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Non obstructive coronary artery disease diagnosis

Spedyrecovry50 profile image
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hi. I have recently been told that I have Non obstructive coronary artery disease. I didn't even know it was a thing. 2 of my arteries have 25% blockage and one of the has 49%. I have been told that I have mild stenosis. they want me to stick with the statins. also the aspirin and bisoprolol. they have discharged me from the clinic and I dont have any cardiologist to follow up. my gp is left to it. they also said I can do what ever exercise I want.the thing is, the bisoprolol makes me sleep all day. I still have all the symptoms. chest pain, breathlessness, palpitations, missing heart beat etc. I have tried doing some exercise but the symptoms get a lot worse. I don't know what to do. they haven't offered any rehabilitation or anything. I have just been left. I also have ptsd which isn't helping. I am at a loss.

my main concern is the exercise. I used to weight train but I don't know if I can do that now. they say I can.

any suggestions would be great. thanks.

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Spedyrecovry50
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Milkfairy profile image
MilkfairyHeart Star

Hello,

I am sorry you are feeling abandoned by the Cardiology team at the moment.

The definition of non obstructive coronary artery disease, NOCAD is not universally agreed.

In the US, the term NOCAD is used to describe people living with angina without blocked coronary arteries.

This type of angina caused by the blood vessels of the heart not working properly is known as

Angina/ ischaemia non obstructive coronary arteries ANOCA/ INOCA.

Either the small blood vessels fail to dilate or stay dilated in response to exercise, microvascular dysfunction, microvascular angina.

Or the blood vessels go into transient constrictions, coronary vasospasms, vasospastic angina.

Microvascular and vasospastic angina are often overlooked and undiagnosed. These types of angina are more difficult to diagnose.

As you are still experiencing chestpain and breathlessness, I suggest you keep a diary of your symptoms, then ask your GP to refer you back to the Cardiology team to ask whether microvascular or vasospastic angina, could also be responsible for your symptoms.

You can have some blockages and ANOCA at the sametime.

I live with vasospastic angina, it took some effort to get my diagnosis which was by a specialised angiogram.

You may find these links helpful.

heart.bmj.com/content/105/2...

internationalheartspasmsall...

Spedyrecovry50 profile image
Spedyrecovry50 in reply to Milkfairy

hi. thanks for the information and reply.

beemiles profile image
beemiles

Hi, I’ve had exactly the same experience as you. Experienced episodes of severe chest pain/heart attack symptoms over a period of 4/5 years, and trips to A&E where I was always told there was nothing wrong, along with breathlessness and palpitations etc. Overtime I had the standard tests of ECGs, echos, stress tests and finally a CT angiogram, and eventually was told I had no blockages, most likely had microvessel dysfunction and sent on my merry way by the cardiologist with a list of a couple of meds to try, back to my GP. I’ve worked thru the list, and researched my own and have now been on Ivabradine for a couple of months, which is probably the best one yet. It really is a case of trial and error, as cardiology refused to do any more tests. I remember I was prescribed bisiprolol originally 6 years ago and I was like a zombie on it so stopped taking it, before I realised how serious the situation was. From my experience, there is little support out there and you really have to do your own research, try meds for a month or two, and then move on to something else, or like me you’ll waste years feeling unwell before something changes.

Good luck

Milkfairy profile image
MilkfairyHeart Star in reply to beemiles

I am sorry that you have encountered the problem of Cardiologists not taking your microvascular angina seriously.

This attitude sadly reflects the belief that microvascular and vasospastic angina are benign conditions and as there are few treatment options why bother to test to confirm your diagnosis.

The research certainly suggests that microvascular and vasospastic angina are serious heart conditions, increasing an individual's risk of a heart attack, stroke, heart failure and major cardiac events.

A perfusion MRI can help diagnose microvascular dysfunction.

I was seen by an expert and offered a functional angiogram when chemicals were used to see how my blood vessels reacted.

This is how my Vasospastic angina was confirmed over 10 years ago.

There is a study taking place into diagnosing microvascular dysfunction, the iCorMicA trial.

There are 25 centres throughout the UK taking part in the trial. It might be worth asking your GP or Cardiologist to contact the Principal Investigator of the trial , if you wish to participate in the study.

clinicaltrials.gov/study/NC...

Spedyrecovry50 profile image
Spedyrecovry50

update.I talked to my gp. she said to stop the exercise until I have been on bisoprolol for a week. then see how I am. she was the one who referred me in the first place

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