Coronary heart spasm?

[Coxtribe]

My profile provides the back story but just to summarise: just discharged from hospital after an MI (troponin level of 8,500) yet mild symptoms. Monitoring, angiogram and echocardiogram all indicate no issues and consultant diagnosed a heart attack caused by the small amount of plaque form my arteries and prescribed the standard drugs. The issues I experience occur when I'm resting. Query coronary heart spasm or microvascular angina. I was wondering if any has experienced something similar. Many thanks in advance.

[Milkfairy Heart Star]

Hello Coxtribe,

Welcome to the forum.

I have lived with coronary vasospams, vasospastic angina for 10 years. I also have Raynauds Phenomenon and migraines.

I experience most of my sometimes debilitating chest pain at rest. Typically between midnight and 6am.

I do have ECG changes but with small rises in troponin blood levels.

Vasospastic angina is often overlooked and undiagnosed.

I had a very specialised angiogram where they injected a chemical, acetylcholine to induce my vasospams, it did!

The BHF has this information about Vasospastic and Microvascular angina.

bhf.org.uk/informationsuppo....

bhf.org.uk/informationsuppo...

Have you asked your Cardiology Team whether they have considered these non obstructive coronary artery disease NOCAD as possibly being responsible for your heart attack?

About 10% of heart attacks occur without any permanent blockages to the coronary arteries. MINOCA, (Myocardial Infarction non obstructive coronary arteries ).

The commonest causes , vasospastic angina, microvascular dysfunction, spontaneous coronary artery dissection, SCAD , blood clot or the rupture of a small area of plaque

Another cause of a very high rise in troponin blood levels is Takostubo Cardiomyopathy.

It's important to know the cause. The treatment options can be different.

Beta blockers are often useful to treat microvascular dysfunction however they can make coronary vasospams worse.

[Coxtribe in reply to Milkfairy]

Many thanks. This is really useful information. I will definitely pursue this with my doctor. 🙂

[arTistapple]

I am actually on the hypothyroid network on Health Unlocked. A week or so ago I asked the question on there about this condition. I had been told it was rare and the medics did not have a cause. I have had it since about 1982. It started gradually and only when I was very stressed. It got worse over the years and I am pretty sure medication (to allegedly help it) made it worse. I had a ‘heart attack’ in 2002. No CHD evident but was treated as if I had. They did not have anything else. The meds after that definitely did not help and may have damaged my health further. Eventually I refused all meds because I was just getting worse. I am in the process of tracking my own story down looking at my medical records etc. I have discovered that certainly from 2008 there was Japanese research proving that this condition was at least sometimes caused by subclinical hypothyroidism. However I went along with the medics that I had. Who else can you trust? To cut a long story short I was diagnosed with hypothyroidism 18 months ago (another story) but only told a year ago. It is no coincidence that my coronary spasm pain has stopped since starting levothyroxine. I am very very grateful for that but reading my notes, hypothyroidism was queried in 2014 but not acted on (subclinical again?). Whist I am still trying to get optimum treatment for other hypo symptoms, the coronary spasm has been almost absent. So from 3 to 4 episodes a day for certainly the last twenty years I have had 3 to 4 episodes in the last year, since starting levothyroxine. Get a test and save yourself years of pain maybe. If I knew how to PM I would but I have not got a clue!