Hi everyone I have been diagnosed with this in July due to having a heart attack mid month. Can anybody shed any light or advice regarding this if you have same diagnosis?
Minoca microvascular dysfunction - British Heart Fou...
Minoca microvascular dysfunction
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Jellybeans49
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MilkfairyHeart Star
Hello,
Welcome to the forum.
A Myocardial Infarction non obstructive coronary arteries MINOCA accounts for about 10% of heart attacks.
MINOCAs disproportionately effect women.
In 2012, I was admitted to hospital with a suspected heart attack, I was incorrectly told I couldn't have angina or a heart attack because at the time there was very little understanding of MINOCA.
The possible causes of this type of heart attack are, microvascular dysfunction, coronary vasospasms, spontaneous coronary artery dissection, a blood clot or small piece of plaque breaking off and blocking a coronary artery.
Microvascular dysfunction is thought to be caused by the inability of the small blood vessels of the heart dilating or staying dilated in response to extra demands like exercise.
I live with vasospastic angina which is caused by transient constrictions of my coronary arteries.
I was originally presumed to have microvascular angina however following a functional angiogram using acetylcholine, I was found to have vasospastic angina and vasospasms in my small arteries.
Have you been offered cardiac rehab?
Have you been offered any tests to confirm your diagnosis of microvascular angina?
It's important to know what caused your heart attack as the treatment is different for each possible cause.
The BHF has this information about microvascular angina.
bhf.org.uk/informationsuppo...
bhf.org.uk/informationsuppo...
You'll find some more information about MINOCAs on the website created by patients who live with microvascular and vasospastic angina and have experienced heart attacks.
internationalheartspasmsall...
There are quite a few members of the forum who live with microvascular or vasospastic angina, a few have experienced a heart attack, hopefully they will be along to share their experiences with you too.
Hello,
Thank you for responding and for the information.
I haven't actually been told the specific reason just that it's spasms of my smaller arteries within the heart.
I had a echo scan done & angioplasty and plenty of blood test so far and I start rehab tomorrow. I'm hoping this will shed some more light on to it and help me deal with my stress and anxiety about it all.
I most of all worried how it's going to affect me in future and to what degree etc.
It seems very up in the air diagnosis and not alot of research regarding it.
I am on a statin asprin,and another one to control calcium build up and have the glycerat spray.
So at the moment just taking everyday as it comes and not planning much of future as I'm very up and down daily.
It can be bewildering at first coming to terms living with a heart condition that very few Cardiologists understand.
It maybe worth asking for more testing such as a cardiac MRI or a functional angiogram.
An angioplasty is when a stent is inserted to treat a blocked coronary artery.
The usual treatment for coronary vasospasms are statins, an antiplatelet and a calcium channel blocker like Diltiazem.
Microvascular angina tends to cause chestpain and breathlessness on exertion while the classic symptom of vasospasms are chestpain on rest, especially during the night.
It can help keeping a diary to see if you can spot your triggers of angina.
Common ones are the cold, emotional, mental or physical stress along with a lack of sleep.
I have to manage my stress.
I practice Mindfulness Meditation, Tai Chi and yoga.
I walk my dog everyday and exercise as much as I can.
I found this free app helpful.
My hospital has a Clinical Psychologist who helped me manage the emotional fall out of my experiences.
Perhaps ask the Cardiac Rehab team if this service is available on your area?
If not maybe ask your GP if you can be provided with some psychological support.
Taking each day as it comes is a good way to start.
I found the support from the cardiac rehab team invaluable.
It's okay to feel a bit 'wobbly' at first.
Hi Yes they said that theirs a psychologist at my rehab which I can use if I need to. I am on both medications that you mentioned. My confusion is is it classed as angina or they just recognise it as this instead if what they diagnosed or it's a type if angina?
I find managing my stress and going through menopause extremely difficult. It's all becoming to much. I tend to get stressed very easily and panic very easily. I am try to change things and introduce things such as meditation etc. I hope I will get there soo er rather than later. This has been extremely helpful Thank ypu I will have a good read of all li ks you sent.
Angina is a symptom of a lack of blood supply to the heart, myocardial ischaemia. Microvascular angina is caused by microvascular dysfunction which happens in the very small blood vessels.
Vasospastic angina caused by coronary vasospasms in the large blood vessels.
Microvascular and vasospastic angina are known as angina/ ischaemia non obstructive coronary arteries ANOCA/INOCA.
A MINOCA isn't a diagnosis as such it's a term for when a heart attack happens without blocked arteries.
The BHF has this information about angina which may help you further.
bhf.org.uk/informationsuppo...
Have you asked your GP to refer you to a Menopause specialist?
HRT can in some instances help with the management of microvascular angina.
