prior to contracting Covid in April 23 I was very fit and regularly ran up mountains and 2/3 hour runs was my usual at least once a week plus some kind of activity every day.With COVID I developed chest tightness and breathlessness, particularly worse on exertion. I repeatedly said that it felt like somebody had sat on my chest and forgotten to get off.
By August I had been told I had Long Covid but because I was due to guide a group at altitude I got a referral to respiratory and a six minute walking test showed a dramatic fall in my oxygen saturation to 85% For 5 1/2 out of the six minutes. Needless to say I did no guiding at high altitude …I got the all clear on my lungs in Feb 24 and eventually got referred for a heart scan ( an earlier request from my gp practice was refused) .
The scan came back showing mild heart damage with a part of my anterior wall not receiving enough oxygen during a stress test through myocardial perfusion imaging test.. I’m told I have angina. Basically this and the six minute walking test are only symptoms and I still don’t know what the underlying causes are.
I finally have an appointment with the cardiologist - which I’ve had to fight for as I was going to be dismissed to be managed locally by my GP practice,(they have been gobsmacked as I don’t fit the typical picture) My resting heart rate is 52. My blood pressure is low my weight is good. My BMI is 23.2. My diet has always been pretty good mostly cook from scratch. I’ve medication now - on lowest dosage of Elantan - an isosorbide mononitrate, aspirin And now on statins as the only indication apart from the MPI scan is high cholesterol coming in at 7.5 . I’m desperate to return to activity as it’s what keeps me together on every level . Prior to all of this my livelihood and recreational time has been focused around being in the outdoors. It has been a major part of my life.
I still get tight chest on exertion ( but better if take GTN tablet first).
I know I’m asking impossible questions as I still have no diagnosis of what is actually underlying angina but has anybody successfully returned and been able to run rather than walk, with angina? If so, what is it that allowed you to return to Running ?
What tests should I push for?
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Ayecan
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Great post, only got a few minutes but can I give you some advice? The mods on here don't like the "C" word, if I were you iIwould edit your post and just make subtle reference to it, or it will get taken down
The usual cause is due to a pernament obstruction, following the build up of cholesterol plaques in the inside of the coronary arteries.
Another cause is when the smallest blood vessels don't work properly, microvascular dysfunction which is more common in women. Most people living with microvascular angina can have breathlessness and chest pain on exertion.
A rarer type of angina is caused by transient constrictions of the coronary arteries, vasospastic angina. The classic symptom of this type of angina is chest pain at rest or following exertion.
Perhaps give the BHF helpline a call and speak to one of the cardiac nurses who are very knowledgeable.
I can only relate my experience, but I hope it is in some way reassuring. Like you, I have exercised all my life, kept my weight under control and endeavoured not to eat too badly or drink too much🫣🫣. But, I ignored signs of high cholesterol for too long, always thinking I could adjust lifestyle to bring it under control. It didn’t work and last year I began suffering from quite difficult bouts of Angina when exercising, to the point where I went from running 4 times a week to barely being able to walk up a small incline. Long story short, had two stents inserted in my LAD in July last year. It’s made a huge difference although Angina not completely gone away, depending on degree of exercise I’m doing. But, I’m back running 4 times a week (5km at a gentle pace these days😀😀). I tend to have a single spray of GTN spray before I start running and that usually stops any Angina-like symptoms coming on for about 25-30 min. When I’m not running I don’t need it for hill walking etc.
Hopefully, once they work out the root cause of your problem and treat you accordingly, you can get back to somewhere near your former self and levels of activity, although you may have to adjust to a certain degree. Since starting on Statins, my (bad) cholesterol levels have more than halved, which will hopefully stop further deterioration and mean I can continue to exercise for some more years to come. So to finally answer your question (!), yes, there is most definitely a life of exercise after an Angina diagnosis. All the very best.
Thanks so much. I think what has surprised me is that I was told previously that I had lots of the good stuff for cholesterol so assumed that was under control and even when I got the high result overall result last year my GP said I had lots of the good stuff and not to be overly concerned. It sounds as if people get back if they have stents or similar so I guess it is wait and see what the diagnosis is for cause.
