Can anyone advise Micro vascular angina

[Lordofrings]

I was told over a year ago after having pains in my chest that I had angina. After doing the tests my arteries were clear so I was told no you don’t have angina. There was no follow up. I did some research and found a story on BHF website about a lady with micro vascular angina. All of the symptoms I recognised in myself. I went back to my doctor and after consulting with the cardiologist, they put me on ranolazine. I’ve actually just stopped taking it, as my headaches are awful and I have a terrible ringing in my ears! Does anyone have experience of micro vascular angina, and if so what are you taking please? I’m still suffering quite badly with pain in my chest and I’m desperate to get some relief. It’s really getting me down. Thank you

[mathematics]

My husband gets microvascular angina and it is always worse when he is lifting his arms up above his head so he now has to avoid this. He was diagnosed but with moving and just life we have misplaced this information. He recently had a test for angina and was told nothing wrong however the usual routine tests for angina miss microvascular angina unfortunately. As far as what he takes when it gets really bad he does have aspirin 4 small ones and chews them before swallowing. Sorry cannot give you more help on this under diagnosed problem.

[Dollywow1999 in reply to mathematics]

Well what were the specific tests done for him to prove he has microvascular angina

[mathematics in reply to Dollywow1999]

My husband says he did not have specific tests as he was getting chest pain but nothing was showing on the tests it was more an agreement that it was microvascular angina especially as he was getting it a lot when he was working with his arms and they were above his head or he was reaching up. Hope that makes some sense.

[Milkfairy Heart Star in reply to mathematics]

A presumed diagnosis can be incorrect. I was assumed to have microvascular angina when I was first admitted to hospital 11 years ago with suspected heart attack.

I was prescribed beta blockers as a result which made my chest pain worse.

My diagnosis of vasospastic angina was confirmed later by an functional angiogram. I later discovered that beta blockers are to be used with caution if you have coronary vasospasms.

I suggest your husband asks for the appropriate testing to determine what is causing his ongoing symptoms.

[mathematics in reply to Milkfairy]

Thank you for your comments yes he does need appropriate testing however when he needed re stenting we had to pay private in our area to get it sorted. So even if we did chase it up it probably would be a long time before anything happened that is if it did. He does not take beta blockers. He has recently been diagnosed with secondary progressive MS and we are waiting for MRI's for this to see if the lesions in his brain are active so he can get appropriate drugs.

[Milkfairy Heart Star in reply to mathematics]

I am sorry to hear that your husband is facing so many challenges with his health all at once.

Waiting times for the care we need has certainly increased over the last few years.

[LSCE]

Do you have a GTN spray?

[Lordofrings in reply to LSCE]

I do, but it makes me feel really sickly and light headed

[Crystal614]

I have had MVA since 2014. I had a CT coronary angiogram/angiogram both were normal. My cardiologist prescribed Trimetazidine to see what response I had to the medication. There was a huge improvement to the chest pain. This drug can only be prescribed by a cardiologist as it isn't licensed for use in the UK. I have been on it for nearly 7 years. Unfortunately, more recently angina has got worse so I am now taking Monomil XL (extended release Isosorbide Mononitrate) the side effect of this drug is headaches for most people they usually subside after 1-2 weeks with me it was a lot longer but I just persevered with it, eventually the headaches subsided. I also use a nitrate patch and I have a GTN spray. Did Ranolazine help with the pain whilst you were taking it?

[Lordofrings in reply to Crystal614]

Thank you for taking the time to reply. The ranolazine only slightly helped. But the headaches were a nightmare. GTN spray makes me feel really sickly and light headed, which is a shame because I only need relief when I’m walking uphill or similar. I’m going to call the doctor today and ask if I can be re referred to the cardiologist.

[Milkfairy Heart Star]

Hello,I was presumed to have microvascular angina when I was admitted to hospital 11 years ago with a suspected heart attack. I was later found to have Vasospastic angina after a specialised angiogram.

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

Unfortunately the awareness of microvascular and vasospastic angina isn't good amongst Cardiologists.

Many of us as patients are misdiagonised and we are incorrectly told we don't have a heart problem.

I suggest you ask your GP to refer you to Cardiologist who understands microvascular and vasospastic angina.

There is a study taking place into diagnosing microvascular angina.

iCorMicA is being carried out in 25 centres throughout the UK.

Perhaps ask your Cardiologist to refer you to one of these centres.

clinicaltrials.gov/study/NC...

Where are you based in the UK?

The symptoms of microvascular and vasospastic angina can overlap, so it's important to have the appropriate testing to determine the cause of your symptoms.

The treatment options are slightly different for microvascular and vasospastic angina.

We all respond to medication differently. It can take time to find the best combination of medication that will work best for you.

Ranolazine seems to be a marmite medication, you either love it or you don't.

It tends to work better for people living with microvascular angina.

I was prescribed Ranolazine before my diagnosis of vasospastic angina was confirmed, it gave me palpitations.

Microvascular and vasospastic angina are complex types of angina which are often overlooked, undiagnosed and under treated.

You may find this website helpful. It was written by 4 patients with over 50 years combined experience of living with microvascular and vasospastic angina. They are supported by 30 world expert Cardiologists.

internationalheartspasmsall...

[Lordofrings in reply to Milkfairy]

Thank you for taking the time to reply and give me all of this information. I’m going to call the doctor today and get an appointment to be referred back to cardiologist

[Fluffybee in reply to Milkfairy]

Hi Milkfairy

Thank you for putting the link on here, looking for other consultants for MVA

[JaninS]

I have micro vascular angina and like you all the usual tests come up as fine. Luckily the very first GP I saw knew about it and persevered with reference to cardiologist. I now take aspirin, statin, beta blocker and isosorbide mononitrate plus GTN spray. Nothing really helps except the GTN spray. Yes you can get light headed when using it but I find that you need to speed up or exert yourself a bit more and the light headedness subsides. I have tried other stuff suggested by cardiologist but they all made me feel rotten, head aches, upset stomach lethargic etc so we agreed to stick with basics. I have managed like this for over 10 years. So you are not alone!

[Lordofrings in reply to JaninS]

Thank you. I feel your pain! Can I ask what you mean by speed up a bit? Do you mean when you’ve sprayed, start walking a bit faster for example? Also, do you take aspirin once a day in the morning? I am still working and have to walk uphill in the morning for public transport and this is when it’s really painful.

[JaninS in reply to Lordofrings]

Hi. Yes, the cardiologist told me to use the spray immediately before trying to do something that was likely to bring on the angina. He said it would give me about 20 mins to go uphill or walk faster e.g. if I am late for something. I only use it 2 or 3 times a week but it always works. But I find after using it I must then climb the hill or walk faster. If I don't speed up from my normal slow walk, I feel faint. Once, climbing an incline I stopped to admire the view and felt very faint but I somehow sensed I needed to keep going and as soon as I did the feeling went away. I guess you could try it one day before you walk up the hill. Dont think it can do any harm. I was initially very reluctant to use the GTN spray in this way, but it really does work for me. Good luck!

[Lordofrings in reply to JaninS]

Thank you. I’ll definitely give that a try!

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Did you consult your doctor before stopping your medication?