This is an excellent reply to Jellybeans49. Cheers from Australia.
hello jellybeans
I was diagnosed with microvascular angina following a angiogram and 3 stents
It took a while after having the stents for doctors to accept that I was still having symptoms after the stents my arteries now being unblocked
It was an assumed diagnosis and also took a while to get the right medication I now take calcium channel blockers and have been well until recently when I had a couple of episodes of fainting I was seen in A & E and am waiting to see a cardiologist but it has been months now!
However i am generally well and able to manage my symptoms I get pain at rest it’s like a heaviness around my chest accompanied by breathlessness and nausea when this happens I take my spray and just stay in bed it sometimes takes a few days for the extreme tiredness to wear off. I’ve been told to go to A&E if I’m worried!!
I do worry when I’m not feeling good but in between I can do most things so I’m just doing my best to live with it.
I have had a few years with no symptoms until recently so once you get the meds right you can have a normal life it’s just a case of living with and managing the condition. It’s frustrating that not many cardiologists and doctors know much about it but it is improving
I got most of my information from here and general research into the condition and from milk fairy which helped me to come to terms with it takes a while to get your head around.
I wish you all the best
Hello Sunshinebrew,
Thank you for this. It reassures me a little more. Milk fairy has helped alot tbh and I understand it now. It's still early days for me I'm on the neds currently and have the spray. I get days where I feel the heaviness and achey arm. Especially days of being stressed or wound up.
Is it classed as a disability or no?
I don’t know if it is ?
It does make it worse with stress so have to avoid getting stressed but that’s easier said than done isn’t it 😩
I try meditating and Pilates and walking my dog and I enjoy a good book .
I’m retired so I’m lucky I do t have to worry about work and being on the sick now which was difficult when I was first diagnosed.
Microvascular and vasospastic angina are long term heart conditions and are covered by the Equality Act.
I have a Personal Independence Payment as my vasospastic angina has greatly impacted on my life.
I am sorry to hear about your recent heart attack and subsequent diagnosis - glad to see that Milkfairy has responded and is helping to answer your questions
I know it is no fun finding that you have a heart condition but in some ways you are lucky that your microvascular issue has been diagnosed and that you are getting treatment - I say this is only recently that doctors have started to become aware of microvascular issues and that effective treatments have been identified - but there are still many unanswered questions and doctors who have no understanding of this at all - so you might find that some doctors are not as helpful as you would hope
you asked "is it classed as angina or they just recognise it as this instead if what they diagnosed or it's a type if angina?" - it might help to be clear that angina is a symptom, it happens because your heart muscle is not getting enough oxygen - you are having this symptom because you have a condition which affects the blood vessels which supply your heart muscle, in your case a microvascular issue - this is different to the most common cause of angina, Coronary Artery Disease, where the arteries are blocked and stiffened bit deposits which obstruct the blood flow -in microvascular issues the arteries are usually clear, with no very little deposit, the blood flow is reduced for other reasons as described below by @Milkfairy ( I originally wrote, incorrectly, that it is : "because of muscular spasms in the artery walls") - so you have the same symptom but is is caused by a different condition and will probably need different treatment
so you are lucky because someone spotted the difference and you are more likely to get the right treatment
'the blood flow is reduced because of muscular spasms in the artery walls'
This is describing coronary vasospasms, vasospastic angina rather than microvascular angina.
Microvascular angina is a functional disorder of the small blood vessels, they fail to dilate or stay dilated in response to extra demand like exercise. It is a separate condition from coronary vasospasms, though you can have vasospasms in your microvessels.
Vasospastic angina is thought to be due to the inner lining of the artery walls not working properly and hyperactivity of the smooth muscle in the artery walls.
Most people living with vasospastic angina can exercise and experience their chest pain at rest.
Microvascular angina leads to chest pain on exertion and breathlessness.
Those of us living with microvascular and vasospastic angina can have a variety of symptoms which require a functional angiogram to confirm our diagnoses.
academic.oup.com/eurheartj/...
Yes mine is after excertion starting with breathlessness and then chest paint,sweating and then pins and needles in arms and sometimes radiation to feet.
We all seem to have our own version of microvascular or vasospastic angina.
We don't follow the text book!
thank you for clarifying that, I will edit my comment to include this and bear it in mind in future
It's not straightforward and the knowledge and terminology is ever evolving 😊
Thank you that's is really helping ne understand very much appreciate everyone has been so helpful so far.
may I ask what this is and your symptoms
Hi it's spasms or blockage off oxygen to small tiny arteries of heart. Comes under Angina. My symptoms are varying tiredness,achey arm and chest pain,breathlessness when excepted or carrying heavy things excessive sweating. Thats all I can rember but each episode is different each time.
