I knew I shouldn’t have got my hopes up for this angina snd spasms to go !!!
I think I’m being a bit dramatic as I think it seems better day to day (shouldn’t say that either !!!) but as I felt a bit better I’ve done more ..... mistake... with that and a lot of other stress going on, it’s a double whammy.
Fingers crossed for a better day tomorrow 😃
I think MVA and VA (microvascular angina, vasospastic angina) are such complicated conditions that learning to live with one or both is a constant learning curve. You're 'doing it right', Fluffybee, to recognise that and to understand feeling better doesn't translate automatically to doing more physically.
Looking forward to reading Milkfairy's reply to you here.
All my best wishes from Singapore FB. I am also excited for you to have a good outcome.
Hi Fluffybee
One of the biggest challenges I face even after 8 years is learning to pace.
Microvascular and vasospastic can be very unpredictable and it can be very difficult at times to navigate your way through.
I am still really bad at this. When I feel well especially in the warm weather it is very tempting to live a little and do too much.
Sometimes I just do it however I know I'll get more pain as a result later.
Sometimes I will get angina for no reason at all!
There is a technique that is used for managing any chronic health condition called the Spoon theory.
Here's a link it may help you with pacing your activity. I often use all my spoons up too quickly too soon in the day and then I am floored and in pain in the night.
Be kind to yourself and yes it is 2 steps forward one step back living with any long term condition .
Sounds familiar
Easy to say you have to learn to manage the condition and listen to your body know your triggers etc but not so easy to actually do
Very challenging condition but you always sound so positive so good for you 👍
Yea it’s mad. I can do an hour high intensity cardio on the cross trainer followed by a 30 weight circuit then a further 30 minutes swimming and feel fantastic. Then later on that day have serious chest pain doing the washing up 🙄
Wow that’s going some, I could do that a while back but not now, brilliant you can, and be really fit to get you through the unwell times.
It’s really bizarre how it behaves, you’d think you’d have pain during it straight after that workout.
I hate the unpredictability of it, so frustrating isn’t it ? 😊
It is, and I’ve had some epic battles with cardiologist’s over it. It seems only a few experts cardiologists understand that exercise is not necessarily an automatic trigger for VA, however it’s does have a rebound effect, hence the pain when washing up. My numero uno trigger without a shadow of a doubt is stress, even a teaspoon of it 🥴
Also, I’m convinced a added extra of VA is the aftershock, if you like.... is a good dose of costrocondritis just for good measure
Oh my goodness stress is a massive factor with me to.
Agreed on the lack of cardiologists having good or any knowledge of VA and or MVA.
If they don’t I feel very dismissed and come back in a few months if you’re lucky!!!!
Trouble is I take it all in what the Dr’s say when I don’t know they’re unaware, like he said VA isn’t dangerous, nothing to worry about !!!!
It’s only when I posted his comments on here that Milkfairy told me how serious it can be.
Worrying to think he’s telling patients that.
The paramedic who came last time I went to hospital who was about to retire, said he’d only come across it once in his whole career, so think it must be an uncommon condition, there’s not much information to read about it is there !!!
I kinda of think it’s very common, it’s just some folk don’t notice or have distinctive symptoms. At cardiac rehab a cardiac nurse ( 30 years applying her trade) knew all about spasms and even classified me as “ oh your one of them” are you. I feel quite honoured ☺️, then I started getting chest pain sitting down because I felt emotion
That’s true, there’s probably a lot of people with it but as some don’t know of the condition and symptoms it’s not diagnosed very often.
I was told when I was actually having my angiogram done that my arteries are clear so there’s nothing is wrong !!!!
Fluffybee
When I had my first angiogram nearly 10 years ago I had chest pain.
The doctor said ' no that's not possible your coronary arteries are clear '
When I had my angiogram with acetylcholine I told them I had chest pain. ' yes the Cardiologist said and I know why your arteries are in spasm and your ECG is showing ST elevations'
It's all about educating our Cardiolgists 😊
Is it just luck having the angiogram while you’re having a spasm.
