How is microvascular angina diagnosed ?

[Snowboarder66]

I've heard there is a trial going on where they insert a fine wire to detect different readings but it's experimental and only available in a few places. So how do the rest of us get diagnosed with it ? I've read that in women especially it's very much undiagnosed and was actually told the other day that it's possibly something cardiologists make up because they can't find a cause for unexplained chest pain ! Thanks in advance

[Milkfairy Heart Star]

Hello Snowboarder66

Microvascular and vasospastic angina are both often overlooked and under recognised conditions.

Both conditions certainly are an accepted cause of angina without permanent

narrowing of the coronary arteries.

Microvascular dysfunction can be diagnosed using a guidewire and adenosine during an angiogram.

These techniques are used already by Interventional Cardiologists during an angiogram to assess the coronary flow reserve CFR and index of microvascular resistance IMR of the blood flow in the heart.

To assess for vasospasms acetylcholine is injected into the coronary arteries. Normal arteries should dilate in response to acetylcholine. If there are temporary constrictions of the coronary arteries then vasospastic angina is diagnosed.

For full details see this recent consensus document.

academic.oup.com/eurheartj/...

You may need to travel but I suggest you ask your GP to refer you to Cardiologist involved in one of these trials.

kclpure.kcl.ac.uk/portal/en...

clinicaltrials.gov/ct2/show...

[bantam12]

I was diagnosed with MVA after an angiogram.

[Hidden]

I was diagnosed after having the test described by milk fairy during my last angiogram. Just before the procedure started the cardiologist asked for my permission to perform this challenge test. I think they basically create similar chest pain you experience by challenging your heart using the injected chemical. It certainly worked on me!

[monotone]

Hi there,

All my main arteries appeared clear in the the various tests I went through when I started having chest pains. The cardiologist then made the assumption that It has to be MVA. However, no particular tests were done for MVA. I guess he came to that conclusion through a process of elimination.

Milkfairy is very knowledgeable about MVA. I've been reading her replies and learning from them. Thank you, Milkfairy.

I asked my GP to put me in touch with a cardiologist who has a special interest in MVA and his answer was that he didn't know of any who did!