Microvascular Angina

[SunsetOrange]

Hi. I was just diagnosed with microvascular angina. Been taking medications but still feel mild chest pains and still feel weak after 4 days discharged from hospital. Is this normal?

[Milkfairy Heart Star]

Hello

SunsetOrange,

Welcome to the forum.

Microvascular angina along with vasospastic angina are types of Angina/ Ischaemia non obstructive coronary arteries ANOCA/INOCA.

The symptoms of these conditions can overlap. I was presumed to have microvascular angina at first, however I had a functional angiogram with acetylcholine which confirmed I have coronary vasospasms, my coronary arteries and microvessels go into transient constrictions. So both microvascular dysfunction and coronary vasospasms.

I have lived with vasospastic angina for nearly 12 years.

Did you have a functional angiogram or cardiac MRI to diagnose your microvascular angina?

Microvascular angina is usually thought to be due to the inability of the small blood vessels of the heart not working properly, they fail to dilate or stay dilated in response to exercise.

It's good to see that your microvascular angina has been recognised.

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

Have you been offered cardiac rehab? Exercise is important to help the inner lining of your blood vessels to work well.

Just like any heart condition it's important to look at your life style, diet and manage your stress.

Keeping a diary of your symptoms and how you respond to your medication along with trying to spot your triggers can help you manage your condition.

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

The BHF has this information about microvascular and vasospastic angina.

bhf.org.uk/informationsuppo...

bhf.org.uk/informationsuppo...

bhf.org.uk/informationsuppo...

You may find this website helpful, it was created by 4 patients with over 60 years combined experience of living with microvascular and vasospastic angina. They are supported by 30 expert Cardiologists.

internationalheartspasmsall...

The forum has several members who live with microvascular and/ or vasospastic angina. Hopefully they will be along to share their experiences with you too.

[SunsetOrange in reply to Milkfairy]

Thank you so much for replying and information. I had CT coronary angiogram and echocardiogram. They are both normal. I had Stress Test (threadmill) and that was abnormal. So my consultant come up with microvascular angina because of my symptoms. Thank you for the link. I will look it up.

[Billyjean123 in reply to SunsetOrange]

Hi Sunset Orange So sorry to hear how the symptoms are affecting you. I had microvascular angina diagnosed 4 years ago but by process of elimination. I did find it difficult to get referred to a specialist in this field as I have already had a bypass.

As the lovely Milk fairy has said its all about finding the right combination of medication and being aware of your triggers. This has taken a long time to work out. For me it's cold, stress and exertion.

I think getting a supportive Dr behind you is really helpful.

I hope you get some relief.

All the best.

[SunsetOrange in reply to Billyjean123]

Thank you so much.

[MustyK in reply to SunsetOrange]

Hi Sunset

Hope that you are feeling a bit better. Milkfairy is by far the most knowledgeable on the subject. She has said it all. I too have MVA, and, it does take a little bit of time to find the right meds combination. Have you been given a GTN spray to help with the pain?. The time to take the meds can also help. I used to them 1st in the morning, then around 6pm. I found that sometimes I have chest pain early evening and early morning. I now take them late morning (around 11.00~11.30am) and 23h00). Since I have been doing that, the pains have almost disappeared. My usage of the GTN spray has dropped by at 90% at least!. I hardly use it all. I am sharing for the purpose of sharing; the fact that it works for me does not necessarily mean that it would work for you

[SunsetOrange in reply to MustyK]

Thanks so much for sharing.

[fishonabike]

i have no further info for you, @Milkfairy's direct experience and understanding are invaluable

but if it has probably already been a long road to getting a diagnosis and some treatment - be prepared for more of the same - doctors are only now developing knowledge and experience in this field - so find out as much as you can for yourself and be prepared for doctors and medical staff who know a lot less than you

i hope you get a good treatment regime established soon and are able to move on into life with his condition

[SunsetOrange in reply to fishonabike]

Thank you so much. I appreciate all the comments and concerns.

[SunsetOrange in reply to fishonabike]

Thank you so much.

[Suzyh]

Hi I had a heart attack 4 years ago and stent fitted then 18 month ago had chest pains so had an other angiagram and other tests checked my stent that's fine . Anyway it turns out he said I have lazy blood as he called it Mircrovascular dysfunction change my meds and told me I will still get chest pains and if they were really disabling to go to Gp .I do get them but it does not last

[SunsetOrange in reply to Suzyh]

Thank you for your comment. I'm in A&E at the moment since 5:30 this morning as I had bad chest pains for hours. It's 1:50 pm now and still waiting for cardiologist. Praying that they will be able to help me as I need to go back to work.

[Milkfairy Heart Star in reply to SunsetOrange]

I am sorry to hear you are back in A&E.

Unfortunately microvascular and vasospastic angina are still not well understood or recognised by Cardiologists.

They are complex heart conditions and there is no quick fix.

I have a careplan to guide the staff how to care for me when I am admitted.

It maybe worth asking for further testing to determine whether you have microvascular or vasospastic angina.

The treatment options are different. Beta blockers can help people with microvascular angina but can cause worse coronary vasospasms

I was admitted to CCU with unstable angina after being prescribed beta blockers before my diagnosis of vasospastic angina was confirmed.

I am now prescribed high doses of a calcium channel blocker, nicorandil, Isosorbide mononitrate, nitrate patches, clopidogrel and rosuvastatin.

I was referred to Cardiologist who specialises in caring for patients with microvascular and vasospastic angina.

This maybe something you can ask for. Your GP or Cardiologist can refer you if necessary.

I hope you feel more at ease soon.

[Poppy451]

Hi SunsetOrange

I hope you got some help at A&E . In the past I have not found it very useful other than to rule out a heart attack. I did not find the doctors too understanding of microvascular angina there. I found seeing a specialist in this type of angina more helpful in the long run.

My symptoms are not as bad as they have been but are still pretty awful at times. I find I use such a lot of gtn spray. ( I am on calcium channel blockers and isosorbate mononitrate too). I hope you start to feel better soon.

[SunsetOrange in reply to Poppy451]

Thank you. After that A&E visit my medicines were not changed. The specialist nurse (angina) recommended that I undergo Endoscopy to further investigate these chest pains. Spoken to my GP and she agreed on that. Now waiting for that appointment. All day in A&E last Thursday no chest pain till now. Hopefully chest pains won't come back.

[Poppy451 in reply to SunsetOrange]

Oh dear sods law you get the chest pain when you're back home. I would pursue it with the cardiologist you saw regarding microvascular angina,aswell as going for the endoscopy. What medication are you on for the chest pain?

[SunsetOrange in reply to Poppy451]

Thanks. I'm on Isosorbide mononitrate 10mg morning and late afternoon, bisoprolol, aspirin 75mg and Atorvastatin and NGT spray

[990herc]

Have you considered taking Ouabain for your Angina? Your doctors probably never heard of it since it was buried by Big Pharma years ago when its patent expired and they no longer could make huge profits on it. Here's some info- infarctcombat.org/heartnews...

[SunsetOrange in reply to 990herc]

Thanks