The wonderful BHF nurses were saying the ultrasound scan I had showing my heart not getting a blood flow or not squeezing was most likely the spasm causing it, with that and the ECG with significant Q eaves, bradycardia and borderline QT syndrome, put together she (Maureen) said it was lucky it was caught. !!
No it wasn't luck my spasms were deliberately provoked with the acetylcholine.
Normal blood vessels should dilate however if you have vasospastic angina they go into spasm.
Catching a vasospasm can be like catching a wil' n the wisp otherwise. The nurses now go chasing my spasms when I am in hospital by doing consecutive ECGs during my chest pain episodes.
It's great to hear that Maureen was able to explain everything to you.
When I finally get my letter. From my cardiologist I’m going to enquire about the test, even though the Dr I spoke to didn’t want me to be put through any more tests, not sure that’s good or bad!! I’ll see what my actual consultant says.
Thank you as always, very reassuring, knowledgeable and kind 😊
Acetylcholine doesn't always show spasms... maybe that's why your cardio is reluctant. I had it done and similar in MRI no spasms but had similar to previous heart attack pain all throughout it. Was told it was probably false negative. For stress and if causes by personal issues in your life try a book called The Four Agreements it takes a bit of work but has helped me enormously stress wise. I can now just bat things away. Not chest pain though 🥺
Hi Fluffy, I was diagnosed with MVD 3 weeks ago and I'm slowly learning how much I can and can't do and have good days and bad days. I'm still learning regarding the condition, I've learned to take things slowly and see how I feel afterwards. For the next time.
Last night I went for a walk with my wife, I'm use to a mile at the minute but she made it 2 mile, I got home and within 45 mins I had on energy a couple of dull aches and went to bed, this morning i still feel drained.
In work and doing things slowly.
It's wierd how quickly my stamina has changed since this all kicked off, I was pretty active but now feel like a beginner.
But getting used to knowing what we can and can't do is gonna take time. Don't give up on the things your missing, we just have to find new ways of doing them.
I've not really had a chance to talk to anyone who has the condition and have aches and pains all the time, read a lot online and need to catch up with my cardiac nurse to answer a few questions. But if I can help in anyway feel free to give me a shout
Thank you so much MrFox68
It’s nice in a good way that there’s someone else on here ( there are a few of us) Milkfairy is very knowledgeable.
I started getting symptoms of things weren’t right just before Xmas, I was then diagnosed about 3 ish months ago.
I’m struggling with what my limits ar, if I feel good I want to go so much and catch up on the things I haven’t had the chance to do while I felt bad.
I went out yesterday to see a friend I haven’t seen for ages, really looking forward to it even though I had a feeling things weren’t great.
Had a lovely time but oh my goodness did I pay for it big time when I got home, I think I’d say it’s the most concerned I’ve been, the pain and heavy feeling, down both arms were just awful.
Quite an achy chest today just sitting here.
I agree life has changed and so quickly, I was walking my dog twice a day biking miles, home from work and straight into something else, hardly ever sat down, now that’s what I seem to do most 😢
What tests have you had done ?
My history starts 3 years ago with blood clots in my lungs and an irregular heartbeat, which stopped when I was put on Rivaroxaban.
But a year later started with different symptoms and they couldnt trace the cause.
Then in April started with a chest pain that felt like a rugby team was sitting on me, I was taken to hospital and from there prescribed GTN spray while waiting for tests, an echo and angiogram. While waiting to hear for dates my chest pain was getting more regular.
I rang my cardiac nurse to ask a few questions and told her it was getting worse. She said can you come tomorrow morning 11:50 we've had a cancellation. I went for an echo, which finished, nothing was said to me but the nurse scanning me left the room, I was then asked if they could do an ECG and bloods. I was asked if I could wait as they were waiting for the specialist to check my results. Once that was done they, I was told my lower left ventricle wasn't working correctly and wanted to admit me as a patient and wouldn't let me leave. Had to be put into a cubicle and have a Covid test and was kept in and monitored, they changed medication so the could do an angiogram 3 days later, I believe an angiogram usually takes 30 mins, I was in an hour and 10.
