We are asked not to name individual doctors or hospitals on the forum.
However, I suggest you have a look at this article which is written by an experienced Cardiologist knowledgeable about ischaemia/ angina non obstructive coronary artery disease, INOCA/ANOCA.
INOCA/ ANOCA is an umbrella term for microvascular angina and vasospastic angina.
Thanks Milkfairy, Can you share your experience throughout these years? Do you feel any symptoms? I do not have chest pain, but mild shortness of breath after exercise.
Milkfairy, I find your reply very interesting. For four years , I experienced mild chest pain when doing any type of brisk, extended walking. In 2019 this happened for the first time which I reported to my family doctor I was referred to a cardiologist and did a contrast dye stress test followed by a nuclear CT both showed no blockages, heart healthy, lungs healthy. These symptoms continued for four years, in which time I always brought up to my family doctor that I was still experiencing the symptoms. . I would go back to the cardiologist who, because of my clear testing, said it was likely muscular. Fast forward to one month ago, April 2024. I have a repeat nuclear CT done and I’m found to have a 90% blockage in my LAD . After reading your post and looking up ANOCA/INOCA , I believe that is what I was experiencing. Very frustrating. Had this been detected four years ago , would I have avoided a 90% blockage requiring a stent? This is a question. I will be asking my cardiologist on my visit… Even after having the stent, I am still experiencing pain when exercising.
There is so much to learn and try to understand. I also have positive LP(a) which I was only tested for this year . I listened to a podcast recommended by another member which was very informative .
Thank you for replying and I will check your recommendations out.
I am in Canada … how do you find out if you have INOCA/ANOCA ?
INOCA/ANOCA is an umbrella term for microvascular and vasospastic. The tests are slightly different.
Microvascular angina is caused by microvascular dysfunction. The smaller blood vessels in the heart don't work properly, they fail to dilate or stay dilated when extra demands on the heart are made by exercise.
Whilst Vasospastic is due to the coronary arteries going into transient constrictions, coronary vasospasms.
i have no direct experience of microvascular issues but the is a US network which has a list of doctors and clinics which offer relevant treatment:microvascularnetwork.com/
I was diagnosed as NSTEMI in 2019 even though I did not have raised enzymes just a short episode of jaw aching. Retired RN so I decided it needed investigating.
i had 80% and 90% blockages and received 2 stents. The day after the angio and stents I had an echo that showed 46% left ventricular stunning - hypokinesis due to ischemia.
Fortunately this improved as a repeat echo 18months later ( following covid lockdown) I had normal LV function and EF of 65%
My note was mainly to say it can improve, hopefully they will get to the root of the problem.
I did walk every day, gradually building the distance and speed until I averaged 3 miles a day. Initially I could barely walk the length of my street and it probably took a year to feel "normal"
In my case, ischemia caused myocardial stunning and ventricle hypokinesis. The stents likely improved the blood flow and the muscle recovered.
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