Unstable Angina

[Pumpkinmoonchild00]

Hi, just wanting to know,why I am still getting Unstable Angina Attacks after Having 2 stents Inserted in June/December 2021, after Having a Silent MI, and even after a recent Micardial Infusion Scan,of which I have been informed all was working well,am still having Problems. Am rather frustrated going back and forth to Hospital, and being informed of having Elevated Trop T's, and then being informed, they are back to normal, just wanting to get some advice on this..PS.. What number states an elevated Trop T.

[Captain_Birdseye]

It depends on the test they use and how sensitive it is... below 14ng/L for the high sensitivity test is considered normal. For other tests, anything above 0.4ng/mL is considered high (note the units!)

[Milkfairy Heart Star]

The latest research suggests any troponin blood level above 5ng/L is of clinical significance.

"patients with cardiac troponin concentrations above the risk stratification threshold of 5 ng/L, but below the diagnostic threshold, represent a high-risk group with a 7-fold greater risk of subsequent myocardial infarction or cardiac death over 12 months compared with those below either risk stratification threshold."

ahajournals.org/doi/full/10...

There is also growing awareness that some individuals experience ongoing chest pain after stent insertion or coronary by pass surgery.

acc.org/latest-in-cardiolog...

It is possible to have angina without blocked coronary arteries due to microvascular dysfunction or coronary vasospasms.

I suggest you ask your Cardiology team consider if microvascular or vasospastic angina are the possible causea of your ongoing chest pain.

[Sunshinebrew]

I would agree with milk fairy my own experience was similar after having 3 stents I continued to suffer chest pain and breathlessness on a regular basis. This was investigated and the stents checked but eventually because of my ongoing symptoms It was assumed that they were caused by microvascular angina and my medications were altered so after a long time and trying different meds I am now able to exercise and have a normal life with only occasional symptoms.

Keep going going back to the doctors to get the pain investigated, and ask if it could be microvascular caused by the smaller arteries, there is more awareness now if this condition.

I wish you well

[WardijaWardija in reply to Sunshinebrew]

Hi Sunshinebrew.Yes, same for me. I also have 3 stents. There was an additional artery needing attention, but it was too small to be stented.

Immediately after the 3 stents were in, my original symptoms persisted ☹️. Went back to my, then consultant who said it couldn't be possible and gave me GTN spray, which when used, made not a jot of difference.

I knew it was something else.

Moved address and got under a top UK Cardiology Hospital and Consultant.

Further tests, and a Cardiac MRI with perfusion, diagnosed an unknown (to me) genetic condition, Hypertrophic Cardiomyopathy with obstruction.

My existing medications were added to, (took some time to get the right balance) but from a cardiac perspective, I improved.

Now nearly 4 years on, I started re-experiencing those old familiar symptoms, especially on just basic daily exertions, lack of breath, palpitations, pain in my neck and shoulderblades, I never had chest pain.

I had a fresh battery of tests, don't have all the results back yet, but the interim letter from my Consultant mentions

"Microvascular Dysfunction" so I'm guessing the small arteries are making their presence known . . .

So I'm in total agreement with yourself and Milkfairy, keep going back to your cardiology team and be as ever, politely persistant with your concerns. 🙏🙏