Microvascular and Vasospastic Angina with worsening oedema

[Mutley20]

Hi,

I hope everyone is managing OK. I just wondered if I could ask for your advice? I see a cardiologist who has diagnosed microvascular angina and vasospastic angina. I take verapamil in the main and diuretics but oedema in feet, ankle and lower legs is getting worse each day. Has anyone else got a similar issue and if so I would be grateful for your advice.

With many thanks,

[Milkfairy Heart Star]

Hi Mutley

A common side effect of Verapamil and other calcium channel blockers is swollen ankles.

I take Diltiaziem and Amlodipine for my MVA and vasospastic angina along with isosorbide mononitrate and nicorandil all have the same side effect swollen ankles!

I rarely have a problem however my feet and legs will swell in the warm weather especially if I am walking around alot. After a night's sleep they are back to normal.

I would contact you GP about the swelling of your legs etc.

You may need your medication adjusting .

Have you got an follow up appointment with your Cardiologist?

If not you could contact your Cardiologist's secretary and ask for a review

Swollen ankles and legs can be surprisingly uncomfortable and restrict your mobility so I hope you are able to resolve this soon.

[Mutley20 in reply to Milkfairy]

Thanks very much Milkfairy. Your advice today and previously has been incredibly helpful. I have been taking Verapamil for about 20 years so had hoped that would not crop up now. I too take Isosorbide. I also take Furosemide which I hoped would assist with the swelling. No follow up appointment is booked but will arrange once the lockdown eases and they are accepting appointments again. Good to know that it is probably just a side effect. Hope you are keeping well and thanks again.

[WardijaWardija]

Hi Mutley20

Sorry to read of your issue. I wonder if I could just ask you a question regarding Micro vascular angina.

I had 3 stents put in last summer 2019. as I had significantly blocked arteries. Following this procedure, I didn't feel any better at all, and had all the same symptoms that I had before the intervention. I was on all the usual meds.

I went back to my Cardiologist, his response was to prescribe me the GTN spray for angina.

Suffice to say it made no difference at all, and I continue to suffer alone as a "shielded patient" having had a prior CVA and being an unstable insulin dependent diabetic.

At this point, I'll tell you that all this happened while I was living abroad. To cut a long story short, I returned home to the UK this February and was immediately referred to a specialist Cardiologist at the John Radcliffe in Oxford, by my GP who queried that I may have MVA.

An appointment came through for March, however on the eve prior to my appointment, we went into Covid 19 lockdown and the appointment cancelled, to be re-scheduled goodness only knows when . . .???

Are you able to tell me what your symptoms were having MVA ? and how was it diagnosed, by what means? and, what specific medication you take to control it?

Hope to hear back from you when you have a moment 🙂. Thanks very much. Keep safe and well.

[Mutley20 in reply to WardijaWardija]

Hi,

I am very sorry to hear of your difficulties and I do hope you feel better soon.

It took some time for me to receive a diagnosis. In my opinion the most important thing is to find a cardiologist who understands MVA. My symptoms were chest, arm (both arms latterly) and jaw pain. I also had a long history of migraine.

I take Verapamil, Isosorbide Mononitrate and Furosemide. GTN spray is generally more helpful for the Vasospastic Angina than the MVA and I do use GTN spray for that when required.

There are some helpful articles on the British Heart Foundation website -

bhf.org.uk/informationsuppo...

bhf.org.uk/informationsuppo...

I hope this helps. Very best of luck.

[WardijaWardija in reply to Mutley20]

Hi there. Thanks so much for your quick response and the links you sent me.

The Cardiologist I am waiting to see at Oxford is Prof. Karabanda - apparently a specialist in MVA .

Hope I dont have to wait too long before I get to see him and a diagnosis made, I just want my life back !!

Thanks again, take care and stay safe.

[Milkfairy Heart Star in reply to WardijaWardija]

You are indeed in good hands.

Oxford are also taking part in the PRIZE trial a possible treatment for MVA

clinicaltrials.gov/ct2/show...

A team at Oxford have also developed a new way of interpreting perfusion MRIs to detect some types of MVA

sciencedirect.com/science/a...

I hope you are able to get the answers you need and the wait for your appointment isn't too long !

[WardijaWardija in reply to Milkfairy]

Thank you Milkfairy for your kind support, really appreciate it.

Take care, stay safe and well (as you can be anyway) 🌹