Recently Diagnosed with microvascular... - British Heart Fou...

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Recently Diagnosed with microvascular angina

LexieB74 profile image
15 Replies

Hi Everyone, newbie here!

I've just been diagnosed with microvascular angina. I'm still in shock and not dealing well with the diagnosis. I feel like they've made a mistake (although probably not....). I had all the usual tests which came back fine and finally the exercise stress test and an angiogram. On the stress test I had my usual breathlessness and tightness in the chest. The angiogram revealed slightly sluggish flow in one of my coronary arteries but no stenosis at all. They thought that although there were no blockages that there were issues based on my history and the stress test and the angiogram.

I've just been put on atorvastatin and nebivolol as well as aspirin and am finding that my symptoms feel worse - I'm getting pains in the chest at rest (which I didn't before) and they're sharper than before. It's causing so much stress. Calling the GP wasn't much help, he was slightly defensive and didn't want to 'question the consultant's diagnosis' when I said I was confused at the diagnosis (I hadn't been discharged by the consultant but someone else and I didn't receive a letter to give me any results....so I asked for clarification).

I'm not sure what to expect going forward and I feel like I've been given tablets and told to go away. I feel quite isolated :(

Any advice or thoughts from people's experience are welcome!

LexieB74

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LexieB74 profile image
LexieB74
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15 Replies
Milkfairy profile image
MilkfairyHeart Star

Hello,

Welcome to the forum.

I am sorry to hear you have been left with such a sense of abandonment and been given such little information.

I live with another type of angina/ ischaemia non obstructive coronary arteries ANOCA/INOCA, vasospastic angina.

My coronary arteries go into transient constrictions causing a lack of blood supply to my heart, coronary vasospasms.

Microvascular angina is thought to be caused by the inability of the small blood vessels of the heart to dilate or stay dilated in response to extra demands like exercise, microvascular dysfunction.

Some people have microvascular vasospasms.

There is also a condition called slow flow phenomenon which is an even less common type of ANOCA/ INOCA.

Microvascular and vasospastic angina are complex heart conditions and still relatively poorly understood by many Cardiologists.

There has been alot of research since I was first diagnosed over 10 years ago.

I was originally presumed to have microvascular angina and prescribed nebivolol. I ended up in hospital with unstable angina.

I later discovered beta blockers should be avoided if you have coronary vasospasms.

I suggest you keep a diary of your symptoms and how you respond to your medication. Discuss your diary with your GP and ask to be refered to a Cardiologist who has some understanding of microvascular and vasospastic angina, especially as your symptoms have not improved.

It can take sometime to find the best combination of medication that will work best for you as an individual.

In over 11 years, I have always been seen by a Cardiologist.

There is some information on the BHF website which you may find helpful.

bhf.org.uk/informationsuppo...

bhf.org.uk/informationsuppo...

bhf.org.uk/informationsuppo....

There is also this website which was created by 4 patients with over 50 years combined experience of living with microvascular and vasospastic angina. They are supported by 30 worldwide expert Cardiologists.

internationalheartspasmsall...

There are quite a few of us on the forum who live with either microvascular or vasospastic angina or even both, on the forum. We all have our own version of the condition. Hopefully they will be along to share their experiences with you too.

I hope you don't feel quite so isolated anymore.

Suzyh profile image
Suzyh in reply to Milkfairy

Hi just been reading some of the links you have given and I want to say thank you. It explains things in detail which I did not know. I'm on a mixture of meds and have MVD my cardiologist is brilliant so guess I'm lucky. I still get chest pains usually at rest or if it's real windy and cold. Anyway thank you

Milkfairy profile image
MilkfairyHeart Star in reply to Suzyh

I am glad to know the links helped you.I hope you are keeping well in the wind and cold weather.

LexieB74 profile image
LexieB74 in reply to Milkfairy

Thank you Milkfairy. That is very kind of you. I will look through these links. The diary of symptoms is a really good idea. Thanks for that. It does make me feel less alone. ❤️

Crystal614 profile image
Crystal614

Hi, I started suffering with chest pains back in 2014. I saw a cardiologist, I then went on to have a CT coronary angiogram and then an angiogram, both normal. For 2/3 years I was seeing my GP frequently with ongoing chest pain and problems with my heart rhythm (I now have a pacemaker). My GP started me on a GTN spray which helped and then Isosorbide Mononitrate. He wrote back to cardiologist querying that I could haver Microvascular disease. Cardiologist started me on medication (Trimetazidine) to see what response I had with it. What a huge improvement it made. I have since had other medication added as pain as been getting worse and far more frequent. I have been told that I have MVA by a few doctors over the years. I too have pain at rest or exercise can trigger it, not always during but afterwards. I have been struggling for the last few months. Just before Christmas I went to see a GP, I became unwell while I was there and he had to get an ambulance for me. I am booked in for a Nuclear stress perfusion scan next week. There are a few things they will be looking for. They will be checking to see if I need any stents and to see if there is evidence of a HA that could possibly have happened a few months ago. I was told a while ago that they think there is some disease in the small vessels so I don't know at this time if it has worsened or it is connected to an "electrical" problem with my heart. Hopefully I will get answers soon. Milkfairy, has given some very good advice and details of websites that you can look at. You are not alone in having this type of problem.

