Heart Attack with unobstructed arteries

[Coffeelover2]

Hi all,

I had a heart attack and a left ventricle thrombus at a young age. There is some mild narrowing in one of my arteries but I didn’t have a stent.

I just wondered if anyone was in same boat and whether you had a confirmed cause/reason for it happening?

[Milkfairy Heart Star]

A myocardial infarction non obstructive coronary arteries MINOCA.MINOCAs account for about 10% of heart attacks.

The possible causes are microvascular dysfunction, coronary vasospasms, spontaneous coronary artery dissection SCAD, a small piece of plaque breaking off or blood clot blocking the coronary artery.

I was admitted to hospital 11 years ago with a suspected heart attack.

However because I had unobstructed coronary arteries I was incorrectly told I couldn't have angina or a heart attack.

The knowledge has moved on. I was later diagnosed with coronary vasospasms which causes vasospastic angina.

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

[Coffeelover2 in reply to Milkfairy]

Thanks for your reply. How did they diagnose your vasospasms if you don’t mind sharing? I had a bubble study today and I don’t have a hole in the heart. I do have mild narrowing so I suppose plaque could have been an issue. Nothing definitive yet though. So bad that they didn’t diagnose you earlier, seemed to be really under investigated and explored

[Milkfairy Heart Star in reply to Coffeelover2]

Vasospastic angina is unfortunately often overlooked and under diagnosed.

I had an angiogram when they injected a chemical acetylcholine into my coronary arteries.

Normal functioning coronary arteries should dilate. I had spontaneous and acetylcholine induced coronary vasospasms, lots of chestpain and ST elevations and depressions.

[Eagle69]

Hi Coffeelover2, I am nearly one year on from a bad HA (Christmas day in fact) while out on a 30 mile bike ride. Long story short I was admitted on Xmas day, it took 8 hours in A&E to finally confirm I was having a HA, then had to wait 4 days for a stent to be put in. A few weeks later I was admitted back in with some pain and tests showed I had developed a LVT. Basically part of my heart, top tip, is not pumping as well as it should due to the damage done by the HA and, I think, the length of time I needed to wait for the stent. As it’s not working as it should, there is a possibility that blood can clot around it. I’ve been told that my artery had a complete blockage and the fact I was on the bike actually saved me as the heart was trying to work hard and therefore created an opening to allow some blood to flow.

I was put on Rivaroxaban and told to do nothing for 3 months while the thrombus dissolved. Thankfully it has and I’m pretty much back to normal and back on the bike.

Good luck mate

[Coffeelover2 in reply to Eagle69]

Thanks mate. I’m still on Rivaroxaban but luckily the thrombus has gone. Glad you are pretty much back to normal.

[Eagle69 in reply to Coffeelover2]

Yeah I'm on rivaroxaban for life now sadly plus a few others. Small price to pay I suppose!

Have a nice xmas.

[Coxtribe]

I had a similar experience: mild HA with atypical symptoms but confirmed initially via a test for troponin levels and later via a cardiac MRI.

The angiogram indicated some fatty deposits in my coronary arteries but nothing significant and therefore stents we're not required.

The MRI indicated that the MI likely occurred deep in the arterial network and was probably caused by a small piece of the fatty deposits breaking away and causing the blockage directly or a blood clot which had the same effect.

It seems that even low levels of fatty deposits can lead to heart attacks. At least I'm on the meds now to help prevent something more serious from occurring.

I hope this helps.

[Coffeelover2 in reply to Coxtribe]

Thank you. That seems very similar to what they are saying to me. The doctors have used the phrase ‘most likely’ so it isn’t 100% but thanks for your reply. They seem to feel it is quite unusual which didn’t help and seemed to suggest it was drugs or something which it definitely wasn’t .

[Milkfairy Heart Star in reply to Coffeelover2]

Cocaine can cause a severe coronary vasospasm. Some people can have coronary vasospasms as an allergic response to aspirin or some antibiotics.

Known as Kounis syndrome.

Microclots and microvascular dysfunction can result from an infection of co**d

You need to perhaps ask them about their understanding of MINOCA?

[SomersetJo]

I'm still learning about all this and haven't had a heart attack. I have 2 stents (unblocked several times). More recently it's been confirmed that I have microvascular disease (and possible spasms) which can cause angina and heart attacks but it is difficult to see in scans because the vessels are so small (and too small to stent). I'm not sure if that helps or not.