Angina

[Treeclimber62]

Hello I've been told since my angiogram was ok I might have microvascular angina or muscular pain or reflux. I had a ha some 10 years ago no problems until recently and since angina when walking or anything fairly physical. He said they is not way to test for microvascular angina and recommend using ranolazine ,I already take bisopolol amlodipine statin ,candasartan and isosorbide ,so I'm reluctant to add to the list ,to be honest I got the impression they've spent enough time and money on me I'm 67 and otherwise in reasonable shape feeling a bit let down any advice would be welcome please

[Milkfairy Heart Star]

Hello Treeclimber62,

I am afraid the advice you have been given is incorrect.

" He said they is not way to test for microvascular angina and recommend using ranolazine "

There are tests for Microvascular angina. A perfusion MRI and during an angiogram special tests can be carried out, to check whether the coronary blood vessels are able to function as they should.

Microvascular angina needs to be treated appropriately, it increases a person's risks of other heart problems.

I suggest you ask for a second opinion .

Yes, you are very much worth it!

Here is some information from the BHF website about MVA and a link to a website, written by 4 patients for patients. The group is supported by nearly 30 world expert Cardiologists.

bhf.org.uk/informationsuppo...

internationalheartspasmsall...

[Treeclimber62 in reply to Milkfairy]

Thanks very much for the advice and kind words much appreciated

[meadfoot]

Oh yes there are tests for microvascular angina which can be undertaken via a MRI perfusion test or an angiogram aimed to look at small vessels.

Please ask for a second opinion its important to have proper clinical advice, relevant tests and treatment and of course you are worth it, we all are. Best wishes.

[Treeclimber62 in reply to meadfoot]

Thank you I just got the impression of the consultant your unlucky I will give you some more tablets and see you in six months go away he mentioned it could be reflux ,which I dont suffer from ,or muscular but said if it is microvascular you cant test for it .

[Hidden]

As previous posts have said you certainly can test for it but I believe it can be difficult finding hospitals that do the tests. I was lucky they did so at my hospital but unlucky I suppose to have it confirmed. I hope you can get a second opinion and actual confirmation. It can be too easy to be fobbed off with more meds.

[Treeclimber62 in reply to Hidden]

Thank you you are spot on good luck

[richard_jw]

As others point out, you can diagnose MVA. When I had an angiogram in June the guy said afterwards that he thought it might be MVA. He recommended Ranolazine as well. It's difficult to get the NHS to go the extra mile and do the required extra stuff in an angiogram and/or an MRI to make a positive diagnosis. I suspect that cost might be an issue, and the idea is that diagnosis may not change the treatment anyway. Basically you need to persevere

[Treeclimber62 in reply to richard_jw]

Yes you are quite right the NHS, when it's working well ,is a fantastic service which saves lives ,but sometimes some of the people who work for it let's say they can fall short of expectations best wishes to you

[Milkfairy Heart Star in reply to richard_jw]

Over the 9 years I have lived with Vasospastic angina, I have had access to the very best specialists and appropriate testing.Everyone should have this level of care regardless of where they live or which Cardiologist they encounter.

It is not an issue of cost.

It is a lack of knowledge about microvascular and vasospastic angina within the Cardiology world along with an acknowledged bias towards women heart patients.

It is important to get a correct diagnosis.

The causes of microvascular and vasospastic angina are different and require different treatments.

Eg, beta blockers are useful to treat microvascular angina however they can make vasospastic angina much worse.

[Proustreader in reply to richard_jw]

Ranolazine turned out to be awonderful drug for what were the repercussions of an acute episide of takotsubo and at the correct dose together with some other drugs kept me going well for a number of years altho I did have episodes of heart problems and was not having to try and work as retired by then.It took 7 years for me to be positively diagnosed with MVA after an MRI at the right moment when my condition was active enough to show up but had been to A&E about 6 times during those 7 years only for nothing to be revealed by tests except 1 or 2 further episodrs of talotsubo.So it was not the fault of anybody as ordinary NHS tests and even many older heart specialists were not familiar with the condition which used to be called Cardiac Syndrome X.I have a very complicated medical histiry so will just repeat that altho I tak e many other drugs for interrelated conditions I found Ranolazine for many years really terrific.But it is expensive and some NHS surgeries are reluctant to prescibe it unless other cheaper drugs have failed to help

[Worvera]

After almost a year of debilitating symptoms and several A&E visits culminating in a stay in CCU I was sent for the MRI perfusion test which confirmed Microvascular Angina. My treatment has subsequently been tweaked several times and I now feel improvement. The fatigue is now the worst symptom rather than multiple daily attacks. It’s challenging enough to have the condition without the stress you’re experiencing being added. I notice that I can’t cope with any form of stress now. Take care 🙂

[Treeclimber62 in reply to Worvera]

Thanks very much I appreciate it hope you start feeling normal again and keep on improving best of luck

[Larkswood]

Hi I feel the same had an angiogram two weeks ago but I was really ill for five days after I just felt so washed out just come round this week I was told I have got micro vascular angina and my cardiologist said my heart is deteriorating and we can’t live for ever which I was shocked at his comment they keep changing my medication waiting for appointment to come through to see what he has to say about this angiogram I think you have to stay strong and do what is right for you but I will be asking a lot of questions when I see him take care and hope things improve for you

[Milkfairy Heart Star in reply to Larkswood]

Hello Larkswood,

Welcome to the forum.

I am sorry you have joined us in the non obstructive coronary artery disease NOCAD club.

There are quite a few NOCADers on the forum.

Many with Microvascular angina a few with vasospastic angina.

Since I was diagnosed with vasospastic angina via an incorrect diagnosis of microvascular dysfunction, there has been alot of research and there is beginning to be more understanding of MVA.

I suggest you ask for a second opinion. The Cardiologist's comments to you are just not respectful or appropriate.

There is some information on the BHF website about microvascular and vasospastic angina.

You may find this website which was created by patients for patients supported by nearly 30 world expert Cardiologists helpful.

internationalheartspasmsall...

[Larkswood in reply to Milkfairy]

Hi thanks for your reply will have a good talk to this consultant when I get my appointment through take care