Microvascular angina

[Goldenheart]

Hi all, has anyone experienced this, that there spasms are intermittent, really frustrating dealing with this. As in some days i can use stairs quite normally, whereas yesterday i had an episode of sudden weakness and light headedness. Took an ecg and the pattern very irregular. Ive had a few similiar episodes,which im also wondering,could the meds be triggering this,,,tildiem 300mg. ..?

[Milkfairy Heart Star]

Hi Goldenheart

My vasospastic angina can be very unpredictable.

Some days I'm fine others not.

If I am a very tired or physically done too much one day I will get more frequent and severe pain in the next few days.

If it doesn't settle I suggest you contact your GP or Cardiologist.

Calcium channel blockers such as Diltiaziem are the unusual medication for Microvascular angina caused by spasm and vasospastic angina.

[Goldenheart in reply to Milkfairy]

Hi milkfairy, thankyou for replying. I have tried to push my dctr, after a 15 month wait,but still waiting. I ve read on here, aswell as from your good self, that tge above meds are the norm. And others experiences with spasms. But never heard of anyone with episodes of the strange weak sensation i experience,which can make me very light headed. Just curious to know,is this symptom typical of either spasms. Of which im being treated for a presumed diagnosis of coronary spasm at the moment. Many thanks.

[Milkfairy Heart Star in reply to Goldenheart]

I do also have neurological symptoms.

I have been seen by a Neurologist and he and my Cardiologist feel this is all related to my vasospasms throughtout my body.

I am really sorry that you are struggling so much to access the care you need.

[Goldenheart in reply to Milkfairy]

Thankyou for your kind words milkfairy. X

[Squash1961 in reply to Milkfairy]

Hi Mikefairy and Goldenheart

I am still trying to work out whether my chest and upper stomach aches (in most days in the evening when at rest not during exercise) are due to non obstructive heart disease, (ie: MV or vasospastic angina) or just the side effects of the post HA drugs. The angiogram I had a few weeks ago confirmed no stenosis is any of the Coronary Arteries. I’d be interested to hear how they diagnosed your Vasospastic angina??

Thanks

Squash

[Squash1961 in reply to Squash1961]

Hi again Milkfairy

I was also wondering can a HA and 2 stents in my RCA then be the cause of MV or VS angina?? Would seem a co-incidence to suddenly develop these conditions independently??

Thanks

Squash

[Milkfairy Heart Star in reply to Squash1961]

Hi Squash

I had an angiogram with acetylcholine.

When acetylcholine is injected into normal functioning blood vessels they should dilate.

Mine went into vasospasms in my coronary arteries and small blood vessels.

Microvascular dysfunction which can cause microvascular angina can also be diagnosed during an angiogram too.

Some patients actually have both obstructive disease and MVA or vasospastic angina.

The stents treat the obstructions but not the MVA and vasospastic angina

You may find this article from the BHF website interesting

bhf.org.uk/informationsuppo...

[Squash1961 in reply to Milkfairy]

Thanks for the feedback Milkfairy much appreciated. I have read about the acetylcholine challenge test and a PET scan as being used to diagnose MV dysfunction. I’ve been given GTN which I haven’t used as yet, since the aches are not too painful, I should give this a go but I’m not sure it would confirm whether I have MV or Vasospastic angina, Since it might just simply dilate all blood vessels and relieve the aches, just like when I exercise!

The article was interesting, it shows that you can have a complete main arterial blockage due to atherosclerosis as well as micro vascular dysfunction. I’m seeing my Cardiologist in December but I might try and see him sooner. Not sure that I want another Angiogram just yet. Calcium channel blockers are also a popular treatment. I don’t think it’s GI related since never had any reflux or acid stomach problems in the past. Anyway, I’ll keep looking for the answers.

So as well has having MV dysfunction did you also have an HA and stents in your main coronary arteries??

Thanks again

Squash

[Milkfairy Heart Star in reply to Squash1961]

I have no blockages in my arteries.

My problem is vasospastic angina not microvascular dysfunction.

I can exercise but get angina at rest along with neurological symptoms due to spasms in the blood vessels in my brain.

Microvascular dysfunction is a distinct condition from Vasospastic angina though some people do have both.

Adenosine and a guide wire are used during an angiogram to diagnose microvascular dysfunction.

Acetylcholine just detects vasospasms not microvascular dysfunction.

Here's the latest consensus document by the Europen Association of Interventional Cardioligists.

See figures 4 and 5

eurointervention.pcronline....

[Squash1961 in reply to Milkfairy]

Thanks Milkfairy, I’ll need some time to read through that one! So if you get aches and pain at rest and not during exercise it’s more likely to be Vascospastic angina and not MVD perhaps??

[Milkfairy Heart Star in reply to Squash1961]

Not necessarily so.

Some people with Microvascular angina also get pain at rest and or exercise.

[Squash1961 in reply to Milkfairy]

Ok thanks, I need to do some more research !

[Squash1961 in reply to Milkfairy]

Hi Milkfairy

With your vasospastic angina, do you have acute short episodes or dull pain that can persist all day? I ask since I am having the dull pain in the chest that can last all day. I am not getting sharp, short classic angina attacks??

Thanks

Squash

[Milkfairy Heart Star in reply to Squash1961]

I experience all sorts of different pain.

My angiogram with acetylcholine showed I have vasospasms in my small blood vessels as well as coronary arteries.

I have prolonged episodes of chest pain which grown in strength and length overtime in clusters

After an episode of cluster pain I feel an imprint of pain a dull ache in my chest as though my heart has been bruised.

However this my individual experience.

I suggest you talk to your Cardiologist and ask for a full assessment of your symptoms.

[Squash1961 in reply to Milkfairy]

Thanks for the feedback Milkfairy, dealing with your symptoms must be tough. I’ll try and get an earlier appointment with my Cardiologist. Hope you have a good day

Regards

Squash

[Goldenheart in reply to Squash1961]

Hi, mine is a presumed diagnosis. I had symptoms of a heart attack twice,bad episodes that led to an ambulance being called. Plus chest pain and breathlessness on exertion. Had a cat scan of the heart,which showed no blockage,just a tiny speck apparently. My cardio told me they dont perform a test for prinzmetal angina anymore, which im unsure of,as others seem to have had this.

[Squash1961 in reply to Goldenheart]

Thanks for the reply Goldenheart. It’s a shame you can’t get a definitive test. Knowing what the disease actually was would certainly help me mentally and then knowing that I was getting the right treatment.

[Goldenheart in reply to Squash1961]

Hi, i totally agree with you, ive been living with this presumed diagnosis for over two years now,and mentaly its a huge struggle, ,,i think naturally we all fear the unknown.

[Squash1961 in reply to Goldenheart]

Absolutely. It’s only been 6 months for me and it is very much the fear of the unknown. Knowing the problem is a first step in managing and accepting.

[Milkfairy Heart Star in reply to Goldenheart]

They perform angiograms with acetylcholine in several centres in the UK

[Goldenheart in reply to Milkfairy]

Hi milkfairy, its getting my cardio to concede to letting me have it thats the issue. I did mention this to him.he very abruptly said no, he wouldnt agree to me seeing a spasm specialist. And that he considerd the test too dangerous now.

[Milkfairy Heart Star in reply to Goldenheart]

There is a team at St Thomas London and Golden Jubilee Glasgow who perform angiograms with acetylcholine without problems.

[Goldenheart in reply to Milkfairy]

Thankyou. Sorry for the delayed reply, ive just mo ved home. X