Hi I have had regular consultations and tests with a cardiologist who has said it is likely I have micro vascular angina. I am on isosorbide mononitrate and is helping. However I have noticed that as the weather is getting colder I am finding the chest pain worse when waking uphill. I also have a constant ache under my left breast at the top of my ribs.
I am going to speak to cardiologist again but wondered if anyone else finds angina worse as the weather gets colder, even on medication? Thanks
I don’t have microvascular angina, but I do have vasospastic angina which gets worse as the weather gets colder. During the winter, I cover my face with a scarf or wear a mask to avoid breathing in cold air where possible. My angina is also triggered during extreme heat waves too. I have these symptoms despite my medication. I’m sorry you’re experiencing this too.
Tos
I have had a HA few year back. Left with huge scar. Heart failure etc. YES, the cold weather makes pains worse. Even having cold feet seems to worsen it too! I think the heart must be working harder when its cold.
I am having lots of different pains since being diagnosed with HF, sharp pains in left chest, center sometimes and also dull ache. All worrying. not sure if its normal for heart failure patients or not.
It’s so difficult with all the changing symptoms isn’t it?! Hope you are ok and taking care of yourself
Oh yes, The heart is a unforgiving organ. Once damaged it just likes to keep reminding me daily that he isn't in the best of shape. Ectopics, pains, anxiety,
❤️🩹
Hello Pinky20J,
I have lived with vasospastic angina for over 11 years.
I have coronary vasospasms in my small and large vessels.
I also have Raynauds Phenomenon along with migraines.
The cold is my enemy 🥶 it certainly makes my coronary vasospasms, migraines and Raynauds worse.
Despite increasing my isosorbide mononitrate and GTN patches in the winter as agreed by my Cardiologist.
I usually end up in hospital with unstable vasospastic angina symptoms in the late winter early spring.
I keep warm as possible.
I wear lots of layers and long sleeved thermal vests and leggings.
I also wear silver threaded lining gloves. I have fleece liners in my boots and shoes.
I have a snood that covers my face and chest.
I wear a down fleece jacket under my main coat.
All topped off my a hat.
It takes me ages to get dressed up to take my dog for a walk!
Has your Cardiologist offered you any specialised testing ?
I was thought to have microvascular angina caused by microvascular dysfunction at first and prescribed beta blockers which made my coronary vasospasms worse.
Let's hope the winter is kind to us this year.
Thank you. So sorry to hear what you’re going through. Cardiologist offered angiogram but said they are only just understand more about angina and small blood vessels and angiogram is intrusive. Gave me option of taking meds then in a year or so having angiogram.
Will take your advice about keeping warm. And now you r said it I think I experienced more pain in the heatwave too!
When I was in Lanzarote in May this year. I had so many heart issues because of the hot weather.
it is common for people with heart and circulation issues to have more symptoms in hotter or colder situations - this is because the heart is a vital part of your heating and cooling system and has to work harder when you need to keep warmer or cooler - so it is sensible to take appropriate action to help yourself deal with the change in external temperature and reduce the demands on your heart
How do you do that, iam of too Spain in January 2024 for 7 nights and iam so scared of having fast heart rate again. My HR can go from 125 to 220 BPM.
i'm sorry jayjay but i'm not sure what you are asking - could you clarify please?
A cardiac perfusion MRI can also diagnose microvascular dysfunction in some instances.
Has your Cardiologist offered this testing for you?
The evidence is now suggesting that microvascular and vasospastic angina are complex heart conditions, which can increase the risks of having a heart attack, stroke, heart failure and major adverse cardiac events.
can i ask what type of pains do you experience with this Angina? Is it for a long period of time? Pain bearable?
I’m fine walking on flat but walking uphill after about 3-4 mins I get chest pain that radiates up to my neck and across to the left side. If I stop for a few moments it subsides and I walk a bit more then need to stop again. I also have a dull ache most of the time under my left breast
Firstly, I am according to my very experienced Cardiologist unusually severely effected by my vasospastic angina. My Cardiologist has seen me several times when I am having severe episodes of my coronary vasospasms. I feel this is why he is so empathetic and supportive.
