myocardial bridge

[Shazna]

Hi. I have myocardial bridge. The cardiologist who is nhs has discharged me. I still have chest pain, pain down my arms and pain in my neck. I’m not sure if I should go to a private cardiologist who knows more about MB. My husband thinks if the cardiologist has discharged me there is nothing to worry about and should leave it now.

[Tos92]

In my opinion, it is safer to rule out/in whether the bridge is causing the symptoms based on my experience. If left untreated, it can really affect your quality of life and your symptoms may increase in severity. This way you can also get on a treatment plan if the bridge is the culprit. As you already know from my experience with the bridge, there is a risk of having a heart attack as well. I do believe if my symptoms were treated sooner, and the bridge found, my heart attack may have been avoided.

I hope you make the best decision for you.

Tos

[Fanfab1 in reply to Tos92]

how did the doctors confirm / prove the MB caused the heart attack? Was there particular tests? Might help the op if considering private route?

[Tos92 in reply to Fanfab1]

My MB spontaneously spasmed at the time of my angiogram after my heart attack to check for blockages and other issues. Due to there being no other risk factors, my MB spasming was concluded as the cause of my HA.

An angiogram is not the only way to diagnose a bridge. A cardiac CT or MRI of the heart are also other ways in which a bridge may be seen. From experience, it is up to the patient’s cardiologist to decide which test would be most appropriate for them.

I am in contact with the OP, so hopefully they will message if requiring further info.

[Shazna in reply to Tos92]

Was this all done privately

[Tos92 in reply to Shazna]

My angiogram was not done privately. It was conducted after my troponin came back elevated at the time of my heart attack whilst I was on holiday abroad. My treatment in the U.K. however has been a combination of both private and NHS.

I have not had unroofing surgery for my bridge. There’s usually a criteria that has to be met to be considered a candidate for unroofing. My symptoms and other factors such as my age, often being told I’m too young by physicians here, currently do not make me a candidate for surgery, no matter how debilitating the symptoms may be sometimes. Post-op complications after the surgery are also common so this is another aspect that has been factored into me not having the unroofing surgery.

[Fanfab1 in reply to Tos92]

Thanks for explaining, sorry one more question are you on any specific meds that help with the bridge? This is all helpful ❤️

[Tos92 in reply to Fanfab1]

So far, I seem to have been resistant to treatment. I’m on a calcium channel blocker and nitrates. I am also trialling a medication that is not licensed here in the U.K. called Trimetazidine.

The nitrate is used with caution due to previously being contraindicated with bridges. It is a myth that has been debunked by one of the leading international specialists in myocardial bridges, Dr Tremmel at Stanford, USA. Nitrates can either be a hit or a miss for those with bridges. It can make some feel better, whilst others worse so should be assessed on an individual basis.

The below video is a good watch. At approximately 32 minutes in, Dr Tremmel discusses medication for bridges.

youtu.be/8_Dfc_9qPek?si=JVW...(Not working as expected?)

[Milkfairy Heart Star in reply to Tos92]

Dr Jennifer Tremmel is a supporter of the International Heart Spasms Alliance.

internationalheartspasmsall...

I have read the information about nitrates on other Facebook groups, in particular on the groups associated with International Heart Spasms Alliance.

Have you been reviewed by the Cardiologist at Hammersmith Hospital who carries out the appropriate testing on the NHS?

From my understanding very few centres offer unroofing surgery in the UK. Some people go abroad for surgery. There is a Cardiothoracic surgeon on the Myocardial Bridge Facebook group who carries out surgery in Greece.

If your symptoms are impacting on your quality of life, have you considered applying for a Personal Independence Payment?

I was awarded enhanced payments for both sections, indefinitely as my refractory vasospastic angina is so debilitating.

Perhaps also ask to be referred to a Pain Management specialist too?

Unfortunately there seems to be little good quality unbiased information about myocardial bridges.

There is no information on the BHF website.

Perhaps contact the BHF and ask them to post something on the website?

[Tos92 in reply to Milkfairy]

 Milkfairy I am aware Dr Tremmel is a supporter of the International Heart Spasms Alliance which you have directed me to multiple times before.

I am currently waiting to see if my referral has been accepted by the cardiologist at Hammersmith.

There is almost a handful of hospitals in the U.K. and one in Scotland that provide unroofing surgeries at the moment.

As you are a member on the MB Facebook group, you may also be aware that not all types of health insurance is accepted for unroofing surgery abroad. I have come to know the costs of having unroofing surgery performed abroad with the Cardiothoracic surgeon in Greece, and it may not be feasible for most unless performed here in the U.K. on the NHS. Paying out of pocket could prove to be a challenge for most of us here in the U.K who have symptomatic bridges.

I am already with a pain management specialist and have been/still am in contact with the BHF to raise awareness of MBs.

[Milkfairy Heart Star in reply to Tos92]

The question to ask is why the surgery isn't offered on the NHS?There are sadly no National Institute of Clinical Excellence, NICE, guidelines of how to identify or manage myocardial bridges.

The local Integrated Care Board will have to agree to fund surgery.

Have you considered approaching the British Cardiovascular Society or British Cardiovascular Intervention Society, both have working groups.

These working groups end up giving evidence to NICE when guidelines are written.

[Shazna in reply to Tos92]

sorry ask but did you have surgery for bridge

[Green_pink]

Hi Shazna, sorry to hear you are going through this. I also have an MB but no symptoms (I also have AF). Interested to hear what TOS 92 has to share so following the conversation. I hope you get the support you need soon. X

[Shazna in reply to Green_pink]

Thank you

[Max2024]

Hi I have the same , we had to put a complaint to get the doctor to do the test again. Then when they found it they said to take tablets but when I took them it gave me really bad headaches and now I'm on the same tablets but a different dose. I still get chest pains. At the moment I get a burning sensation between my shoulder blades.