Just spoken to a nurse at the BHF helpline and surprisingly hadn’t heard of micro vascular angina or coronary artery spasms, I quoted different names for it but said she wasn’t familiar at all with the conditions so couldn’t help.
The other nurses where on calls.
She suggested seeing my cardiologist!!!!!
Or my GP.
Cardiologist doesn’t know much at all about it, but waiting for him to speak to my consultant for some answers or a plan and my GP obviously goes by what the cardiologist says.
Going round in circles a bit here.
Just need to be patient and wait for any news if any 😕
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Fluffybee
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I remember just after my angiogram left me with a diagnosis of 'angina with normal coronaries' and going into the GP surgery for post procedure blood letting - the nurse said 'Oh, it's not angina then' so I ran 'microvascular angina' (MVA) and 'vasospastic angina' (VA) past her...blank look then a blink then 'Oh, it's not angina then.'
Yeah huh.
My cardiologist told me he thinks I have MVA but the queue booking for the definitive test is nearly two years on and my condition is currently well managed with low-dose meds, lifestyle, and the occasional use of the GTN, so no rush to put the actual words microvascular angina on my notes.
On the plus-ish side, the day will come sooner rather than later you realise you really do know more about your condition than most professionals. I am convinced Milkfairy should have an honorary doctorate for the way she's educated herself about MVA and VA.
Sunnie2day, I am dumbfounded that a definitive test for MVA has a 2 year waiting list. That is an extremely long wait. Can you advise if you only experience Angina at rest or can u also suffer during exercise or slopes. I know from Milkfairy that the test for MVA is complex and very specialised but 2 years is too long to suffer anxiety. Fyg from all my tests, I have a good working heart even with 45-50 pct stenosis. Ffr 93 and 87 respectively no impaired bloodfow from those 2 arteries and LVEF of above 57. During angiogram arteries went ino spasm hence my ongoing investigstions. Uphill is a nightmare for me which is not the normal manner in which spasms can occur...... or can it be both rest and effort. I would love to hear back but I wish you every best wish possible. Mr Grandfather told me a Scottish saying long long ago. "May your Lum Reek !
I agree I do not understand why in Scotland there is a wait for 2 years for testing.
The recent consensus document from the European society of Cardiology published last week gives a new pathway for care of patients with Ischaemia no obstructed coronary arteries (INOCA)
This is an umbrella term
Microvascular angina can be due to the inability of the small blood vessels of the heart to dilate in response to exercise. Microvascular dysfunction.
This can be assessed during an angiogram using adenosine and measuring the resistance of blood flow through the the small vessels.
Some cardiac MRI can detect this type of Microvascular angina.
A less common cause of INOCA is when the blood vessels go into spasm this can be in the small vessels or large blood vessels or both this is vasospastic angina.
The test for this is to use a chemical during the angiogram to provoke vasospasms- acetylcholine.
The problem is there is little knowledge about INOCA within the Cardiology world meaning that as a group we have difficulty accessing the expert care we need.
I am fortunate that I live in London and have seen the best at St Thomas hospital.
As usual, thank you Milkfairy. I will peruse the link. The Head of Cardiology at the Nat Heart Centre here in Singapore has shown me the video of my main arteries going into spasm during 2 separate angiograms but it is unclear whether the wire triggered the spasms due to agitation of those arteries or whether it was spontaneous. I have a 8 minute film to watch..... he did say as did his Fellow that one could provoke spasms in the micro vessels but new research showed that to be a little more dangerous than at first thought. I think that is the specialist test sunnie2day is waiting for. Of course in the general "heart patient" community the perceived "danger" would prob relate to those very elderly patients or those with particular co-morbidities. Would you agree ? Is it poss to post videos on here as I could post my LAD and other artery going into spasm.
Many Cardiologists are not familiar with using it and don't like admitting they don't know something.
The recent CorMicA research used acetylcholine with minimal problems.
The European Society of Cardiology in it's consensus document is recommending the use of both adenosine and acetylcholine during an angiogram to assess the function of the coronary blood vessels.
Ask your Cardiologist to look at the links I sent you.
There are several presentations in the webinar if you scroll through you will find a presentation of a patient speaking about getting their diagnosis introduced by Prof Divaka Perera it leads on from Dr Tom Ford's final comment of his presentation.