Just looking for hope as I have had a year plus now of being patient and trying not to push things not knowing that there was an underlying heart issue.
Mine is 7.5 and my mum had angina and there is family history on that side but I really never thought it would be an issue for me as I’ve always been fit and healthy with much better lifestyle than her or other relatives. I’ve asked for testing but been told to ask via cardiology. Don’t want my kids going through this!
My blocked artery was due to strong family history , so unfortunately the odds are stacked against you when it’s hereditary. I think my kids too are worried after my stent . Wish you well
Thanks. I have gathered that angina is not hereditary but high cholesterol can be. We’ve early deaths from heart attacks and my mum’s cholesterol was high but I assumed all was due to their life styles but I’m thinking it’s also due to genetic predisposition. I thought I was immune as my lifestyle has been pretty good. I do feel better screening and taking family history as a warning sign would help for others. I’ve been unlucky. Mostly my GP practice is great however I feel a little let down on this one.
Angina itself isn’t , but the blockage to the arteries that cause it is . My paternal grandfather died of mi in his 40’s , my dad died aged 63 following in his 3rd mi , my brother had mi and stent fitted aged 58 , and I had my stent fitted Aged 60 , so definitely genetically predisposed
Have you been diagnosed with microvascular or vasospastic angina? There is some research to suggest that these types of angina non obstructive coronary arteries ANOCA maybe inherited.
I appreciate there are forms of angina caused by things other than plaque build up, but for the most part a predisposition to the retention of cholesterol based plaque in the coronary arteries is the cause of most angina, and there is most definitely a genetic component to this.
I had severe blockage to my LAD artery in 2 places and had 2 stents fitted in 2018. I started back running 3 moths after (from brisk walking) and and have no further problems so far, joined a running club a while ago as well, so there is hope. Like you say you will just have to wait for a diagnosis which sadly might be a while at the moment. I do feel for you, having led the life you have it's very unfair. I also felt "why me?" afterwards, but the better way of looking at it is "Why not me?". This happens to people who have done everything right all their lives unfortunately.
yes, the unknown is not a great place; it made a real difference to my mental health once I had the diagnosis and my Cardiologist mapped out a way forward. Hopefully, you get some information soon 🤞🤞🤞🤞
Hey if you are having to use your GTN frequently, I would request a angiogram or cardiac CT. They will be able to get a better picture of what's going on. 🤗
Thanks. Yes I’m thinking similar. It takes very little to trigger chest tightness 😟 with the occasional short sharp pain firing across which I’d imagine is not a good sign…not sure if cardiac Ct available in my area.
I am / was an ultra marathon runner. I had a heart attack (reasons unknown) last August. It's taken me a year of rehab to get back to bring able to run 5k a day. Perhaps find yourself a cardio physio who understands your condition. They've seen it all before. I've been told that I should be able to get back to half marathon, even marathons if I want to push it. Good luck. Like everything it will likely be a programme that pushes your activity slowly up over time to see how your body reacts. Wish you the best as running keeps me sane.
Hi I was diagnosed with angina amidst cardiac problems,so when saw cardiologist I asked him and he said you can get angina without any heart problems,it's just like having cramp in heart muscle,the gtn opens the blood vessels ,I now take a long acting gtn tablet twice a day and I can walk a lot faster and longer with my dogs so it has improved my quality of life
following on from maradonas suggestion, depending where you’re based, there’s a lady called Angela Hartley who does something like this (she is an ex cardiac nurse and now a cardio rehab specialist. Search healthy hearties on Facebook.) She does one to one rehab/training online as well as in person. Just thinking she has a wealth of knowledge and you are outside the ‘norm’ which I find always makes it difficult to get tailored help. My cholesterol was 6.6 at 49, I have a terrible family history but still the GP was unconcerned. I saw a cardiologist privately in the end and had a CT angiogram which showed mild atheroma in my LAD. i did also get referred to the lipid clinic on the nhs which was useful and the doctor there agreed I likely have familial hypercholesterolaemia (a condition where you make too much/can’t get rid of cholesterol, can’t be cured by diet alone, I take statins now)
Personally i would ask the cardiologist what tests they want to do but I’d push for a lipid clinic referral (from GP) and definitely try to find a cardiac rehab specialist as I think they will be much better at looking at you as an individual. Good luck 🤞
I had partially blocked lad and needed a stent. On isosorbide, aspirin, clopidogrel, statins. Been back running for about a year. All good. Up to doing 10 miles ish
CT angiogram, cardiac MRI, echocardiogram. You should not be running until you know what’s happening. Too much pressure on your heart. Wishing you a speedy recovery and best wishes.
