Back in 2018 I was diagnosed with Microvascular Angina through MRI Cardiac Perfusion scan. I have breathlessness on exertion on a daily basis, but not quite sure if this is solely related to cardiac issues, as I'm also under investigation for lung problems.
For those with Microvascular disease, do you experience breathlessness on exertion or any other symptoms such as fatigue, palpitations, tinnitus? I have been prescribed Nicorandil 10mg, but not sure if I'm benefiting from this.
Thanks!
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ZM1980
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I have 'presumed' microvascular angina (MVA) and am responding well to a once daily low-dose beta blocker+aspirin regime that includes use of a GTN spray as needed.
I do have other heart conditions (see my profile but be warned it's boring, lol!) so distinguishing between the lot when symptoms hit is never easy. One of my conditions is recurrent pericarditis which causes shortness of breath (SOB) when an acute flare is coming on - but another of my conditions is Rheumatic Heart Syndrome (RHS), which also causes symptoms similar to yours.
Still, I can say for me, symptoms like you describe do hit depending on: weather (for me it's warmth and high humidity, but for others it's cold weather that triggers symptoms), diet 'oopsies', and/or if I'm trying to do too much during a weather-related spell. For example, if I have too much salt in a meal or snack, it can bring on similar symptoms. Heat and humidity can do the same. I have to be very careful about choosing holiday spots - no more Tuscan or Grecian hols for me, sadly!
Milkfairy is one of our HeartStars and hopefully will be along soon - she's very helpful to all of us enduring microvascular dysfunction in various forms. Her posts include links to research and 'fact sheets' that make all the difference understanding our conditions a bit better.
Hi thanks for your reply! I'm glad the beta blocker is helping your symptoms - my GP was going to prescribe Propranolol, but as I'm currently using Fostair inhaler, he decided against it, as possible interactions. What tests/scans did you have for your heart conditions?
I find my symptoms tend to flare up a bit before the rain - like a 'tightness' in my head and feeling lightheaded - although I'm not 100% certain this is related to the cardiac issues. Tinnitus seems to worsen after exercise, so could be circulatory/blood pressure.
I find alcohol brings on palpitations, can't seem to tolerate it anymore - it's a shame that all the good stuff seems to exacerbate symptoms, isn't it?!
Tests and scans so far: bloods, resting ecg, stress ecg, chest x-ray (more than a few), echocardiogram (several - I'm monitored for any progression of my aortic valve scarring plus the residual pericardial effusion), standard angiogram. I'm in the queue for the specialised angio with provocation (definitive for MVA) but that queue is years long and as I'm responding so well to the regime, they're happy to call it 'presumed' MVA.
Do you keep a log of symptoms, blood pressure, ox-sats? I find my log helps me recognise (and avoid) anything that might be a trigger - or that one of my conditions is trying to go bolshie, lol! Joking aside, it is helpful to keep a log.
Same here - I've had a few ECGs, echocardiogram, stress echo, CT coronary angiogram, a few chest x-rays as well - all of which were normal. It was only when I had the MRI Cardiac Perfusion that Microvascular Angina was discovered. Is the provocation angiogram an invasive test? Hope you can get a definitive diagnosis in the not so distant future, although it's good you're benefiting from your current treatment.
Recently I've been keeping a log of BP readings and oxygen sats, though not consistently. I need to get a bit more organised and get a notebook or diary, instead of written notes here and there and on my phone!
I keep mine in a 3-ring and as a spreadsheet on my computer so I can email it monthly to my cardiologist (done owing to the pericardial effusion).
The angio with provocation is indeed invasive - in addition to the cannula for the acetylcholine, wires are sent through from either wrist or groin (or both, my last one was a 'double act' with the wrist wires for the standard angio and the groin one for a right heart study).
And yes, I am doing very well on the beta blocker+aspirin+prn GTN - so I'm in no hurry for the angio with provocation...I have a needle phobia that is only just short of hysterics when they come at me with one
Sounds like your consultant is being very thorough with the scans and tests - at least with the provocation angiogram, you'll have a definitive diagnosis. Although I know what you mean about dreading certain tests - I'll be having a CT pulmonary angiogram on Thursday - a CT scan itself is not something I'm usually apprehensive about, but I dislike the feeling of the dye and after effects 😖 Will be over quickly, I suppose!
You have had some great advice from Sunnie2day already.
I don't live with microvascular dysfunction as such. I can exercise my problems are due to temporary constrictions vasospasms in my small and large bloods, microvascular and vasospastic angina.
My vasospastic angina was diagnosed by an angiogram when they provoked my spasms with acetylcholine.
Beta blockers can be very helpful for those living with microvascular dysfunction though they can make coronary vasospasms worse.
I agree with Sunnie2day's advice of keepimg a diary of your symptoms, weather, physical activity and other stresses.
You may then spot what your triggers are.
Usually the cold, mental and emotional stress.
My husband calls me a human barometer. One of my worse angina episodes occurred as the air pressure dropped suddenly followed by a storm.
The BHF has some information about microvascular angina on their website.
Thanks for the links re Microvascular Angina, will have a look. It's always helpful to hear of other's experiences with the condition.
I remember reading some info about vasospastic angina. Were you prescribed any medication? Did you have an MRI Cardiac Perfusion scan as well as angiogram?
I definitely think my triggers are anxiety, stress and like you, when the air pressure drops before rain or a storm - human barometer seems like a very good description! I don't tend to feel a lot of pain with my symptoms, more a lightheadedness, chest tightness, feeling 'not right'
Hopefully this weather will be a bit more stable soon ☺️
I take medication to try and keep my blood vessels relaxed.
Definitely no beta blockers for me as these landed me in hospital with severe vasospasms.
I take high doses of Calcium channel blockers, isosorbide mononitrate extended release, GTN patches, Nicorandil, clopidogrel and a statin.
I also use oxygen at night to help me sleep. It helps prevent my angina at night which is a classic symptom of vasospastic angina.
I have now had 3 perfusion MRI's. My Coronary Flow reserve is borderline and my blood vessels can dilate they just have a habit of going into spasm.
I ended up in A&E after my last MRI with angina, the adenosine had kicked off my vasospasms and I had changes on my ECG.
This is a different mechanism to microvascular dysfunction causing microvascular angina.
It's trial an error to get the best combination of medication that will work for you best.
I suggest you ask your Cardiologist for a review of your medication,
There are other medications to try.
Breathlessness is a common symptom of microvascular angina, it can be just as distressing as pain effecting your quality of life so please don't feel you should just put up with your symptoms.
Yes that's true, perhaps I need a review of my current medication - I'm not sure I'm benefiting from it much, if at all.
What you said about vasospastic angina vs actual Microvascular dysfunction got me thinking about my actual diagnosis and if it is true Microvascular damage - as on the MRI report, it stated 'Microvascular Angina', but not the actual cause. I need to read the report through again and discuss with my consultant.
Sorry to hear you ended up in A&E after your MRI - must have been distressing. The procedure is quite exhausting, can take it's toll on you.
Although it's good you've found a combination of medication that helps keep your symptoms mostly under control.
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