Apparently the cardiologist tested everything and was diagnosed with MVD.
I'm now take Rivaroxaban, Lanzoprazole, Bisoprolol, Ramipril, Amlodipine, Atorvastatin and always carry GTN spray.
To be honest, I'm still scared shitless a lot of the time as I don't know what's gonna happen next.
Like you I was active, ran, cycled and swam twice a week and walks with my wife.
Now I struggle, but just starting to do walks again, slowly and not far.
Hi McFox68
I acknowledge that sense of bewilderment we all feel when we are first diagnosed with the condition.
My diagnosis took sometime and more is now know about Microvascular dysfunction and vasospastic angina.
I agree it can be very frightening however as human beings we are very resilient.
With time you do learn to find your way. I had great help from a Pain Management programme which is were I was learnt about the Spoon theory.
Managing stress is really important too. Again you need to fi d what works best for you.
I find Tai chi, meditation and Yoga helps me.
Be kind and patient with yourself.
I to have started meditation, would love to try Tai Chi, I need to see if there's anywhere local to me.
It's nice to know there are knowledgeable people like yourself willing to share what they've learned.
Thx MilkFairy
Wait, MVD?? Oh no, I just got used to the idea of MVA!
Half-joking aside, is there a difference between the two?
Yea, but I’ll let MF explain coz it’s a tricky one 🥴
Microvascular dysfunction is when the small blood vessels are unable to dilate in response to exercise.
aka MVA
Spasms in the small vessels causing pain at rest or on exertion.
aka MVA.
So both disorders of the small blood vessels not functioning as they should causing the symptoms of MVA.
Vasospastic angina spasms in the large coronary vessels
Some people have vasospasms in their small and large coronary blood vessels.
Whatever it hurts!
I will be testing you all later😉
Oh so there actually the same thing then ?
See BHF information leaflet on MVA
bhf.org.uk/informationsuppo...
It describes MVA
' when your heart needs more blood to work such as during exercise or you are stressed, the small blood vessels might not be able to expand enough to allow more blood towards the heart muscle. (microvascular dysfunction)
Or these blood vessels may tighten ( spasm) limiting the supply of blood. (microvascular spasms)
Both these different causes of a lack of blood flow to heart leads to microvascular angina .
Hi Milkfairy
As you know my cardiologist says I have MVA and coronary vessel spasms.
Ive read as much as I think I can find but if you have time I wandered if you could explain it to me in English (there’s so many articles that speak Dr language) what you’ve learnt so I can understand what’s actually happening. Thank you
Hi Fluffybee
I suggest you read the BHF information on their website. I would just concentrate on this information for now. I agree with you it would be great if doctors could write a plain English summary of their clinic letters and research!
bhf.org.uk/informationsuppo...
bhf.org.uk/informationsuppo...
At the beginning of this article is an animation which illustrates Microvascular and vasospastic angina.
bhf.org.uk/informationsuppo....
Maybe just having this one source of reliable information may help you best.
Thank you Milkfairy,
Its because I need more information and there isn’t much reliable info to read.
Like you say the BHF site is very good, tells you in straightforward language.
When I had my original consultation with my own cardiologist I asked when he writes his letter and copies me in could it be easier for me to understand as I don’t know all the abbreviations and medical terms.
He was brilliant and did just that, another medical professional who has no relation to cardiology said ‘I wish my letters were worded like that, would make life so much easier’
Not just me then !!!!!
Thank-you, and thank-you for the links you posted for Boo and FB also. I really do love this forum, I honestly learn something new nearly every day.
Thank-you again!
Forgot to add this to my first reply - to be clear in my Bisoprolol fogged brain, MVD refers to both MVA and VA, and then the MVA and VA refer to two different not necessarily concurrent conditions both caused by MVD?
