Potential Diagnosis. Vasospasms - British Heart Fou...

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Potential Diagnosis. Vasospasms

Dshadzz07 profile image
17 Replies

So about 8:30am this morning I had a sudden punch to the chest and pain in my arm, it felt different so I did decide to go to hospital felt short of breathe too.

ECG fine

Second ECG fine

Troponin was only 6. So obviously ruling out a heart attack, however I had two more episodes of the same thing in hospital one in front of the doctor all at rest. So being 22 he’s in certain belief it’s nothing obstructive due to extensive testing but thinks it’s vasospasms and vasospasic angina causing me issues from the extreme stress and anxiety I deal with.

It’s very hard to diagnose usually involves CT with a special thing that triggers them but they don’t want to give that radiation too me, I couldn’t like debate with him because I’ve had the combo too many times.

So he prescribed be calcium channel blocker that might help with what I’m experiencing so I’ll give it a go he also mentioned micro vascular angina too very knowledgeable on cardio stuff also stating my weight won’t be helping any of it carrying around an extra 40kg would also give me symptoms but I felt heard today.

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Dshadzz07
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17 Replies
BeKind28- profile image
BeKind28-

Hello :-)

I am sorry you found yourself at the Hospital but relieved you had not had a heart attack

You were lucky in a way you had an episode while the Doctor was there so he witnessed it and I am no expert when it comes to Angina there are plenty know about it that will reply but I would try the medication that you have been prescribed

I am just about twice your age now and had anxiety all my life and I would never want to frighten you as you are young there is more to help so you can change things where when I was suffering there was nothing but when I was talking to the Surgeon after my Bypass operation and asked why has it come to this she told me two things one it ran in my family but equally the way I live life so full of anxiety she explained just how much pressure that puts on the heart

There was no therapy back then and I have ended up so complex with my anxiety there seems to be no support for me now but you could get support and as this fear withy your heart is causing you so much stress there is only you can do it and I believe you can and you won't be putting your heart at risk if you do but you have to lose weight now and get as much support with your anxiety as you can

I know it is not easy but you have been told what you need to do and I am hoping you will do it you deserve a happy life it is there for you as soon as you make these changes :-)

Let us know how you get on :-) x

Milkfairy profile image
MilkfairyHeart Star

I have lived with vasospastic angina for over 11 years.

My coronary vasospastic angina was diagnosed by an invasive angiogram with acetylcholine which induced my coronary vasospasms.

A CT angiogram can only look for permanent blockages of plaque, not the transient constrictions of the coronary arteries that cause vasospastic angina.

Microvascular angina tends to effect women around the menopause.

The BHF has this information about microvascular and vasospastic angina.

bhf.org.uk/informationsuppo...

bhf.org.uk/informationsuppo...

Maybe give the BHF helpline a call too and speak to one of the cardiac nurses?

bhf.org.uk/informationsuppo...

I suggest you also keep a log of your symptoms.

The cold, emotional, mental and physical stress are common triggers of vasospastic angina, however I am not sure it's true to say that anxiety in itself causes coronary vasospasms.

Calcium channel blockers are the usual treatment of coronary vasospasms however I suggest you discuss your recent A&E admission with your GP and ask to be referred to a Cardiologist to confirm your diagnosis so you can be given the appropriate treatment.

Dshadzz07 profile image
Dshadzz07 in reply toMilkfairy

I will speak to GP about it but as I said even with the experience at A+E they are quite reluctant to refer me due to previous testing done and they definitely wouldn’t give me that kinda CT scan or one at all I’ve asked till I’m blue in the face.

I appreciate the response and help. The doctor today was trying to come up with the best ideas and logical ones for what’s going on.

He said anxiety itself would not but I have constant stress which can cause episodes that are acute and the angina feeling in general. But sure your body probably has more underlying causes too.

Milkfairy profile image
MilkfairyHeart Star in reply toDshadzz07

Vasospastic and microvascular angina can only be confirmed by a Cardiologist after appropriate testing. Without the testing a person has a presumed diagnosis rather than a confirmed diagnosis. It is possible to diagnose microvascular dysfunction by a cardiac MRI.

Sometimes it's possible to catch the ECG changes caused by a coronary vasospasm when an ECG is performed while a person is experiencing chest pain.

Sometimes a week long holter test can pick up these changes.

These types of angina are complex and serious heart conditions so you you need to be under the care of a Cardiologist so you can be given the appropriate treatment to prevent any of the possible complications of microvascular and vasospastic angina.

Dshadzz07 profile image
Dshadzz07 in reply toMilkfairy

I agree to this for me it’s a presumed diagnosis hence why I’ve been prescribed a calcium channel blocker.

You just know the nhs just has endless backlog and I’m not and never will be priority due to my age and previous normal testing. Issue is with the vasospasm that are assumed to be happening it’s very hard to catch on an ecg ofc.

However I’m trying to figure out why they started now the chest pain coming like a sharp tight pain for a minute then goes. I feel short of breathe afterwards, happens at rest. So like it’s too short to be considered an MI, isn’t a panic attack. I don’t even know, maybe it’s from the antidepressant I’ve started in the last week I have no clue. I’m trying.

