe I wouldn't curl up into a whimpering ball of misery but I know me and know I very likely wouldn't show the same grace and courage you do.
Thank you Sunnie,
I have a secret weapon my very special family😊
I don't always cope well. I do every now and again scream, shout and stamp my feet at the unfairness of the curve ball that life as bowled my way. Don't we all!
I have also had some life affirming care, compassion and kindness from those healthcare professionals who help support me.
I use all the strategies I know to manage stress and pain. Many I thaught to others in my previous profession.
I am blown away by the many awesome people on the forum who find their ways of living as well as they can with their challenges.
Oh and humour. Laughter is truly the best medicine😂
Good thing you’re not in the USA. If you don’t have a lot of money they medical community could care less
Heart missing beats
Heart advice .... 
Heart failure and feeling scared
Heart Failure & coughing 