Omg there all my symptoms I keep thinking maybe I have that because somebody I know has it my symptoms are exactly the same but don’t know who to speak to about it even talking gets me out of breath sitting down like I am now I get constant aches in my chest arms like I’ve hurt my muscles but I haven’t x
Definitely first port of call is to go drs and get some tests done tell them it's pain in heart,arms etc but if it's extreme I would go to A&E immediately. I kept putting mine down to menopause,and panic attacks but turned out to be this and ending in a heart attack with no main coronary obsy obstruction but the small vessels within heart getting lack if oxygen. Hospital will check Troponin levels to rule heart attack put unfortunately mine was high.
Yeah I’ve been a&e so many times thinking it was a heart attack with all the symptoms u describe but all my markers and checks came back fine my mild heart attack I had at Xmas when I had my angiogram after everything came back clear it’s like now aches in my chest but there like above my breast area sometimes then armpit arms there different all the time if u get me
Sorry I think I meant angioplasty something like that 🤣
Yeah it could be other causes too it chest related maybe worth getting a second opnion. I'm aware that they have also linked Minoca to menopause in women. It's very hard to get info as it's quite a new thing. Milk fairy has helped me alot maybe message her and she may be able to have an idea of what u could do.
The BHF has this information about microvascular and vasospastic angina.
bhf.org.uk/informationsuppo...
bhf.org.uk/informationsuppo....
My vasospastic angina was confirmed by a specialised angiogram.
Microvascular angina can in some circumstances be diagnosed by a cardiac perfusion MRI.
I suggest you keep a diary of your symptoms, discuss them with your Cardiology team and ask them to consider if microvascular angina is causing your ongoing symptoms.
Sometimes after a stent is inserted it reveals the underlying previously hidden problem of microvascular or vasospastic angina.
It’s like flashing pains not all the time but most and it’s above my Brest top chest and under my breast there like flashing pains but last week I was in a&e because they were like shooting pains across my chest it’s just getting me that way that my mental health has taken a nose dive I’m on aspirin 75mg atrovastatin 80mg isoborde 40mg tamari 10mg verapamil 120mg in morning verapamil240 evening
Sounds like here treating you for similar things g I would ask your GP to clarify why they are treating you for a heart condition but haven't diagnosed exactly what it is. I'm relatively new to all.this myself so I'm still asking questions. That's the main reason i joined here as I didn't feel like I was getting a proper explanation of what to expect now. My co evidence has taken a true knock too.
Yeah I haven’t had a proper answer to any questions I’ve asked and don’t have a clue what I’m being tested for just was told I g he ad mild heart attack 😢
Did you not get any rehab offered? I'm not sure what your surgery is like but mine have a patient app you can see all your medical things on.
I did go not long after ha but had to stop because I was still suffering chest pains then on and of was getting chest infections but I’m now back at rehab Tuesday gone then every week now
The pains are so scary though like now I’m sat here and just had them again it’s so hirrible
Sorry to hear that I hope your Dr checked things like magnesium and vit D etc. I have anemia also and going through menopause so alot has happened for me over the last year. I'm used to walking between 5 and 10 miles someday but I've had to stop until I get bit better. Just feel like everything is on hold and a slow process. I think women already go through alot and all this just adds to it especially ladies of a certain age. I really hope you get some proper answers to it all and don't be scared to question or ask things at rehab.
You may find this website helpful. It was created by four patients who work with the world leading expert Cardiologists and researchers into microvascular and vasospastic angina. internationalheartspasmsall...
If you are on Facebook there is this group listed on the BHF website
I am sorry that your mental health is being affected. I acknowledge how disheartening it can be being in pain and nobody understanding what's causing your symptoms.
They are real!
I have found not having my pain and its cause acknowledged by medical staff, one of the most difficult aspects of living with vasospastic angina.
I felt I was going mad at one point, the staff I met implied my pain was in my head and I didn't feel believed.
I had to be very persistent to find a Cardiologist to listen to me and offer the tests needed to confirm my diagnosis of vasospastic angina.
Unfortunately microvascular and vasospastic angina are still not well understood and as a group of patients we can be dismissed and ignored.
Have you discussed your ongoing problems with your GP or Cardiac rehab team?
Perhaps give the BHF helpline a call and speak with one of the cardiac nurses too?
bhf.org.uk/informationsuppo...
I have appointment Monday morning so I’m gonna speak to her as I have u lot u have been so helpful I’m just so so fed up depressed with it all I’m so down and for many be half a day a week I don’t have niggly pains I’m myself and happy but they come back and I’m down again
I your appointment goes well.It might help writing down all your questions before your appointment to help you remember everything.
This website has more information about microvascular and vasospastic angina.
It is extremely frustrating when you feel like your not being heard and just left to deal with things. I felt like that when it initially happened and I'm already undera cardiologist for regurgitation and asked to see her but was told no need till my yearly check. Then this happened, it's infuriatwhen drs do nottake on board that you know your own body. Persistence is key. And look at second opnion if you feel your drs not.listening ot call BHF helpline and speak with someone at least they can give you more Information or put you in touch with someone.
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