Back pain

[Zerbie]

I had a heart attack a few days ago and am now back at home recovering. My upper back is still painful ( I had chest and upper back pain during my attack). Should I be worried? I had an angiogram that showed no blockages my echocardiogram did not show anything although the right side was not clearly visible. The outcome was heart attack with no known cause. I am now waiting for an out patient mri.

[Milkfairy Heart Star]

Hello Zerbie,

Welcome to the forum.

I am sorry to hear about your recent heart attack. The lack of clarity about the cause can be unsettling.

About 10 % of heart attacks occur without any blockages, Myocardial Infarction non obstructive coronary arteries MINOCA.

The possible causes are microvascular dysfunction or coronary vasospasms, these are types of Ischaemia/angina non obstructive coronary arteries INOCA/ANOCA.

Spontaneous coronary artery dissection or a an artery being blocked by a piece of plaque or a blood clot are other possible causes of a MINOCA.

Microvascular dysfunction aka microvascular angina and coronary vasospasms aka vasospastic angina are more common in women and still poorly understood and often overlooked.

Has your Cardiology team considered whether microvascular or vasospastic angina are the possible cause of your MINOCA?

It's important to know the cause of your heart attack. Some of the medication routinely prescribed following a heart attack can make coronary vasospasms worse.

I have lived with vasospastic angina for over 10 years and often feel my angina pain in my upper left back as well as central chestpain.

I suggest you do not ignore your upper back pain.

Not everyone feels central chest pain when they are having heart pain or angina.

I suggest you ring 111 or if necessary 999, explain about your recent heart attack and ongoing symptoms.

[Zerbie in reply to Milkfairy]

Thank you for your reply and advice. It’s all a bit over whelming at the moment for me. It came completely out of the blue. I don’t smoke or drink, eat healthily, run twice a week, swim once a week and do aquafit once a week ( it actually happened in the pool whilst I was swimming!!). They did say that there could have been a little bit of plaque come away even though my arteries were clear.

[Milkfairy Heart Star in reply to Zerbie]

I acknowledge your bewilderment and feeling overwhelmed.I was rushed to hospital over 10 years ago with a suspected heart attack.

I was told I couldn't have angina or a heart attack because my coronary arteries are unblocked.

Which I now know was incorrect.

I did have specialised testing which confirmed my diagnosis of vasospastic angina, later.

I was very fit, not over weight and no risk factors.

The uncertainty of not knowing why you had your heart attack can be unsettling. Made worse by the lack of knowledge about MINOCA's and the possible causes.

I keep been told my vasospastic angina is rare.

I wonder rare or underdiagnosed.

However it's good that your Cardiology team has recognised your heart attack.

Have the Cardiac rehabilitation nurses made contact with you?

[Zerbie]

The rehabilitation team came to see me in hospital and said I would get a call from them a few days after discharge.