I had a heart attack nearly a year ago (43F), I was fit, ran a lot and no risk factors.
I'm still really exhausted a lot of the time, I get short of breath and now have angina. MRI, ECG not shown anything which could be causing my exhaustion.
I'm getting really fed up that I'm not picking up but there is expectation that I should be fine.
Stopped betablockers as thought that may be an issue.
Any advice on where I should go next...?
Have you had your thyroid levels tested? I felt as you describe with awful tiredness and an underactive thyroid was what was wrong with me. Taking the medication Levothytoxine has changed my life and I have energy again.
Jean
I have, that seems fine. I keep thinking about vit b12 but apparently that is also ok. Thank you for your reply 
what about your vitamin D levels? I was very tired when they were low.
Has anyone considered non obstructive coronary artery disease? NOCAD.
These include microvascular and vasospastic angina.
Both are possible causes of a heart attack.
Microvascular angina is more common in women, it is often overlooked and an under recognised cause of angina.
Breathlessness and exhaustion are common symptoms along with chest pain of microvascular angina.
The usual tests often do not pick up Microvascular dysfunction the more common cause of Microvascular angina. Vasospastic angina can only be confirmed by a specialised angiogram.
The BHF has this information about Microvascular angina.
Yes. Go to another cardiology team if you can. It's your body, your health, and if you are having these symptoms then something isn't right.
Beta blockers can definitely have side effects but angina is not one of them.
Stopping Bisoprolol (at least) can indirectly cause angina, in that taking it slows the heart and probably reduces blood pressure. If you stop, the heart is under more stress, and angina may result.
It's true that stopping Beta blockers is likely to make you feel less exhausted, 2 cardiologists have suggested that to me. Stopping caused angina for me. I have had an angiogram last monday, and the main coronary arteries are OK. Doctor thought it might be microvascular angina.
We have swapped the beta blocker for ranolazine, and stopped it quite a long time ago now so I think the impact of stopping should have passed. I hope that they get to the bottom of your issues, the consultant did say that microvascular issues are often so much harder to deal with.
Did the Cardiologist test your coronary flow reserve during the angiogram along with testing the function of the micro vessels?If your Coronary flow reserve is less than 2.5 that can indicate the small blood vessels are not working as they should, microvascular dysfunction.
Microvascular angina is a complex condition with several possible causes.
Unfortunately few Cardiologists have much experience in caring for patients with non obstructive coronary artery disease such as Microvascular and Vasospastic angina.
The BHF has this information about Microvascular angina .
bhf.org.uk/informationsuppo...
Beta blockers are often useful to treat Microvascular dysfunction the more common cause of Microvascular angina.
Good to know...I haven't yet stopped it. But I've been lucky (unlucky) to never have had angina. Heart attacks, yes, cardiac arrest, yes...but no angina. I could have used some warning signs...
Actually beta blockers make coronary vasospasms worse.I spent 5 days in hospital after being given beta blockers for this reason.
They are contraindicated by the NICE guidelines for the treatment of stable angina for patients with Vasospastic angina.
Really? That's good to know. I've been on biso for a while but only with mild to moderate side effects (some dizziness when standing up too fast, mostly). But I haven't gone off of it yet...thanks!
Nearly a year since mitral valve repair
Pill cutter is rubbish
Hearing In Later Life!
Nearly there.
Lateral back muscle pain Angina?
