Heart attack/angina with normal BNP/CRP?

[April_May]

Is it possible to have had a heart attack or angina episode but have normal CRP and BNP levels? Troponin and CK were not tested. I would have sworn absolutely blind that was what was happening, hit me from nowhere whilst working out hard, couldn’t breathe, sweating, radiating incredible chest pain that felt like it lasted forever. Like nothing I’ve ever experienced. Couldn’t get to a hospital so didn’t get blood tests til 12 hours later. GP didn’t do ECG or troponin test but CRP and BNP normal so I’m assuming it can’t have been heart attack or angina?

[Milkfairy Heart Star]

Hi April_May

Without an ECG being performed or troponin blood levels being taken it's not really possible to say way you experienced your chest pain.

CRP is a blood test to detect infection and inflammation

BNF is to test the function of your heart muscle.

I suggest you give the BHF helpline a call and speak to one of the Cardiac nurses for further advice.

[Phil_London in reply to Milkfairy]

Bi, how long ago was this, hospitals and A&E take this very serious and even after the event from my exleriance it takes a few days for troponin levels to go down to normal and as such, I would head for A&E explain, for get the GP (I would have assumed they would have sent you to A&E as mine did even with elevated BP after chest pain, o messing around just, go to A& E now was my advise which I took. if your still within days, and it was that bad pain youw ill still have elevated troponin levels, I would go now and get it checked.

[April_May in reply to Phil_London]

It’s 2 weeks now unfortunately. I was booked for blood tests anyway the day after it happened as I had been complaining that my shortness of breath wasn’t getting any better. So when I went in for the blood draw I told the tech what had happened, and she told the GP. He then told me there wasn’t anything he could do 12 hours after the event, that I was already having bloods done so he didn’t need to do anything extra. And that if it had been that bad I would have gone to hospital. I had a cardiac MRI 14 months ago and it didn’t show much so he said he was confident it was anxiety or a pulled muscle.

I requested the test results and finally got them yesterday. They were all normal but they didn’t cover most of the cardiac markers, no troponin or d dimer or CK or myoglobin. It did test BNP and CRP which were both normal. The rest of the results were full blood count, bone profile, liver and thyroid. I think the diet of things you get when complaining of fatigue.

[Phil_London in reply to April_May]

So the MRI didn't show any narrowing and your not any heart meds or under a cardiologist? I have had a lot of anxiety pre and post HA and although now much less, I thought I had bad anxiety but nothing than knocked me like you had. sorry little more most of us can say, I think they were still watching my troponin drop 2 weeks latter (I think it was that long) and I caught my event on time and had only low troponin leak, It might be cheating the system but if your that concerned (short of paying for your own blood test) go to A& E and explain your still getting out of breath, chest discomfort, the first check they do is a troponin test as well as other bloods. Have they done a heart echo cardiogram? to see if you have any muscle damage after the event, sorry these are just my experiances and checks I know they did for me so I am sorry but I am unable to help any further.

[April_May in reply to Phil_London]

No that’s really kind of you to reply, thank you. I know people only gave their own experiences to go by. If it does happen again (I hope not!) I will bypass and go to A&E. I’m on 2.5mg bisoprolol but only because they didn’t really have any other ideas so I’m no longer under a cardiologist. The MRI and echo showed some dilation of right atrium and slightly low right side EF and slightly low cardiac output, but only slightly so they said not enough to cause my issues.

[April_May in reply to April_May]

I’m pretty lucky that it doesn’t cause me much anxiety, more frustration that I want to crack on and do more but always feel limited. I try to run and work out but it’s all a big effort.

[April_May in reply to Milkfairy]

Thank you. I did just that. They also thought troponin should have been run. Think GP thought if it was HA or angina I wouldn’t be up and looking ok 12 hours later. I’ll admit I don’t want to feel like that again. I’ve had minor chest pain and shortness of breath for two years now, with nothing but a bit of atrial dilation to show, but this latest event was plain scary and hit me from nowhere.

[Milkfairy Heart Star in reply to April_May]

I agree with Garden Red change your GP!

I live with vasospastic angina and experience debilitating chest pain when a severe coronary vasospasm occurs. I agree it's very scary. I end up in hospital with unstable angina about once a year.

I suggest you always go to A&E in future and you ask for your chest pain to be more fully investigated.

I hope everything settles down for you and you feel more at ease soon.

[April_May in reply to Milkfairy]

I will definitely be off to A&E if it happens again. I don’t feel mega stressed about it but equally I definitely don’t want that to happen again! I assume your angina showed on MRI? It sounds miserable. From what I remember, micro vascular angina can be set off my emotional stress as well as physical right? Must make it a challenge to be cool as a cucumber at all times!

[Milkfairy Heart Star in reply to April_May]

I live with vasospastic angina so all my coronary blood vessels go into spasms not just the small vessels.

My cardiac MRI was normal as my small blood vessels can dilate. I don't have Microvascular angina caused by Microvascular dysfunction as I can exercise and I get my chest pain at rest in response to my stressors later or sometimes just out of the blue!

My vasospastic angina was diagnosed by a specialized angiogram which used a chemical to provoke my vasospasms.

Like most people with angina whatever type I am affected by the cold, emotional and mental stress.

I am working on my Zen like calm🧘‍♀️

Stay well, stay safe, and stay calm 😊

[April_May in reply to Milkfairy]

Ah okay. When you have blood tests done do they show anything that would indicate you had this problem? Do you know what causes the vasospastic angina? Is it a genetic thing?

[Milkfairy Heart Star in reply to April_May]

When I go into hospital I have had ST elevations, depressions and T wave inversions on my ECGs.My troponin levels are raised but not enough to show I have permanent heart muscle damage.

One acute admission to CCU was due to being prescribed beta blockers which are contraindicated if you have vasospastic angina.

It was my angiogram with acetylcholine that confirmed my diagnosis.

The theory is that vasospastic angina is caused by the inner lining of the blood vessels not working properly endothelial dysfunction.

The BHF has this information

bhf.org.uk/informationsuppo...

I have been fortunate as I have had input into my care by some of the world leading experts into vasospastic and Microvascular angina.

Both are very complex conditions however the awareness of the conditions are growing.

I would ask to be reviewed again by a Cardiologist.

[GardenRed]

Change your GP

[April_May in reply to GardenRed]

I don’t think ill see that particular one again.