Note to self - need more tea!
Angina is a description of the symptoms that occur when there is a lack of blood supply to the heart- myocardial ischaemia.
The usual cause a build up of plaque causing permanent blockages.
Microvascular angina can be caused by Microvascular dysfunction OR vasospasms in the small vessels both cause a lack of blood supply to the heart the mechanism is different the symptoms Microvascular angina the same.
Vasospastic angina is not caused by MVD it is a disorder of the larger blood vessels the coronary arteries though some people have vasospasms in both their small and large blood vessels. MVA and VA
One theory is that it is due to the inner lining of the blood vessels not producing the chemicals that dilate blood vessels. Endothelial dysfunction.
Beta blockers tend to help those with microvascular angina caused by microvascular dysfunction.
While those living with MVA caused by vasospasms or have vasospasms in their coronary arteries VA, beta blockers can increase the vasospasms.
It is nearly 30oC here in London already.....🌞
Thank-you again - I feel certain I understand at least 75% of your explanation. Especially the part about MVA caused by MVD can be helped with beta blockers - I'm on Bisoprolol 1.25mg+300mg aspirin (and a GTN spritz as needed which isn't often) and it has made a huge difference for me even during an acute flare of pericarditis.
We're much cooler up here, lol - had a bit of a heat wave, we actually got to 22C!
Hi
I had a heart attack a year ago and for the last month I’ve been experiencing palpitations and I’ve been put on medication for angina and I’m
42 years old. I struggle with stress a lot now due to feeling so uncertain about the future but I try and enjoy each day and try not to worry as hard as it is
If I can help please let me know
This has been really comforting to read- thank you. Between you you describe exactly what I’m going through.
My Cardiologist is settled on it being MVA, but still waiting for the new equipment to arrive to do the tests. He does keep saying that tiredness is not a heart symptom, which seems nonsense though.
For the moment we describe it as ‘one of the microvascular problems’ since there is overlap and confusion (it seems).
I’m off to buy some spoons.....
😂😂😂😂 I’m going to get some as well, thank you so much for replying, I think we’re all in the same boat with Dr’s and consultants.
Let us know how things go for you, take care with those spoons, each and everyone is special 😂😂 xxx
What’s the spoon to flight of stair conversion rate? Bearing in mind I always have to up twice because I’ve forgotten what I went for!
You have to keep 😂 😂😂😂....😥
I wondered if silver spoons last longer?
🥄🥄🥄🥄🥄
I can only talk from my own personal experience of the last 12 months and I’ve gone from being in the best shape I’ve ever been. Going the gym 5/6 days a week and running for a hour and weights for sometimes another. To now I can sleep 20 hours a day and even just a slow pace walking uphill absolutely knocks me sideways. Mine is definitely heart related but hey, doctors always know best 👍🏻
Hi FB,
Apologies only saw this this morning!
I'm struggling to function properly at the moment too. So frustrating 😒 and feel pretty lousy and to top it all my ankles are swelling up too but think this is due to the diltiazem tablets.
Like you two steps forward and half a dozen back!
Spoke to GP for our 'catch up' she is going back to cardiologist for advice.
I seem to have the same cardiologist as you though - nothing to worry about it's not your heart! Easy for him to say but when you're struggling to function doing what should be the simplest of tasks like washing up/hoovering/hanging out washing that brings it on - not so easy!! Especially if you've had some restless nights to boot.
Heyho hopefully some better days to come 😊
Hi Dauris
I know exactly what you mean, I had a bit of a panic just now and thought, what if the worst happens!!!!! I know it’s the tests coming up that’s probably started it but makes you feel very vulnerable.
I know I hide behind laughing and having a good time but underneath I’m feeling terrible and anxious, to be honest pretty frightened.
Just need to have a good talk to myself and think myself lucky. !!!
Ticagrelor due to be stopped soon.
Heart Bypass Soon
Exercise
cardiologist appointment soon but now with extra things to tell.? 