I get chest pain to the left of my sternum which radiates through to my upper left back. I feel pain in my stomach and kidney.
My heart feels as though it's being squeezed.
My episodes of coronary vasospasms come in clusters of increasing length and severity lasting on and off upto an hour in length. It feels like being in labour in my heart.
I usually experience my chest pain at rest especially in the night.
During the cold winter months I start getting exertional chest pain along with chest tightness. When I can't breathe in, I can't do my breathing and relaxation techniques so my pain becomes difficult to manage and I go into hospital.
I am given an infusion of GTN and morphine.
I usually have ECG changes, I go completely pale, feel very cold and the staff struggle to get my cannulas in.
Vasospastic angina is unfortunately often overlooked and undiagnosed.
Oh my sorry that your experience this. This seems like a very tough ride. 😳 hope they can fix it for you.
Thanks, I feel some people have to live with even more challenges than I do.
It's not all doom and gloom. My care has improved since I had my admission plan agreed.
I am involved in working with several researchers into my rare type of angina. I am hopeful that research will find a new treatments for coronary vasospasms in the future.
I’m exactly like you . My cardiologist watched a spasm during an angiogram and LAD was completely blocked. New symptoms over past 12 months or so chest pain and breathlessness on minimal exertion. My wonderful cardiologist has retired and I have a new GP who’s baffled . Cardiac Ultrasound showed stiffness in right side when HR 110+ but now I’ve just been left to get on with it . I have been recommended a brilliant book by Prof Angela Maas about Women and heart issues . Google it !
I know well Prof Angela Maas' book and work about raising the awareness of women and heart disease.
You may be interested in this article. One of the co authors is a women heart patient.
academic.oup.com/eurheartj/...
I hope you are able to find a Cardiologist to support you in the future.
AOh yes beta blockers are not a good thing in many of the spasms problems .......im suggesting a magnesium soaking solution i cant remember what its called but id seen it advertised on facebook .....go to facebook and type in the manifyibg glass the words magnesium bottle see if it pops up
Hi there, thank you for posting. I have the same pain as you on the same side of the chest in the same place. Since the colder weather my chest is also tight or chest pressure. Do you have your spray with you so you can spray under your toung when the tightness comes on. If you are using your spray and you use it 3 times in a short period of time, you need.to goto straight to hospital for a check up. I have been in this situation before, you waiting 10 hours to be seen by the doctor at the hospital and time they get to you the tightness has gone off.take care.
Dear Pinky, I had a heart attack in 2020 and although I had 4 stents fitted still further occasional angina although a very good GP and my cardiologist have worked hard to balance my meds to offset the number of times it occurs. I also suffer more in winter but if out walking and I can feel the angina coming on before trying the “ nuclear option “ of GTN spray I first slow down my pace slightly and start a pattern of really deep breathes. This I find does work and if not I then go for the GTN. I recently after consultation with my GP and the Cardio unit underwent another angiogram and they have prescribed a new med which I commence today. I’ll let you know how I get on but it’s in addition to my isotard 69 mg.
Cold weather and very warm temperatures both make my MVA worse by making me more short of breath. But I've never had worse angina pains.
I suggrst vitamin k2. And also some nattokinaise
I also experience more symptoms in cold and very hot weather. I usually get pain at rest in the morning when I’m not doing anything but have realised this is typical for vasospastic angina and it feels like my chest is being squeezed. I usually need to rest more and do less which works along with all the medication. I’ve learned to manage it and only get occasional symptoms now but definitely worse in the cold weather.
Wrap up warm time to get the thermals out 🥶🤗
Hi yes I suffer from the same. I had heart attack and stent fitted 4 years ago then started with chest pains a year ago after angiagram again the consultant said I have it or lazy blood as he calls it . I find I do still get chest pains now the weather is colder. Especially when out walking . My cardiologist said its ok that does happen because your heart has to work harder but yes have a word with him I'm also asprin and an other heart tablet ranazoline twice daily. Hope this helps .