I remember when I got discharged from the hospital after I had blood clots in the lungs back in 2017 and had asked the nurse about when was it safe to resume exercise and she had said that gentle walking was fine and to stop if I got puffed or didn't feel very well.
Carry on with the running but stop if you don't feel very well and try again another day!
Hello. With ref to the high cholesterol perhaps you might be able to have the Inclisiran injection. I qualified as I had a MI infraction 4 years ago and, as I couldn't take statin for the side effects, I was put on Ezitimibe and last year I started having Inclisiran because of my history. Now LDL is 1.8 and HDL is 1.4. Maybe just talk with your (possibly useless) GP and see what happens. Xxx
Those of us living at low altitudes with heart conditions ( i live on the coast) are likely to be more susceptible to problems at anything moderate in height in a way that someone living in the mountains wouldn't notice.
I found I was affected for the first day or so when recently in Switzerland at around 5000 feet. Humidity also has an effect
Following on from my post above about the importance of altitude to heart patients, I am posting a link showing the amount of oxygen in the air at various heights
Oxygen is at a maximum of 20% or so at sea level so a level of say 15% at a greater height means a 25% reduction in available oxygen, which is quite significant. I believe plane cabins are pressurised to a height equivalent to around 8000 feet
Very interesting comments about how oxygen and air pressure can affect heart patients.
The sudden drop in air pressure during storm Ciaran last autumn triggered my coronary vasospasms. I was admitted to hospital with unstable angina, for 10 days as a result.
I have to use oxygen when flying as again the air pressure drop triggers my coronary vasospasms.
That is very interesting. I wonder how many other people were also affected but didn't realise the cause?
As I say, above around 5000 feet caused me problems for a day or so as it did my wife. Air pressure, oxygen content due to altitude and humidity are all big factors.
When in Switzerland I looked at the cable car ascending to a glacier at 3000 metres. There is a specific warning that those with heart conditions should not use it.
Hi Ayecan, I had a similar experience. I used to use a gtn spray before exercise which worked just fine. However, after an angiogram discovered a 98% blockage, I had an urgent double bypass. I'm now able to exercise and do everything normally (although I'm on the usual 3 drugs, Aspirin, Bisoprolol and Statin) which cause weight gain and shortness of breath. I hope this helps to show it isn't an end to life as you knew it 😀
I had similar problems starting back when I was 47 - I was riding and running 3-4 times a week,I ended up have a cardiac stress MRI, CT and then Angiogram which shown a 15% blockage in an artery . I am now on Asprin , 10Mg of Mononitrate twice a day and Statins ( high cholesterol even though I am fit and healthy) . I find that a prolonged warm up before exercise is essential to get things moving gradually , my symptoms come and go but are less common when I ride my bikes , I think this is because its easier to manage the effort on a bike.
Some days I feel strong and back to normal other days I just hit a wall and have to walk home .
Yes I'm finding warming up really important and also have been borrowing an electric bike which has been soooo good for my head and been a sense of liberation. Holding off buying one until I have clarity as to what is going on as ideally I'd like to be back in the mountains.
As your cholesterol was high, suspected angina, shortness of breath as lack of blood flow to the LAD, I would be pushing for an angiogram with the view to a stent fitted if required.
Your healthy lifestyle and fitness means nothing if coronary artery disease is genetic. Is there a history of heart disease in your family?
I was 45 when I had chest pain. It a long story but I had to pursue the BHS to act. I was diagnosed as moderate block by one hospital but when they stented me, another hospital confirmed this was severe block on LAD. This when when I was cycling about 250 miles per week 😬
My advice is to chase the NHS at every opportunity as my experience demonstrates the administration is poor.
