Microvascular Disease/Syndrome X

[Dougie]

Hi, I'm new to this forum. I have chest pain/discomfort most days and am very restricted in what I can do. I get breathless and tightness in my chest when I try to do things that most people would take for granted, including light housework, light gardening, lifting/pushing/pulling most things heavier than a bag of sugar! I am also unable to exercise or walk any distance before I have to stop. The walking part is the most frustrating as its something that's recommended to help keep the heart healthy.

I have been like this for at least 10 years and none of the doctors seem to be able to find a cause for my problems. It started around time of menopause and has got gradually worse over the years. I have high blood pressure (controlled fairly well on perindopril 4mg) and hypothyroidism on 125 mcg thyroxine. During the Covid pandemic, I had an episode of bad chest pain and GP didn't see me but recommended I go straight to A & E. I was admitted then and had an angiogram which showed mild build up in left coronary artery. I was put on statins and aspirin at that time. From then on, any doctors I have seen try to reassure me that I don't have cardiac disease, however the symptoms are still the same and I have no diagnosis. I also had a cardiac echo test which was apparently also normal.

The last consultant I saw again said heart tests looked normal, but as a kind of last ditch remark at the end of the letter suggested that my GP might wish to try me on nitrates, Amlodipine or Ranolazine. Said it is possible I have a degree of microvascular dysfunction or Syndrome X. I have tried taking Elantan LA 25 and it seemed to make me worse and brought me out in a red itchy rash all over, so I stopped it. I am waiting now for my GP to prescribe one of the other drugs mentioned.

Apologies for the long post, but I wonder if anyone has had this condition or can maybe recommend where is best place in UK to go for investigations and proper diagnosis as I feel I have not had this so far. From what I have been reading, this condition seems to be more common in women and is difficult to diagnose. I assume this is why I am so long now without proper investigations as our doctors in N. Ireland may not have the expertise to diagnose this, just recommend trial and error approach to different medications.

The other thing I forgot to mention is that I seem to have some degree of contortion/twisting of the blood vessels leading to/from the heart. This was just mentioned in passing following my angiogram. From my reading up, it seems this can be caused by high blood pressure, but I wonder if this is also a factor in my symptoms, or if anyone else has heard of this condition. Thanks in advance.