Hi Pinky20J. I suffer from microvascular angina and yes, both cold weather and hot weather makes it worse. I find that having a scarf over my mouth so I'm breathing through it helps when the weather is icy. However, most of the time I just use my GTN spray. Uphill is definitely worse than walking on the level. Every weekend I walk my daughters dog and the route is uphill on the way back to the car. I have never ever walked up the hill without having to use my GTN at least once.My cardiologist said not to worry about over using the GTN, but if I do use it too much, I go a bit light headed.
I'm not sure there is much else that can be done about it and as I know it will happen, I Rake my GTN everywhere with me.
Hi a cardiologist needs to do a provocative angiogram to rule out mircovascular angina so you can have the right meds. Angina can get worse with the change of weather, also stress etc, see if you can have a provocative angiogram to see if you do have mircovascular angina.
The term now being used is a functional angiogram rather tgan ' provocative ' angiogram.
During a functional angiogram adenosine is used along with guidewires to measure how the blood flows through the small blood vessels. From certain measurements microvascular dysfunction can be diagnosed.
Acetylcholine another chemical is then injected into the coronary blood vessels. Normal functioning blood vessels shoukd dilate in response to acetylcholine.
If the coronary arteries constrict accompanied by ECG changes abd the person experiencing chest pain then vasospastic angina is diagnosed.
In the UK there are only a few centres carrying out these type of angiograms, though there is a study iCorMicA carrying out the Interventional tests for microvascular dysfunction.
clinicaltrials.gov/study/NC...
The BHF and National Institute of Healthcare Research NIHR produced these guidelines.
Yes. It is common. Cold weather, hot weather, and uphill walking all affect my angina. Not always pain but difficulty breathing.
Hi
I’ve got Microvascular angina and it’s a big definite yes to the weather being cold, I’ve been having a lot more chest pain recently. I’ve just increased Nicorandil which seems to be a more effective one for me, I also take a couple of others.
My pain is right across my chest then down both arms if it gets worse then up my neck also.
Exercise is another one, there’s a few things, I even get have it when I wake up.
Who is your consultant cardiologist?
Hi, Read with interest as my symptoms are the same as everyone that has replied. I have seen a Cardiologist who simply diagnosed Bradycardia (though 7 day hood showed up too low and high bpm 🤷🏻♀️).
I mentioned to him about vascular/cervical angina which he noted but didn’t put in report back to the Dr. when he signed me off.
Can I ask what tests specifically led to your diagnosis? And if you are U.K. based.
I hope you stay warm and don’t suffer too much this winter.
Thank you
Yes, absolutely. I often don't go put in cold weather or hot weather for that matter. I have found that it's good to find a way of exercising indoors. I hate the gym but do on line oilates and zumba in winter on cold days instead of going for walks. My diagnosis is also microvascular angina and I take bisoprolol, aspirin and isosorbide mono nitrate as well as a gtn spray, but nothing helps when it's cold except the gtn spray temporarily.
Hi, I suffer with Microvascular angina which I have had since 2014. I had worsening angina when walking up hills. I had a discussion with my cardiologist and he told me to stop pushing myself to the point where I was getting chest pain to know my limitations and pace myself. I now walk up hills slowly and that seems to have done the trick, for now at least. I have never had the specialised tests done I have had the usual CT coronary angiogram/angiogram I had a referral for an MRI stress perfusion at another hospital that was declined, one of the reasons is that I have a pacemaker and they said "it will limit diagnostic image quality". The cold makes my angina worse and I too need to wear several layers and sometimes two pairs of gloves! I have Raynaud's. Raynaud's Phenomenon has been mentioned to me but when I get the chance I will ask the GP about it. Despite having the heating on I make sure I put extra layers on even indoors. I am on Monomil XL, Trimetazidine and I use a Nitrate patch as well.
Hi I also have Microvascular angina, do you mind me asking which consultant and hospital you go to please ?