I'm not suffering and I think that's why the long wait. I'll be at the back of the queue and pushed to the back every time someone else has a real need - my need isn't really even a need the now. I still can't do inclines (stairs, hills, gentle slopes) but then I never could in the first place even before angina - I have Rheumatic Heart Syndrome and a very mild case of rheumatoid arthritis thanks to a childhood bout with rheumatic fever.
I don't experience angina pain at rest - it's only on exertion and then only if I try to do something strenuous without a good warm-up beforehand. If I know I'm going to have to get out of the car for a long walking period (grocery or other shopping, sight-seeing, etc), I take a prophylactic GTN spritz. But, lol, even then I still can't do inclines of any kind without having to stop to rest my knees, catch my breath, and to recover from a spot of angina on the rare occasion the GTN didn't prevent an incline induced angina attack.
I am completely happy to be at the back of the queue - all things considered, let that be a very long wait indeed!
All they will/can do once you have had the tests is find the right meds that are right for you, and if the meds you are on at present are keeping you symptom free then maybe that's why the 2yr wait? I'm in Scotland but as part of a study I got all mine very quickly.
Bingo! My cardiologist said he could 'fast track' me but the meds I'm on now are working so well there's no rush. I'm doing nicely just on the Bisoprolol, aspirin, and GTN spray so we've agreed my diagnosis is 'angina with normal coronaries' and he'll escalate if/when that stops working so well.
Milkfairy, I am sitting on my porch trying to calm down with a modest red wine. I was seething as I watched a grab cyclist riding on the pavement scold a lady with a stroller who did not get out of his way quick enough. I felt my emotions rise and I went into a 10 second chest pain which was short but intense - far worse than a predictable "walk up a hill" energy sapping pain. I was in a very calm state before seeing the incident but as my anger rose, my chest pain evolved intensely. However after a few deep breaths it subsided over 10 seconds or so. May I ask if you can relate to such a scenario as possible Vaso / Vasco / prinzmetal or could it be main CA spasms.. Of course I know you are not a doctor but given your decade of experience and acquired knowledge, may I have a personal opinion. Emotion seems an enormous factor with some Angina. Tks.
Thank you for taking the time to provide your feedback and I am so sorry to read you have had that experience on our Heart Helpline today. Our goal is to provide a high standard of service so I am disappointed to read that was not the case. If you would like to phone back before 5pm today, I will ask that your call is put through to me and hopefully I can provide some help as well as find out more about your feedback. I look forward to speaking with you, Maureen
Lovely to speak with you just now, and hopefully answered your query. I also appreciate you taking the time to provide feedback and I will follow up with the team. Enjoy your visit with your daughter and all the best! Maureen
Thank you so much for answering my questions, you’ve described what is happening and why with my echo, if I’m explained things I can understand, make sense of it and try and accept what’s happening to me.
Also being very understanding and kind.
All of the nurses are amazing and so grateful for what you all do.
Hi FB. Wonderful that you spoke with that helpful nurse from BHF in particular during these awful times. Are nurses available on this forum to assist and if so, how does one get hold of them please. I can't phone as live in Singapore. Tks
My cardiologist sad that during my angiogram there was significant radial artery spasm. He said that even though it is very difficult to test for coronary Artery spasm as the arteries are very small he believed that the degree of spasms during procedure convinced him of the coronary artery spasm diagnosis. He put me on Diltiazem and this has helped enormously. Good luck.
It is possible to test the function of the small vessels for microvascular dysfunction during an angiogram as well as the large coronary arteries for vasomotion disorders.
My vasospastic angina was diagnosed by this type of angiogram. I had spontaneous and acetylcholine induced vasospasms in my small vessels and coronary arteries.
It's good to see your Cardiologist recognise as you experienced spasms in your radial artery in your wrist that your coronary arteries may be effected too.
Yes. I had two stents. It was a long procedure. I was there for four hours. When I came home I was still in pain and felt very discouraged. Now that the Cardiologist has diagnosed coronary artery spasms he has changed my meds and the angina pain has pretty much gone. You really are a fairy but I think more like an angel. I see all the wonderful things you do for people. ❤️❤️
Hi Sunshinebrew I have discussed CAS with them...and they were very knowledgable. I think you have just got the wrong nurse and would suggest you try again. I asked about spasms in relation to Cov 19 and the risk level. She took the question up into a meeting and they now have inserted a paragraph in their cov19 angina page to say we are at high risk. I was very impressed. I hope you get the answer to your question...do try again.
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