Hi I posted on here almost 3 years ago, but stopped after being dismissed by cardiac consultant. I've continued to have angina type pains so have requested a referral to different doctor and specifically an acetylcholine test as on treadmill test I didn't get any pain!
Should add I'm a 53 year old post menapausal woman
My question is what should I go to New Dr armed with as evidence of my requirements? Many thanks
Hello WIgranny
Only a few centres in the UK carry out angiograms with acetylcholine.
Perhaps ask your Cardiologist to refer you to one of the centres carrying out research into Microvascular and vasospastic angina.
There is a trial at St Thomas's hospital London looking at ways to diagnose microvascular disease.
There is also the PRIZE trial which is a possible treatment for Microvascular angina.
clinicaltrials.gov/ct2/show...
Also the European Association of Percutaneous interventions published this recently. A document with recommended diagnosis and treatment pathways for Microvascular and vasospastic angina.
There was a very interesting article in the Times on Tuesday in their health section, written by John Naish. It is entitled 'Warning ! Don't miss the signs of a heart problem', with a subtitle 'New research shows how often cardiac conditions go undiagnosed among female patients. They needn't - here are risk factors to watch'.
The article goes on to look initially at recent research that showed that 45% of men had their condition correctly diagnosed, compared to 39% of women. The article goes on to look at differing symptoms in men and women , which are not commonly recognised by doctors looking for Male type symptoms.
The article also has a sub heading 'The test to ask for', which goes on to discuss work done by Dr Angela Mass, Radboud University in the Netherlands in which she looks at women and men developing different types of symptoms and that these can be less clear cut in women. The drug acetylcholine is used to test for arterial angina spasms specifically for women.
Another sub heading deals with blood pressure, especially 'the one size fits all' and suggests that guidelines need to be lower for women. Interestingly it proposes 'The taller you are the higher your blood pressure needs to be to get the blood to your head', and vice versa, with research sources to back the proposal.
Finally 'The role of Hormones'
Premenopausal women who suffer migraines are also highly likely to develop cardiovascular disease later. After menopause hormonal changes strip out any protection and women's heart attack risk becomes similar to men.
It is a very interesting article and I have attempted to summarise it . Hopefully you will find it useful and be able to discuss the findings with your Doctor, who will probably find it absolutely enchanting.
Hi Lancs2
Thanks for posting.
It was a great article.
My coronary vasospastic angina was diagnosed using acetylcholine during an angiogram in 2014.
Unfortunately there are still very few places in the UK that perform this type of angiogram.
Cardiologists still don't know enough about how to recognise, diagnose and treat Microvascular dysfunction and vasospastic angina.
Here's the original reseach that the article is based on.
escardio.org/The-ESC/Press-...
Prof Angela Maas is a fantastic advocate for women's heart disease she is one of the many supporters of a newly formed patient group.
Thanks for replying I'll read up on the other articles and links Have an ECG and blood tests tomorrow at GPs prior to hospital appt
would you go for a second opinion in my shoes?
Getting back up again, sometimes it’s an effort 
Going back through it again - error!
Polite Request Please
confused after cardiologist visit different opinions 