Milkfairy profile image
MilkfairyHeart Star in reply toDshadzz07

I agree it can be very challenging to understand coronary vasospasms. My experience of coronary vasospasms is that they last for a long time, coming in ever increasing stronger and longer episodes of pain lasting upto an hour in length.

My vasospasms feel like being in labour, it feels as though someone is squeezing my heart in their hands.

Maybe give the BHF helpline a call and speak to one of the cardiac nurses?

bhf.org.uk/informationsuppo...

Dshadzz07 profile image
Dshadzz07 in reply toMilkfairy

yours seem to last way longer than mine like literally mine less than a minute, what the hell could be going on. My head hurts by it all maybe it isn’t vasospasms but like what else?

I don’t know what to say to the cardiac nurses? Like oh I maybe have this and I just get so anxious on the phone as it is.

Milkfairy profile image
MilkfairyHeart Star in reply toDshadzz07

We all seem to have our own version of the condition.

Are you getting some support to manage your anxiety?

Dshadzz07 profile image
Dshadzz07 in reply toMilkfairy

Yeah I’m on a new antidepressant recently the last week, and getting therapy again, just hard to deal with being a hypochondriac. Having GERD don’t help as I may have mentioned he thinks it might also me oesophageal spasms causing this,

Like he was a great doctor listened to all my history, I’ve had 4 of these episodes of the squeezing sharp in my chest now, all when laying on my back. So found that interesting.

I’m keeping note to mention to GP.

Yumz199725 profile image
Yumz199725

Sorry to hear you had to go to A&E but you must be relieved to have a diagnosis! ❤️❤️❤️. Have they got a treatment plan or is just medication??

DWizza profile image
DWizza

Really sorry to hear your situation but also glad that you are being seen and heard . Wishing you all the best fit the future . Carrying that extra 40kg around must be incredibly taxing on your body, as a weight lifter I know that moving 25kg weight plates can be a struggle trying to get them on and off the bar. I can’t imagine the struggle walking , standing , just moving, living with 40kg strapped to me. Wishing you well on your journey to better health 👍🏻👍🏻👍🏻👊🏻👊🏻👊🏻

dunestar profile image
dunestar

There's an active Facebook patient support group for microvascular angina and coronary artery spasms if you think it would help to chat with others on the same road. Microvascular Angina, Coronary Artery Spasms & CMVD Community.

Tos92 profile image
Tos92

Hi Dshadzz,

I remember one of your posts from last year where I suggested if this has been considered before. I’m sorry to hear this might be the case.

From experience, you will benefit from speaking to either a specialist in INOCA (ischaemia in non-obstructed arteries) or a cardiologist that has some knowledge of this. It will definitely speed up your diagnosis and they can determine the right testing and then treatment for either VSA (vasospastic angina) and/or MVA (microvascular angina). I have found that a suspected or a working diagnosis can affect the care you receive as it is still open to interpretation by other doctors and cardiologists and not all medical professionals will hold the same opinion or agree. Having a definitive diagnosis helps.

I was able to find my cardiologist via the below website which seeks to provide support to patients with these conditions. However, I did choose to go private. I have both VSA and MVA. It might be a good next step to see the doctor you saw in A&E that prescribed you the calcium channel blocker. If they are only an A&E doctor (which I presume they are), you can find a specialist and ask to be referred to them via the NHS through your GP although, you might find that there is a long wait.

The below website is also a good informative resource.

inocainternational.com/doct...

As dunestar has suggested above, INOCA International do have a sister Facebook Group. You might benefit from sharing your experiences and learning from others in similar positions. A lot of people do still have a working diagnosis like yourself as it is under diagnosed.

facebook.com/groups/2879606...

Also keep a list of side effects to your medication. Close monitoring is often required.

I hope you get some answers soon.

All the best.

Tos

Dshadzz07 profile image
Dshadzz07 in reply toTos92

Thank you I think it’s between a vasospasm angina or oesophagul spasms both cause similar pain. I have gerd and getting an endoscopy soon so I’m gonna ask about that too.

I’ll try the calcium channel blocker worst it’ll do is lower my bp which isn’t bad but obviously not needed if it’s the prior issue. I’ll look at a specialist to go private when I have money, I’ve ruled out conorary disease at this point with my testing and age. Need to look else where. I’ll check out the site so I appreciate that

Tos92 profile image
Tos92 in reply toDshadzz07

I’m being investigated for oesophageal spasms as well. The pain feels similar to having a heart attack. They can feel worse than the coronary artery spasms themselves. A manometry can help with a diagnosis.

You do not need to necessarily go private, this is just an option that suited me. You can in fact ask to be referred to a specialist on the NHS via your GP when you’re ready. The specialist I saw has now retired from the NHS and only holds a small private clinic. There will be many others that still work within the NHS.

Where in the U.K. are you based?

Dshadzz07 profile image
Dshadzz07 in reply toTos92

I’m based in Portsmouth. My GP is very reluctant on referrals for me is very stressful and upsetting for me.

Tos92 profile image
Tos92 in reply toDshadzz07

I will send you a PM.

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