Angiogram result

[Dunandjam]

I am fuming! I’ve just received a message from a doctor I haven’t seen before to say that she has received a letter from my cardiologist suggesting a change to my medication and she has issued the prescription to my pharmacy. I checked my repeat medications and the added medication is isosorbide mononitrate 25mg.

I believe it’s for angina but I had conversation with the cardiologist at the time when he confirmed my arteries were clear. I said is it microvascular or vasopastic angina and he seemed a bit non pluses! I’ve got no follow ups with him and I’ve not received a copy of the letter yet.

I phoned surgery last week, had to listen to a series of irrelevant messages which cannot be bypassed and was then told I was no 5 in the queue so thought I wouldn’t have long to wait. 30 mins later I asked for appt wit GP and was told only phone appts available and they’re booked up to the end of May. I said I’ll wait for the Dr to phone me.

I intend to write a letter and deliver it by hand to surgery.

Just wondered what others feel about this.

Thanks in advance!

[Hidden]

It seems to me that your issue may be with the cardiologist not the GP, who may only be acting on what they have been told to do. So my advice is you should wait before you get a copy of your cardiologists letter before doing anything. You could ask the surgery to provide a copy of the letter that the GP received, alternatively contact the medical secretary to the cardiologist to chase things up for your copy. When you see what the cardiologist has advised you can then decide what to do.

[Dunandjam in reply to Hidden]

Thanks, you’re right! I will try and chase it up as you suggest 👍

[Heather1957 in reply to Hidden]

I agree, my GP followed the instructions of the cardiologist but she read out the letter over the phone (I have never been sent anything from the hospital)

The cardiologist probably prescribed isosorbide mononitrate as a belt and braces more precautionary for possible angina pain.

I very much doubt your GP will be able to answer your questions as it is a specific issue.

[Milkfairy Heart Star]

Hello Dunandjam,

I am sorry you are going through a struggle at the moment.

I had a bumpy ride to my diagnosis of vasospastic angina too.

Unfortunately microvascular and vasospastic angina are poorly understood by many Cardiologists.

The Cardiologist's reaction appears to indicate they need to update their knowledge and skills,

also the lack of follow up and appropriate testing and treatment.

The treatment options for microvascular and vasospastic angina are different.

Microvascular and vasospastic angina are types of ischaemia/angina non obstructive coronary arteries, INOCA/ANOCA.

They are serious heart conditions that require the input of an understanding and knowledgeable Cardiologist.

It is not appropriate to be discharged at present until the cause of your symptoms are determined.

Unobstructed coronary arteries doesn't mean you can't have angina or even a heart attack.

If you are still having symptoms I suggest you ask your GP to refer you to a Cardiologist who understands microvascular and vasospastic angina.

Perhaps ask the Cardiologist in question and your GP to look at the link below.

academic.oup.com/view-large...

[Dunandjam in reply to Milkfairy]

Hi Milkfairy,

As always you have put things in perspective for me and given me some good advice. I will be pursuing further help and have copied that Flow Chart. I am otherwise fit and healthy and not overweight and don’t have diabetes but I’m not good at stress management.

I looked at the information on the medication that he has prescribed and there are so many side effects and to cap it all, it mentions not suitable for patients with glaucoma!

I will keep you posted and so very grateful to you

Linda

[Dunandjam]

Thanks and it is I’m afraid.

[Nes71]

morning, sorry to hear you are experiencing this, what I would say is you are right to challenge and ask questions, I recently had a similar thing and was even sent the prescription of something never discussed, it took a few days and my cardiologist secretary input but I had been given someone else’s prescription by mistake! They had got the consults muddled up, I appreciate they very busy but it shows importance of being able to question and confirm your own treatment, even the experts make mistakes, I hope you get it sorted x

[Dunandjam in reply to Nes71]

oh my goodness! Thanks for being supportive, I don’t like questioning professionals but it seems we have to these days! x

[WardijaWardija in reply to Dunandjam]

You sound upset, which is quite understandable but please try and calm down. Stress is the one thing you really don't want if you have a heart issue.

I've had to learn how to manage my stress triggers . .

I know those phone systems are SO frustrating - they go on so long, with repetitive messages.

I put my phone on loud-speaker and put it on a nearby table, so I can hear it when they answer but not pressed to my ear . . It lessens the stress while I turn my attention to doing something else, i.e writing a shopping list, whatever.

Before you know it, they'll have picked up your call.

The matter you have posted on, can be easily resolved, as other members have already suggested to you.

It's totally fine to ask questions of your health providers. I'd suggest you write down exactly what you wish to discuss, as an aide memoir and be as clear and specific as you can.

Above all keep calm, be persistent (if needs be) and above all, be polite. It pays dividends.

If its of any interest, I take Isosorbide 60mgs daily for Hypertrophic Cardiomyopathy & Microvascular Angina. Been taking this medication for 3 years, alongside many others and never had any adverse effects from it.

Good luck.

[Dunandjam in reply to WardijaWardija]

Thanks so much for your valued advice. You’ve made some very valid points. It’s also reassuring to hear that you’ve been taking the isosorbide for 3 years with no side effects.

[Heartattackvictim]

For what it's worth: I have had 2 NSTEMIs and have no blocked arteries. Since being prescribed isoboride mononitrate my spasms have decreased as my cardiologist told me my issue was in the small vessels of my heart feeding the arteries - "the B roads (are the issue), that feed the A roads, that feed the motorway (main arteries)" is how he described it!

[Dunandjam in reply to Heartattackvictim]

Hopefully that will be the case. Did you have the test to confirm micro vascular angina?

[Heartattackvictim in reply to Dunandjam]

My "differential diagnosis is either microvascular coronary artery disease or coronary artery spasm" as written in my consultant's letter to my GP.

[Dunandjam in reply to Heartattackvictim]

Oh my goodness! I haven't seen the copy of the letter that my cardiologist sent to the GP yet! I suspect it probably says something similar though.

[Bran_flow]

This is 2 of the conditions my cardiologist has mentioned I may have that caused my minoca I also have been put on isodur 25 but not before I was examined and questioned thoroughly about my symptoms. My blood pressure is also very high they having a hard time getting it down at minute as I am I also. Definitely seems to be your cardiologist you need to speak to about adding this to your script without a detailed informative chat with you about this medication and why you are now on it.

[Dunandjam in reply to Bran_flow]

I absolutely agree with you and thanks for your response. Hope your BP gets under control soon. Mine is oK and I take 2 tablets for it, Lacidipine and Losartan .

[ETHEL103]

I deliver letters to my surgery too.It does help.

[Dunandjam in reply to ETHEL103]

it does! I was walking home from the surgery during the Covid testing me, having hand delivered a letter to GP and secretary phoned me and I had tel appt straight away!