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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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.
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.
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.
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
update.I had to stop the bisoprolol because it was making me drowsy and I was sleeping for at least 4 hours in the day aswell as the normal 8 at night. I also started to get really dizzy. they have double the dose of statins. which worries me because of my liver. I have had trouble with exercise because if the level of breathlessness and I get chest pain while doing it. I need to lose weight but I don't know what to do. I have written a letter to the cardiologist explaining all this. I hope to hear back soon.
update:I spoke to my cardiologist today. she said the angiogram was the same as the last one taken 12 years ago. she was happy with the results and thinks it could be stress and me being overweight. I am having an echo stress test. to see how my heart works when exercising. she says I can go back to exercise that I was doing before. she didn't say anything about what tablets I am taking.
if my heart is the same as 12 years ago then why am I on the tablets. also I cant do now what I could do then as far as exercise is concerned. is it really just stress?
update. I had a stress echo test. I had stopped the bisoprolol for three days before. all of my symptoms got worse. they did the first echo and had trouble seeing my heart. in the end they could only see it if I breathed in half way and held my breath. I thought I heard the nurse say is this hardening but the doctor said no. when I was on the treadmill my blood pressure went up to 250/120. so they stopped the test. I was then put back on the bed where they tried to get another echo picture. they then said my heart was fine and I needed to sort out my weight and high blood pressure. since being back on the bisoprolol my blood pressure is back to normal but I am still getting all the heart symptoms. they say its the ptsd that is causing the symptoms but I have them all the time. also when I go for a calming walk in the fresh air I still get breathless and chest pain. I cant see how anxiety would cause the symptoms all the time. the report hasn't been done yet so it will be interesting to see what it says. I will keep you all updated. thanks for all the help and advise.
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