Diagnosed with MVA, eventually, after all the usual frustrations of being made to feel a total fraud since nothing was found through numerous painful ‘attacks’ and the usual ECGs and angiogram. At 62 and previously a very fit male, I’m very thankful to the cardiologist who suspected MVA and put me on seemingly the right path to a less painful time. I have been very happy and good on the three drugs, listed above, that we eventually settled on, but I have had two very severe attacks in the last two weeks.
My episodes have started again after having several months with very little serious chest pain and my cardiologist is suggesting the addition of the IM (30 twice a day). Will this not replicate the work of the Ranolazine? Heard some very mixed reviews about taking the IM so I am a little worried.
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There are a few of us on the forum who live with Microvascular and / or vasospastic angina.
Have you had an angiogram to test the function of your blood vessels?
The usual way is with a guide wire and adenosine.
It's important to know the cause of your Microvascular angina either Microvascular dysfunction or vasospasms.
The treatment options are different.
There has been alot research since I was diagnosed with coronary vasospastic angina 9 years ago.
Isosorbide mononitrate nitrate is a medication that those of us living with coronary vasospasms can't live without along with Calcium Channel blockers.
It relaxes your blood vessels it works in a different way to Ranolazine which has mixed results for some people.
It gives you a headache at first but this wears off over a couple of weeks.
I suggest you keep a diary of your symptoms, slowly add your tablet at night at first, then add the second a week or so after.
If it doesn't help there are alternatives.
The BHF has this information about Microvascular and vasospastic angina.
Thank you so very much for responding so quickly and also for being so helpful on this site. It is very much appreciated and reassuring for those of us who are seemingly adrift in resolving the pain in which we find ourselves.
My diagnosis has been very much a process of elimination carried out by the cardiologist: Following increased bouts of chest pain I was diagnosed with angina and given medication; sadly pains continued and prescribed Ranolizine and then Amlodipine with some good success, although GTN spray not really very impactful; eventually referred through for angiogram in June 2019 (all clear and positive tubes, although some possible spasm detected due to irregular entrance of tube into top of heart.)
Pains continued at random intervals so MRI scan (July 2020) with right ventricle dilated with hypokinesia of the inferior wall, resulting in double contrast echo to query possible shunt which proved to be ok. Concerns raised over bradycardia because heart rates of between 39 - 42 regularly recorded following reported just pain. Diagnosis of Microvascular angina/coronary artery spasm given.
All has been good with just occasional bouts of pain, self-managed by aspirin, paracetamol, GTN spray and rest for several months until 2 very recent serious episodes/attacks resulting in 999 calls. Now cardiologist suggests taking Chemydur on top of everything else.
Sorry to ramble but good to clarify things for myself, I guess. Thank you again for your good advice and links.
Hi there. Yes waiting for a final diagnosis is very frustrating and angst provoking. For a long time I thought I had MVA as I didnt respond to the GTN spray.Anyway after a cardiac MRI last year, I was diagnosed with HCM Hypertrophic Cardiomyopathy, an inherited heart disease.
I was put on a whole host of medications, take 11 every morning - including IM to which you were referring.
Some say they have experienced headaches when the start them.
For what it's worth, I didnt have headaches, or any other side effects from them.
Thank you for taking the time to forward me your experience of IM - I’ve read so many stories of people really suffering from starting on it, I was genuinely very anxious about taking yet another drug and how it would negatively impact on the body.3
From always being very healthy and fit, I became very ill when I was first diagnosed with “angina” and given the initial cocktail of various drugs: that awful experience has made me quite anxious about what I take.
Hi. I don't have MVA, but had a silent heart attack 3 years ago which presented as severe gastric problems. I had 2 stents and an ICD. Over the next year I had several more bouts of "gastric problems"with slightly raised troponin levels which indicated heart distress. After the last bout I ended up being kept in hospital CCU for 24 hours and the cardiologist prescribed IM. I haven't had any severe problems since then, and no side effects from the IM.
Thank you for sharing your experience, Alison - very kind of you to take the time.I’m thinking I will give the IM a go and see how my body copes with it. It has to be better than the ups and, increasingly more frequent, downs I am having at the moment.
I’m pleased to hear that things have very much brightened and settled for you. Thank you.
Hi. Sorry to hear about your issues with your MVA. I am on the same meds as you plus ivabradine and I also take IM three times a day as well as using the spray - my doctor and cardiologist stressed tablets were not instead of spray and vice versa but should be used on back of each other. The other meds are targeting others issues as well as overlapping bits of each other. I don’t have problems with side effects as such - other than weight gain! The IM seem to help reduce number of attacks during the day for me but I definitely need spray during night and on waking still. Also occasionally during day. It’s a minefield getting these meds right. I personally would say it’s worth trying. Good luck
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