Advice needed

[theclark]

Hi. I ended up in casualty again for the 8th time with constant chest pains and subsequently stayed the night and next day in coronary care. The cardiologist indeed mentioned Microvascular disease and started me on isosorbide mononitrate I have been recently diagnosed with mild stenosis but he says I should not be getting the pains from that hence the thought of Microvascular. Trouble is I am still having these chest pains which run down my left arm,back,jaw and neck. I am at my wits end now and it is getting me down. It’s been 10-12 weeks with very little let up. Feels like everyday I’m going to have a heart attack and have to take to my bed. I would appreciate any advice I could get. It’s wearing me down day by day

[Prada47]

Hello

I know very little about microvascular angina but Milk Fairy a regular poster has a very good in depth knowledge of the subject, so one would hope she will be along soon to help you out.

I think a stress MRI can help with diagnosis, but again you need better advice than what I can offer !!

Stay well and try not to worry

[theclark in reply to Prada47]

Ty so much for your time. I seem to be getting nowhere with my dr and there’s such along waiting time for tests to be done. Meanwhile I’m still having chest pains to the point again I nearly passed out today. Last time I rang the dr he basically said there was nothing he could do re pain and to wait for my stress echo. If the pain got to bad to ring 999.

[Milkfairy Heart Star]

Hello theclark,

I am sorry to hear you are struggling.

Microvascular and vasospastic are unfortunately poorly understood and recognised types of angina.

I am not sure many healthcare professionals really understand just how debilitating and painful angina caused by microvascular dysfunction and vasospastic angina can be.

I would encourage you to read through the information I sent you in answer to your previous post.

Keep a diary of your symptoms.

Try and see if you can identify your triggers.

Mine are the cold, emotional and mental stress.

I have to manage my stress very carefully.

Ask for a review of your medication by a Cardiologist who has some knowledge of microvascular angina and vasospastic angina.

Also ask to be tested appropriately for microvascular dysfunction and vasospastic angina.

I have lived with vasospastic angina for 9 years which was confirmed by a specialised angiogram. It took sometime for me to find Cardiologist to diagnose me.

I now have a very supportive Interventional Cardiologist who works with me and this includes having a written care plan to manage my inpatient care.

I live with frequent episodes of angina which land me in hospital from time to time. However this is me, I am unlucky.

Many patients living microvascular or vasospastic angina with the appriopriate medication can manage their symptoms well.

Prada47 is correct a Cardiac MRI

can help diagnose some types of microvascular dysfunction a common cause of microvascular angina.

Coronary vasospasms can only be confirmed by a specialist angiogram.

I would also try to keep active as much as you can. Exercise actually helps improve the function of your blood vessels. This I acknowledge can be very challenging to do when you feel tired and disillusioned.

I find Tai Chi and yoga helps me exercise.

Practicing meditation, breathing and relaxation techniques can help to manage my stress.

Microvascular and vasospastic angina are serious heart conditions and need treating appropriately.

There is growing evidence that suggests living with microvascular and vasospastic angina does increase your chances of having a heart attack.

This is not always recognised by some Cardiologists.

How supportive is your GP?

Where are you based in the UK?

[theclark in reply to Milkfairy]

I don’t think my gp really gets it as I suffer with anxiety and he’s gearing towards that which is a little disappointing. I do try to exercise but sometimes it does get to much and I end up just sitting down. No amount of painkillers or spray will relive it that’s with the isosorbide mononitrate on top. I have tried a hot water bottle which does relieve it. I find myself in bed a lot of the time as I’m worried I get up and have another event. I am based in Newcastle,England. It feels like a living nightmare at the minute. If I could get rid of the pain I would feel much better

[Milkfairy Heart Star in reply to theclark]

I am sorry, the pain I know is soul destroying at times.

I was told I was having a panic etc, and given beta blockers to treat my presumed anxiety.

This landed me in Coronary Care as beta blockers made my coronary vasospasms worse.

Beta blockers I later discovered are contraindicated if you have vasospastic angina.

It sounds as though you need some different medication. Nitrates alone are rarely sufficient to treat microvascular dysfunction or vasospastic angina alone.

The forum guidelines ask us not to name Cardiologists so I will send you a PM.

[theclark in reply to Milkfairy]

Oh that’s great. Ty so much