LexieB74 profile image
LexieB74 in reply to Crystal614

Thanks Crystal614. It's such a new one on me that it's hard to know where to start. Everything seems to be bad for the condition (foodwise) and I find it hard to eliminate stress from my life more generally. Plus, I just feel like I don't want to go to work at the moment. It all feels overwhelming. But I guess that might change over time. Good to know this place is here.

Poppy451 profile image
Poppy451 in reply to LexieB74

Do you drink coffee? I found this to be a huge trigger for me . I haven't had coffee for about a year and a half now. I have MVA aswell.

LexieB74 profile image
LexieB74 in reply to Poppy451

I do but I mostly drink decaf at home. When I'm out I mix it up. It's not too bad with the caffeine - only if I have too much-more than 2 or 3 cups, which is rare anyway.

Crystal614 profile image
Crystal614

I can understand how you feel. I have changed to the Mediterranean diet I try to eat heathy as much as I can, with lots of fish, vegetables and fruit. You will need to find the right combination of medication that works best for you and better support as well. You need to take one day at a time and things will improve. If you haven't already done so look at the web sites that Milkfairy included in her post to you, you will find them useful.

Warm-heart profile image
Warm-heart

Hi there, I want to encourage you that this may all resolve naturally. I had chest pains a while back that were thought to be microvascular angina, but placed on bisoprolol made the pains and breathlessness worse (this is a beta blocker like nevibolol), so I stopped it and the whole thing resolved. The increase in symptoms may well mean they do not suit you. Remember always: the body has a wonderful ability to heal itself given the right conditions, to trust your gut feeling, and give it a good heart healthy diet. This book was written by a cardilology consultant amazon.co.uk/Pioppi-Diet-21... And you are in charge of your own body and what you do so do what you feel to be right as you have no firm diagnosis currently. Very best wishes.

LexieB74 profile image
LexieB74 in reply to Warm-heart

Thank you for your kind encouragement. It means a lot.

Warm-heart profile image
Warm-heart in reply to LexieB74

You are very welcome. Let us know your progress if you wish 💌

LexieB74 profile image
LexieB74 in reply to Warm-heart

Thank you warm-heart ❤️

1Aeroman profile image
1Aeroman

Hi LexieB74. I too was shocked when diagnosed with MVD and 25% restriction to my LAD artery, when I was [otherwise] healthy. It was a scary time for me until I'd had the angiogram - that is when I was reassured by the cardiologist's knowledge and explanation of the condition. Maybe I was fortunate to be looked after at a teaching hospital, so lots of information was given to me and I had time to ask lots of questions. I was prescribed aspirin, bisoprolol, atorvastatin and felodipine - it took 6 months, a change to a more Mediterranean diet and increased exercise before I felt better. It is now one year since diagnosis, and I feel great in myself, with only occasional chest pains & breathlessness, which are brought-on by stress or strenuous exercise (like cycling - where a short rest and/or the GTN spray sorts it).

Lots of great information (thanks Milkfairy) and friendly support on this forum helps me stay positive - I hope you will too, given time.

LexieB74 profile image
LexieB74 in reply to 1Aeroman

Thanks. I think I'm struggling to accept the diagnosis. I have other conditions that all might lead to shortness of breath (sleep apnea), aches and pains (menopause), so I am battling with accepting that it is MVD. I have no stenosis, no markers for anything on any tests. Also, one thing I'm finding is that I now have more pain in my chest than before. I have it 'at rest'. Before I only ever got it when exerting myself and not always then. It seemed to come on in the cold more than anything. Now I'm aching in my chest a lot. I have had a few sharp pains and I'm finding lying on my back on my left painful. I'm not sure the nebivolol is a good fit for me. It's making me panic a bit. Plus the omeprazole isn't working and I have almost constant heartburn. Some of the fingers on my left hand also feel odd. I think I'm in more discomfort than before I was put on the medication. 🙄 It's a bit much and I'm out of my depth really!

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