Yes family history - 3 deaths - cousin, uncle, grandfather all in 60's ( 2 early 60's all male) plus my younger female cousin had heart attack 6 months ago and my Mum had angina and was statins from her late 50's onwards -she is still alive in her 90's with dementia, diabetes and a host of other issues. Not a good life! The penny only really dropped recently that that family history has an impact. I thought my lifestyle would protect me. Slow learner and usually the eternal optimist!
I was up Munro's regularly before this and ran 60 in 60 days for my 60th birthday nearly 5 years ago with no issues ever. Did 20 plus in around 20 days just 2 years ago and was up some just weeks before covid struck in April last year. Based on all the threads I'm increasingly thinking there is more on the go and I need to fight to be heard. Totally agree NHS admin very poor. Had cancellations for several things in the past year - one even was when I arrived at hospital - so a 50 mile round trip for nothing!
I hope you manage to get a diagnosis of any underlying condition. I don't know if the BHF guidance on bhf.org.uk/informationsuppo... is of any use to you?
My mild angina was caused by a 90% blocked LAD heart artery. The only indicator was a high cholesterol level and it needed an angiogram to detect the blockage.
3 months after 2 stents were fitted I was back to running without angina and my endurance and times had improved. The stent seemed to knock 2 minutes off my parkrun time and yesterday was a nice jog along the south downs way.
I'm not qualified to give you medical advice, but I would wonder, given that you have heart damage (identified from a echocardiogram?) whether you could request an angiogram to ascertain the level of blockage in your coronary arteries? There could be a blockage there that was the underlying cause of the heart damage?
Then whether that results in an intervention or not, its about toning down your goals and perhaps walking rather than running up those mountains? You are still outside, but maybe you need to reprogram yourself not to push too hard? I've had two heart attacks, have stents and still get occasional angina and have moved on from marathons and half marathons to enjoying parkrun (sometimes with walk breaks) on a Saturday morning.
What have the medics told you about resuming running? I was told it was OK as long as I don't push myself too hard - so no silly sprints at the finish. I let everyone overtake me and am happy to do a 5k parkrun in 35 minutes rather than 25. And I never run, in fact never go anywhere, without my GTN spray.
It's not easy reprogramming yourself to have different goals but it can be done; I think it helps to start with gratitude, that you've had those tests, are on that medication etc to help you stay safe. You need to balance the positive boost to your mental health and wellbeing that you get from running with the possible danger. I really hope you can find that balance, as I have eventually.
Hello , in 2019 I experienced tightness in my chest and upper back while out on my regular brisk walk . My family doctor referred me to a cardiologist and I was booked for a contrast dye test followed by a nuclear CT . While I awaited these tests, I was put on a statin and a low-dose aspirin.
All results came back clear no arterial plaque.. Heart was excellent. Lungs were clear. I told I could discontinue to statin and aspirin. The symptoms persisted for four years, and only while brisk walking or climbing multiple stairs . I would mention this to my doctor whenever I would see her, and I was referred back to a cardiologist. My second visit with the cardiologist, he suggested that it was likely muscular as when I spread my shoulders and stretched it seem to alleviate the discomfort.
This past November, I told my doctor I wanted to go back to the cardiologist because I wasn’t satisfied with the diagnosis and I felt something wasn’t right. I was sent back for. a repeat of the contrast dye stress test and nuclear CT. The results of this rest test revealed mild ischemia.
Investigative options were repeat of any nuclear CT or angiogram. After discussion with my cardiologist, he agreed that a CT was a good option and then if it showed anything we would do an angiogram. The results of the CT showed a 90% blockage in my LAD! To say I was shocked would be an understatement.
When I asked the cardiologist how I could go from nothing to a 90% blockage with no changes and symptoms whatsoever his reply was “ you had a blockage in November” to which I responded “this is news to me” . He showed me the results of my stress test , indicating mild ischemias. I later googled mild ischemia and discovered this only occurs if you have a blockage . This was never explained to me at the initial appointment. I believe I have is referred to as stable angina, meaning this only happens upon exertion such as exercise. I should have been given an angiogram in November instead of a CT. On April 24, I had a angiogram and angioplasty and had a stent placed in my LAD . they also discovered I have a 40% blockage in a smaller artery.
