Hospital Update

[Jenzhearts]

just wanted to update and once again thanks for all the help and advice especially MilkFairy.

I emailed Pals on Mon I didn’t receive a reply as I had to get an ambulance as my pains were bad and gtn wasn’t stopping them.I emailed them to say I was in and had been for several hours but was getting nowhere.then I was given a prescription upping my nicorandil so I said tell him (my consultant) I’m not going anywhere I want admitting I was also keeping pals updated.

Then I was admitted to a general medical ward,the next day the consultants registrar came to see me and said they had decided to keep me in until my scan.

Found out last night my scan is Monday 22 Jan 😀

Have had my morphine upped and I think we are managing to control the pain but today I’m feeling under the weather nausea fatigue etc could be the morphine tho.

So roll on Monday although I don’t know what il do if this scan doesn’t show anything but got to be positive

Il keep you all updated

[Milkfairy Heart Star]

Thank you for your update.

I am glad you felt able to advocate for yourself.

Have you been prescribed any anti anginal medication too ?

GTN spray or isosorbide mononitrate?

Have you been prescribed any anti sickness medication?

I also ask for anti sickness medication when I am given morphine as it makes me feel very nauseous.

If the morphine doesn't help do tell the staff and ask for the Cardiology team to review you.

[Jenzhearts in reply to Milkfairy]

Hi I’m on isosorbide GTN Ranolazine Ramipril Nicorandil bisoprolol amlodipine I think that’s it and this is why they were starting to doubt I had chest pain they said the amount of drugs didn’t correlate with my pains

BUT this visit I feel we are getting on top of it they have increased my morphine and Nicorandil I think and I have paracetomol and morphine together.I don’t like being on morphine but I need it at the mo.

Am praying that the cardiac mri scan on Monday gives us answers otherwise they will write me off as a time waster I think xx

[Milkfairy Heart Star in reply to Jenzhearts]

Before my diagnosis of vasospastic angina was confirmed, I was presumed to have microvascular angina. I found the Cardiologists just kept giving me various medications, in a scatter gun approach.

Including Ranolazine which gave me palpitations.

Beta blockers actually made my chest pain much worse and I ended up being admitted to CCU for 5 days.

I found out later that beta blockers should be avoided if you have vasospastic angina.

My cardiac MRI was ' normal' other than scarring from a previous episode of myocarditis.

My vasospastic angina was confirmed by a specialised angiogram.

Most tests are designed to detect obstructive coronary artery disease rather than microvascular and vasospastic angina.

So you are absolutely not waisting anybody's time.

Unfortunately microvascular and vasospastic angina are poorly understood, under recognised and undertreated by Cardiologists.

I am on top doses of all my medications, but still have for over 11 years experienced daily episodes of chest pain . I am admitted to hospital once or twice a year for treatment with IV GTN.

Not responding to your medication isn't an indication that your chest pain isn't cardiac in origin.

Are you having your troponin blood levels checked and ECGs done everyday?

[Jenzhearts in reply to Milkfairy]

Hi

I’ve had quite a few ecg,s done here and my troponin levels are not raised.

On my discharge notes from December it says Microvascular and on my discharge from last week it says Unstable Angina but surely the stress angiogram would have shown Microvascular so I don’t know why I’m being sent for a cardiac one.I’m mindful also that if it doesn’t show Microvascular that I’m back to square one.it’s a rotten disease this isn’t it xx

[Milkfairy Heart Star in reply to Jenzhearts]

If microvascular angina isn't diagnosed that doesn't mean you don't have the less common type of Ischaemia/ angina without blocked coronary arteries, coronary vasospasms

That requires a functional angiogram using acetylcholine to see if the acetylcholine induces any coronary vasospasms.

[Jenzhearts in reply to Milkfairy]

I had the pressure wire angiogram last week is that the same thing? Xx

[Milkfairy Heart Star in reply to Jenzhearts]

An angiogram with a pressure wire and adenosine is how microvascular angina is diagnosed.

Coronary vasospasms which can occur in the microvessels and coronary arteries is diagnosed using acetylcholine.

That how my vasospastic angina was confirmed. I had spontaneous and acetylcholine induced coronary vasospasms.

I had lots of my usual chest pain and ECG changes.

Occasionally dynamic ECG changes are seen during an episode of chest pain. ST elevations, ST depressions, T wave inversions.

I have dynamic ECG changes which is why I am admitted and treated with IV GTN.

Have you got a copy of your angiogram results?

If your coronary flow reserve is below 2.5 and the blood didn't flow easily through the small vessels then that indicates microvascular dysfunction.

[Jenzhearts in reply to Milkfairy]

That’s what I had the pressure wire.I’m just wondering why they didn’t diagnose me after that as the consultant said he thought it was Microvascular but instead have sent me for the cardiac mri?.xx