vasospastic angina and Troponin levels

[Sunshinebrew]

I’m feeling worried and hoping for reassurance. After feeling increasingly tired and having occasional chest pain and episodes of feeling dizzy with sickness I went to A & E last Friday after an episode of chest pain with dizziness I was discharged it not being a heart attack. But I continued with mild chest pain over the weekend and felt really exhausted so I saw my GP on Monday she insisted I go back to hospital I continued with chest pain off and on while there and the blood test showed a rise in troponin from. 11 to 15 but I’m home again now I’ve been referred to cardiology but that could be months the chest pain has eased but I’m so frustrated ok I’m very glad it’s not a heart attack but still if the pain comes back it’s back to A & E then with no resolution I’m sure it’s a vasospasm but it would be really good to speak to a cardiologist when in hospital to reassure me and explain that this is the case and what I can do about managing it while I wait for my referral!!!!

[Milkfairy Heart Star]

Hello,

I suggest you go back to your GP to see if they can get in contact with the Cardiology department to see if you can be seen sooner.

Your troponin blood levels are slightly raised and I am surprised you were discharged from A& E without seeing a member of the Cardiology team.

It perhaps reflects the lack of knowledge about vasospastic angina and how women heart patients are different amongst the staff.

Coronary vasospasms are not harmless and if you have dynamic ECG changes with even low rising troponin blood levels accompanied by chest pain that is a type of acute coronary syndrome.

I am always admitted in these circumstances.

You may wish to contact the Patient Advisory Liaison Service PALS of the hospital and raise your concerns and request to be seen by a Cardiologist promptly.

Next time you need to go to A&E ask to be seen by a member of the Cardiology team for a review.

Vasospastic angina is a rare complex condition which in my experience very few A&E or Cardiologists know much about which is why I have an admission plan.

I hope you get to see a Cardiologist sooner rather than later.

[Sunshinebrew]

yes I agree I also have 3 stents which were put in 7 years ago and I think my GP was of the opinion that it’s unstable angina which was why she wanted me to be seen again. But the A & E doctor did speak to cardiology in the phone when I insisted and my medication has been increased and the pain has settled today if I get any more i will go back again and I will speak to my GP I think she was going to email them as well to ask if I could be seen urgently 🤷‍♀️I’m exhausted it seems unless you’re actually having a heart attack they don’t want to know I’ve been through all this so many times and surely having been really well fir years this chest pain and dizziness Thats come on again needs to be investigated urgently I’m so frustrated!!!

But thank you for your reply and good advice and I hope you’re ok.

[Milkfairy Heart Star in reply to Sunshinebrew]

I share your frustrations 🫤

It does seem that vasospastic and microvascular angina are not taken seriously until you have a heart attack 😳

I find after episodes of coronary vasospasms I am exhausted too.

I have just started keeping a log of my chest pain episodes as I am going to start a new medication. It's been quite a shock as someone else said we normalise the level of pain we live with.

I am seeing my Cardiologist next month but looking at my log I may need to be admitted sooner rather than later.

I rest well and I hope you are seen soon by Cardiologist.

[Sunshinebrew in reply to Milkfairy]

Yes that’s very true a certain level of pain and tiredness becomes the norm and it’s only when we note it and read back that we realise it. I appreciate your replies and I’m much calmer now wishing you well thanks again 😊

[Bunkular in reply to Sunshinebrew]

I'm surprised the docs haven't lined up further tests for you (besides blood work). Just because you've had 3 stents inserted doesn't necessarily mean those coronary arteries are now problem free. I've read on this forum that some persons have had another blockage buildup right beside the stent a few years later. An MRI would clearly show up any further plaque buildup. Even an ECG would show if there's a block. Keep asking questions, OK? In the meantime do breathing exercises to remain calm while pursuing your healthcare. There is a solution for you.

[Sunshinebrew in reply to Bunkular]

I have been referred to cardiology but not sure how long this will be and not urgent enough to be admitted but if I get anymore pain I’m going back and insisting I see a cardiologist before they send me home again. Thank you for replying I appreciate it and agree with your points 😊

[Tos92]

Hi Sunshinebrew,

Your A&E experience sounds similar to some that I have had in the past. You have already been given good information however, I just wanted to add something regarding your Troponin levels. I had a MINOCA in Jan 2022 from a coronary artery spasm. The first blood test came back at the same number as yours, 15. I was then told I’d be admitted either way (they didn’t know I had a heart attack at this point yet) and another set of bloods were taken. The second set of bloods came back 4 or 5 times higher which indicated that I had in fact had the MINOCA. So I am a little bit surprised that you were discharged without intervention from cardiology and this is concerning.

For some people, a slightly elevated Troponin maybe normal for them (I have a slightly elevated D-Dimer which has not budged since Sept 2022) however, I would contact your GP or local cardiology team urgently. I am not saying that you have had a heart attack, so please don’t be alarmed, but it is safe to rule this out.

I hope you get some answers soon.

Take care.

Tos

[Sunshinebrew in reply to Tos92]

O thank you for replying I know it’s very confusing because the first doctor I saw told me that if the troponin was raised he would admit me but by the time the 2nd blood test was taken he’d give home so the remaining doctor when I insisted called cardiology and they said over the phone that the bloods were fine they increased my meds but didn’t see me. If I was still having chest pain I’d go back but it seems to have settled now so I hope I’ll be okay. I appreciate your reply and I will be speaking to my GP about it all.