While at my mother’s cardiologist, he was asking about my procedure and I told him all about my journey and he told me that when I had that first chest pain back in 2019, I should have been given an angiogram at that time. He said chest pain on exertion should be investigated with an angiogram.
I am a 66-year-old female, healthy, normal weight very active and have never had any serious illnesses. I didn’t fit the profile and my symptoms , apparently, were not taking seriously by my cardiologist. Thank gosh, I have an excellent family doctor and her comment to me was thank God you were persistent and listened to your body.
my point in all of this is, not everyone fits the mold of what you would expect for heart disease. It comes in many shapes and sizes fit and unfit people. If you think something is wrong keep persisting and ask for an angiogram. That is the gold standard. Is it pleasant? No . Is it life saving? Likely yes.
As a side note, I also am positive for LP(a) which is a protein that affects your LDL cholesterol… It is something that you are born with, it is inherited. It has been suggested that everyone be tested prior to their 18th birthday. This is relatively new testing, but very simple blood test, which may be worth looking into as well. Hopefully you will find answers soon . Take care
Well said. I wish I could have a fiver for everyone coming on this board with heart problems that had no previous symptoms and a healthy lifestyle.
I suspect the medical establishment sometimes does not know anywhere near as much as they think they do, compounded by a proportion of people not living as healthily as they believed!
Thanks so much. That all sounds pretty similar. I’ve said since last April is not right. I do think for me COVID has been a trigger for what was perhaps already underway but dismissed as resources are so stretched and superficially I present as healthy. Not helped that our health board don’t check ldl for some reason so my diet which has been good has masked things as I’ve good hdl score. I’ve been concerned about more invasive testing like an angiogram but it really sounds essential!
Sometimes women need to be persistent to have their heart problems recognised.
A good starting point to investigate the cause of your symtoms would be a CT angiogram. If no blockages are found, keeping pushing.
Women are more likely to have angina/ ischaemia without blocked coronary arteries, microvascular or vasospastic angina.
I live with vasospastic angina, my coronary arteries go into transient constrictions causing myocardial ischaemia. I had to have a very specialised angiogram to confirm my diagnosis.
It’s definitely not something I looked forward to. I am so fortunate I didn’t suffer a catastrophic heart attack walking around for 4 years , thinking everything was ok with my heart . I would say it’s definitely worth considering. Good luck
The number of "non-typical" heart patients is astonishing. When I found myself in hospital being stented after HA, there were people on the ward from 28 to 82 for the same thing, all shocked and mystified because they "don't fit the profile".
I don't know why they claim that angina is non-hereditary because the chief cause is atherosclerosis, a build up of cholesterol plaque in the arteries, which eventually causes a total blockage leading to a HA. The tendency to build up cholesterol is certainly hereditary. I have it on both sides of my family. Particularly bad on the paternal side. Father first HA at 44, dead at 47, uncle HA and dead at 57, cousin dropped dead on way to work with HA at 41. And so on. Mother died of stroke following years of angina. Her mother angina then heart failure, dead at 54.
I was 62, and investigations at same time as stenting after the HA showed the culprit blocked artery to be the RCA. I also had over 90% blockage to 2 other main arteries (LAD and circumflex). They couldn't stent those because they were too tortuous (twisty). 18 months later, I was getting symptoms of unstable angina, so I opted for triple bypass of the remaining unstented arteries. It was a long climb back after the operation, but OK now, almost 5 years after original HA. Playing badminton, long hill walks, etc.
Prior to my HA, I was fit, ate well and healthily, with no symptoms whatsoever. Then one day it's bang, there you are, and what only happens to other people has happened to you. The life I have led is the polar opposite of those led by my relatives listed above. I staved it off for longer than they managed, but it came back to bite me in the end. Certainly in my case nature rather than nurture, and I suspect in many others too.
Definitely push them for answers and meaningful treatment. Good luck.
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