Hi. I went private in the end. Bath Clinic
Thank you, I’m with Prof Colins from the Royal Brompton, had all tests done in Norfolk then referred on. Only had telephone consults with him though.
I have felt a little during snd after my last couple of phone calls he didn’t listen to me as the letter back to my Gp with me copied in didn’t reflect what I’d said.
Probably just a misunderstanding.
Hi Fluffybee,
I hope you’re well.
Am I okay to PM you regarding the Professor you’ve mentioned above if that’s okay?
Tos
Hi Fluffybe, My consultant has now moved on to a new post at another hospital. A new consultant has taken over my case, at the moment I don't know who that is.
The cold weather causes our blood vessels to constrict and blood flow can be reduced which is why we struggle more in the winter.
Your symptoms sound exactly like mine! I'm on a cocktail of tablets now, most recently Ranolazine which I have found has helped with the walking. Stay well, keeping going!
Hi Pinky
Yes. I’m on Isosorbide mononitrate too and it has helped me a lot but in answer to your question I also know that things get different in the very cold weather and also sometimes when it’s very warm weather. I like to walk regularly in the woods near my home.
My advice is …in the winter wear a scarf over your nose and mouth but do be aware that if you wear specs they will most probably steam up! If you can manage without your specs for a short time without risking a fall then do so but only if it’s safe to do so.
In the summer/ hotter days…stay in the shade and just be aware and look after yourself.
Good luck. I do hope that you go on ok.
Hi. I was having severe chest pains and my cardiologist also said it was likely to be vascular angina or unstable angina. However it was never a definite diagnosis and by the sound of it, neither is yours. I was put on all types of medication which I have now weaned myself off with the help of my cardiologist and now I am just taking a calcium channel blocker. After 12 months the symptoms disappeared. I do get out of breath if I over exert but I have been on trekking holidays and it hasn’t stopped me. I always have a GTN spray with me but have only used it a few times in the past year. I tell you this because it might or might not be vascular angina and it might go away but it certainly wouldn’t hurt to do more research and maybe get a 2nd opinion. I found it helpful to have an angiogram as it showed minor narrowing of the main LAD artery but quite significant narrowing of a minor artery. This prompted me to be put on 80mg Atorvastatin daily.
Hi Pinky ,I also have angina probably vasospastic. I have difficulty in hot , humid weather and in the cold . I have to bundle up really well in the winter and don't go out when It is very cold. I don't use the nitro spray often . I have to stay in as I live in Montreal where temps go down to -20°C !!. I will be starting Ranolazine next week and am very anxious as all meds give me terrible side effects. Good luck with the cold .
thank you all so much for sharing your experiences. Really helpful and what a great network to have 😘
Absolutely. I have the exact same condition. Also taking isosorbide monitrate. Noticed it yesterday during a cold am walk.
Hi. I have the same symptoms as you. They tend to come in the early hours of the morning when I am having to travel for example, and sometimes in the evening when I go out for a walk. In both cases, I tend to get them from a position of rest. So, now before I venture out, I do some simple slow warm exercise (10 to 20mn) and I find that after that, I very rarely get the pain). But when I do, I use my GTN spray (which I carry with me always) and that works.
I also suffer from Raynaud's syndrome which means my hands and feet get cold especially if I am sat for a long time. Again a 10 to 20mn warm exercise works much better than adding layers only (I still do use thick thermal socks).
Hope that helps
I am on a cocktail of tablets, was given 375mg Ranolazine earlier this year and after a recent failed attempt at an angiogram that was increased to 500mg, I also have chest tightness and breathing problems when the weather is either of the two extremes of cold or hot or walking uphill. I also get a dull pain to my left side behind the left breast. Cardiologist has said that other than increasing my Ranolazine to 500mg there is nothing more they can do for me. I do most of my exercising indoors and have less issues than trying to exercise outdoors. As we are all different you are wise to speak to your cardiologist. Best wishes.
Can anyone advise Micro vascular angina
Micro Vascular Angina
Micro Vascular Angina 
