Microvascular Dysfunction Tests

[Himala]

Does anyone know which tests are used to detect Microvascular Dysfunction/Disease? I have been experiencing breathlessness and chest pain and my doctor referred me to Cardiology. I have had a 24hour ECG, blood tests and a CT Coronary Angiogram. All have come back normal. However, I continue to have chest pain when anxious and sometimes for no reason. I have been taking Bisoprolol 1.25mg for 2 months, which has helped. When I asked for an Echocardiogram the Cardiologist told my GP that there was no need for me to have further tests as the tests I received have all reported normal. I am thinking of using my life savings to pay for tests as I do not want to continue worrying about what is wrong with me and also taking medication that I may not need.

[Milkfairy Heart Star]

Hello,

Microvascular dysfunction causes microvascular angina which along with vasospastic angina are types of ischaemia/ angina non obstructive coronary arteries INOCA/ANOCA.

Microvascular angina is more common in women and breathlessness is a common symptom.

MVA is often overlooked by Cardiologists.

A stress echocardiogram or perfusion MRI can help to diagnose microvascular angina in some cases.

In larger heart centres functional angiograms are offered when the way the blood vessels work are assessed.

Adenosine and guide wires are used to measure how the blood flows through the small blood vessels and this is how microvascular dysfunction is diagnosed.

Acetylcholine is then used, if a person's coronary blood vessels constrict and narrow accompanied by ECG changes and the person has chest pain then vasospastic angina is confirmed.

My vasospastic angina was confirmed by this type of angiogram in 2014. All my other tests were normal, though I do have ECG changes during my episodes of severe chest pain.

The BHF has this information about microvascular and vasospastic angina.

bhf.org.uk/informationsuppo...

bhf.org.uk/informationsuppo...

I suggest you keep a log of your symptoms and see if you can spot any triggers of your symptoms.

Common ones are the cold, emotional, mental and physical stress.

Perhaps also ask your GP to refer you to a Cardiologist who has some understanding of microvascular and vasospastic angina.

[Himala in reply to Milkfairy]

Thank you Milkfairy for your response and information. I will certainly follow up your suggestions.

[Poppy451]

I agree with Milkfairy , perhaps asked to be referred to a microvascular angina specialist. I had a cardiac MRI that showed a perfusion deficit and that is how my MVA was diagnosed.

[Himala in reply to Poppy451]

Thank you Poppy for your response and information.

[Mash_]

Hi, A stress echocardiogram or perfusion MRI can help to diagnose microvascular angina in some cases, would these types of testing also help to diagnose vasospastic angina? Thank you

[Milkfairy Heart Star in reply to Mash_]

Vasospastic angina can only be confirmed by a functional angiogram.

I had spontaneous and acetylcholine induced coronary artery vasospasms, accompanied by my usual chest pain, ST elevations and depressions on my ECG when I had my functional angiogram.