Micro vascular angina, coronary artery spasm now heart murmur and possible valve disease

[Sunshinebrew]

Hello everyone

I have 3 stents and have also been diagnosed with MVA and CAS. I am on lots of medications for angina and still have regular and sometimes severe chest pain breathlessness and fatigue.

Had an appointment with cardiologist last week and I saw one of the team not my consultant it is a teaching hospital so I'm not guaranteed to see the consultant.

After examining me and listening to My heart the doctor asked if I had a heart murmur because he heard something and said I may have a narrower valve which can also cause chest pain, but he said he may be wrong!

He had a look at my swollen feet and legs which have been getting worse, then had a conversation outside with my consultant and they have taken me off amlodipine and ordered an echocardiogram and will speak to me again once I have had this done.

I was a bit taken aback no one has mentioned a valve problem before, I have just got me head around the microvessel disease, and I'm worried. I wasn't expecting this and didn't ask any questions, and now I'm feeling a bit tearful, on top of this my GP has left the practice so I'll have to see someone else and I really liked her.

[Milkfairy Heart Star]

Hi Sunshinebrew

That must have been a shock and quite bewildering when someone suggests another possible reason for your chest pain.

The positive thing is that the doctor you saw you took the time to listen to your heart sounds and discussed this with the Consultant.

You are going to have an echocardiogram so they can check that your heart muscle and heart valves are working well.

Have you had a cardiac MRI previously ?

I hope your wait for the echocardiogram isn't too long.

I also have a heart murmur and it was a shock too at first when I found out during the ward round after the Consultant had listened to my heart sounds. All the junior doctors were sent my way to listen to my murmur by the Cardiologist.

I had a CT scan and ultrasound whilst I was in hospital so no wait. All is well for me.

The waiting for the tests to be performed and then the results is the worst bit.

Are you receiving any other treatment for your MVA and vasospastic angina now they have stopped your Amlodipine?

As your Amlodipine has been stopped I suggest you keep a diary of your symptoms.

This will help the Cardiologists if the is any uncertainty about what is causing your chest pain.

[Sunshinebrew in reply to Milkfairy]

Thanks for your reply I am on nitrates and ranolazine but they haven't replaced the amlodipine with an alternative. I'm hoping the ankle and leg swelling will go now I've stopped the amlodipine, and I'll see if I feel any different I keep a diary.

He said 6 to 8 weeks for the echo the last one I had was 3 years ago.

I haven't had a cardiac MRI

I've had 3 angiograms since my stents and they are fine which is why I have the MVA diagnosis, but although I do have good days and can have a 'normal' life in between bouts of chest pain generally I feel breathless and tired more often than not and was hoping for more improvement. Just have to take each day at a time and not get disheartened.

[Milkfairy Heart Star in reply to Sunshinebrew]

I hope you feel better soon.

I am always worse in the cold weather and with the recent frosts I have been hibernating.

MVA and vasospastic angina can be so unpredictable.

I am not sure what is ' normal' for me anymore🤷‍♀️

[Sunshinebrew in reply to Milkfairy]

I know what you mean

I can be feeling fine one day and go for a walk with no pain until that night or the next morning , so it's difficult to know if I'm doing too much because I seem to get a delayed reaction.

last week I did some light gardening and felt ok until the next day when I had quite severe pain which lasted off and on for 3 hours and then I was so exhausted spent 3 days resting in bed,

How long do you get with no pain and feeling reasonable?

The longest I've gone is about 7 days then it comes back, despite taking all the meds is this the best I can hope for?

[Milkfairy Heart Star in reply to Sunshinebrew]

This reply comes with a health warning.

My Cardiologists says I am unfortunately badly effected as I have vasospasms in all my coronary blood vessels as well as my brain and kidneys.

I feel at my best in the summer. I walked up Haystacks in July.

I was laid up in bed next day ....hey but is was worth it😊

I get on planes and fly way on holiday.

I get pain every day mainly in the evening and night at rest. I have found ways of managing it otherwise I would live in hospital!

I still do need to go into hospital for a week for treatment with IV GTN and morphine a couple of times a year.

The Pain Management programme which I attended was very good teaching strategies to emotionally manage your pain

Pacing is really important. I will often rest in bed in the afternoons.

If I have increasing pain I slow down and rest. Increase my nitrates, start clexane, use my oxygen and TENS.

When I run out of steam I go into hospital.

I take Diltiaziem which has been increased again recently and has improved my pain a little. However it has so far been a mild winter. It might be worth discussing using Diltiaziem with your Cardiologist as this is the usual treatment for vasospasms.

Managing your stress is essential. Saying that I am about to stress myself by doing a presentation....I will be in bed for a couple of days afterwards.

Perhaps ask to be referred to a pain management programme?

[Sunshinebrew in reply to Milkfairy]

Thank you

It's all about quality of life and managing the symptoms to do things you want when you can.

It's also important to stay positive, I'm trying.😂

Thanks for the advice and support

Not long till summer

[Kristin1812 Heart Star in reply to Milkfairy]

HiMilkfairy! Just a thought....this year I’ve been much better in the cold, far less angina, and so less hibernation, more exercise. Some slight drug juggling worked an absolute treat. Perhaps worth a try fir you, too?

[Milkfairy Heart Star in reply to Kristin1812]

Hi Kristin1812

Thanks for the thought.

My Cardiology Prof has just tweaked my medication.

It is a balancing act as I am now on very high doses of Diltiaziem which is affecting my heart rhythm.

I have had some spectacular reactions to changes in my medication. I landed up in CCU after one change a couple of years ago

My Cardiologist will now only change my meds when I am in hospital.

My blood vessels are very twitchy 😊

[Kristin1812 Heart Star in reply to Milkfairy]

Ah! Sounds pretty delicate.

[Sunshinebrew in reply to Kristin1812]

That's what I was hoping for but at the appointment they seemed more concerned about a heart murmur so have to wait for the echocardiogram and stopped amlodopine.

I'm thinking have I got MVA with vasospasm or something else or both?

I was a bit shocked and didn't ask questions but I'll just take it easy now and if I get severe pain I'll go to A and E just in case

It's just knocked me back a bit.