I am newly diagnosed with Microvascular Angina after months of chest pains, fatigue and feeling generally poorly. An angiogram showed my main arteries are all ok. Therefore it turned out that it is this disease. It is a relief that I can put a name to my condition but equally not great because it’s not surgically resolved, just meds. The pain has been so extreme at times that it’s debilitating. I struggle at work because it can be stressful. Sometimes I get soooo fatigued.
Is this condition progressive? How do people cope when the pain is so severe? My Gtn spray helps but you are supposed to only use that a couple of times per day and I would be using it every 15 minutes!!
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Ronnie17
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I am sorry to hear you have joined us in living with angina without obstructed coronary arteries, ANOCA.
I have lived for over 10 years with vasospastic angina which is caused by transient constrictions of the coronary arteries. I also have vasospasms in my small vessels too.
Microvascular vascular angina is thought to be due to the inability of the small vessels to dilate or stay dilated in response to extra demands like exercise.
The symptoms of microvascular and vasospastic angina can overlap.
The BHF has this information about microvascular angina.
There are quite a few of us on the forum who live with microvascular or vasospastic angina. Hopefully they will be along soon to share their experiences with you too.
Thank you so much for your reply 🥰 and your diary link. I’ve been prescribed Ranolaxine started on low dose. The cardiologist wants to see me in 3 weeks to evaluate the dosage. Meanwhile, if they don’t work I’m to contact her. They came to this diagnosis cos my angiogram yesterday showed my arteries were fine. I’ve suffered so badly for about 6 months now and it’s got to the point of deterioration with daily pain, fatigue and low mood (not like me cos I’m a glass half full person).
It's good to hear that your Cardiologist is working towards getting the best medical treatment for you.The knowledge of microvascular and vasospastic angina is growing but still poorly understood by many Cardiologists and cardiac nurses.
It's encouraging that your Cardiologist has diagnosed your microvascular angina in the past you could well have been discharged and told there was nothing wrong with your heart.
When I was first admitted to hospital with a suspected heart attack over 10 years ago, I was incorrectly told I couldn't have angina or a heart attack.
I had a specialised angiogram which confirmed my diagnosis of vasospastic angina.
I attended a Pain Management Programme which I found helped me psychologically manage my pain. Perhaps ask your GP to refer you?
Coming to terms with living with a life changing diagnosis takes time.
It's something all of us as heart patients have to come to terms with.
The Portuguese have the word Saudade it sort of means a wistful longing for our former Iives and grieving for the loss of the future we thought we were going to have.
Thank you 😊 Yes, I feel so grateful and very lucky to have the diagnosis so soon. It’s really interesting that you found the Pain Management Programme helpful, that’s really encouraging 😊 Do you mind me asking you about vasospastic angina? I could Google it but it would be more beneficial to hear it from you and for others reading this to know. Is it similar to Microvascular?
Vasospastic angina with microvascular angina is a type of non obstructive coronary artery disease, NOCAD.
My coronary arteries go into transient contrictions causing a lack of blood supply to my heart, angina.
These vasospasms also happen in my brain causing migraines and I have Raynauds Phenomenon.
I can exercise, however I will experience chest pain later.
My episodes of chestpain can come in hour long clusters mainly in the evening and at night.
My episodes feel like being in labour.
I am unfortunately badly affected and despite being on the highest doses of many medications will end up in hospital from time to time to stabilise my angina symptoms with IV GTN and morphine.
A common strategy by Cardiologists, to try use different medications to see how their patients respond.
This hit and miss approach isn't always helpful.
I was originally presumed to have microvascular angina as it's more common than vasospastic angina.
I had an angiogram with acetylcholine to confirm my diagnosis of vasospastic angina.
I landed up in hospital when I was prescribed beta blockers which can help microvascular angina but can make coronary vasospasms worse.
I have a written careplan which was co designed by my Cardiologist, Pain Team, Cardiac Psychologist and myself to guide the staff how to care for me when I am in hospital.
If you don't respond to your medication, I would suggest discussing with your Cardiologist if they can carryout the appropriate testing to determine whether you have microvascular or vasospastic angina.
Thank you so much for that explanation. That’s a lot to contend with! Your advise is noted too. Can I say, and I’m sure on behalf of the others on this site, I honestly hope you have very very few bad episodes that require hospitalisation from now on. I wish you to have the most fulfilling life as possible and hope to write between us again soon. Keep in touch ☺️
I had my angiogram on Thursday last week and my arteries weren’t blocked either but I’ve been having severe chest pains and using GT spray.I asked the cardiologist if there is a test for microvascular angina and he said no but had heard of MVA and said he will be contacting my GP re medication (not told exactly what it will be though) and no further appointments to see him again! I feel left in the lurch! However MilkFairy is very knowledgable and so is BeKind and I’m sure there are more of us suffering with this unstable form of angina, wishing you well 😀
I am afraid your Cardiologist is mistaken.It is possible to diagnose microvascular angina by an cardiac MRI.
Also during an angiogram adenosine and guide wires can be used to measure how the blood flows through the small blood vessels.
Acetylcholine is used to see how the blood vessels respond. If they constrict, vasospastic angina is diagnosed.
I suggest you ask your GP to refer you to a Cardiologist who has not only heard about microvascular angina but knows how to diagnose and treat this type of angina.
I will message you with some suggestions. I agree it's disappointing to be discharged. It is sadly a reflection of how poorly understood and recognised microvascular and vasospastic angina are by many Cardiologists.
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