Minoca

[Hestir]

I am a 75 year old woman still very active and health conscious. I had a heart attack a week ago without any evidence of obstruction in the arteries. I would like to liaise with people that have experienced the same condition

[Milkfairy Heart Star]

Hello,

Over 10 years ago I was admitted to hospital with a suspected heart. This was before high sensitivity troponins were available and a lack of knowledge about how heart attacks can occur without pernament obstructions of a person's coronary arteries.

I was incorrectly told I couldn't have angina or a heart attack as I had unobstructed coronary arteries, even though I had dynamic ECG changes and other symptoms of a heart attack.

I was later diagnosed with vasospastic angina following a specialised angiogram. My coronary arteries go into transient constrictions causing a lack of blood supply to my heart.

It's good that your heart attack has been recognised. About 10% of heart attacks occur without obstructions, affecting women more than men.

The main causes are spontaneous coronary artery dissection, SCAD, microvascular dysfunction, coronary vasospasms, a small piece of broken off plaque or a blood clot blocking the artery.

Have your Cardiology team offered you any further testing to determine the cause of your heart attack?

MINOCA isn't a diagnosis as such more a description of a type of heart attack. It's important to know the underlying cause so treatment can be aimed at treating the cause.

Eg. I am on medication to help manage my coronary vasospasms and I know I mustn't take beta blockers or adrenaline as they make coronary vasospasms worse.

There is some more information about MINOCAs on this website which you may find helpful.

internationalheartspasmsall...

[Hestir in reply to Milkfairy]

Milkfairy what do the vasospasms feel like? I sometimes experience a dull tightness in the breastbone area, almost like anxiety or could the acute abdominal pain I’ve felt when I’ve been admitted be such a spasm? Thanks in advance.

[Ennasti in reply to Hestir]

Hi Hestir, you’ve got some great advice from Tos.

I’ve been newly diagnosed with coronary artery spasms. My symptoms were chest tightness at the top of my chest and oddly, at rest not when active! I have a few other cardiac conditions and had wrongly assumed it may have been a progression of these. My cardiologist moved my next appointment up to see what was happening as he was concerned.

An angio a few weeks later showed coronary artery spasms and the lack of blood flow to my heart was setting of my left bundle branch block. I’m now medicated and working my way through my new diagnoses and medication!

[Tos92 in reply to Hestir]

When I had my MINOCA from my spasm, it was accompanied by intense abdominal pain. It took a day and a bit to resolve. When I questioned my cardiologist on why I had such intense abdominal pain, he said that a heart attack can activate the autonomic nervous system which can lead to involuntary bodily functions, and our digestion is one of them that can be affected. There can also be reduced blood flow to the stomach during a heart attack as well. I actually went onto experience intense abdominal pain every time I had a severe coronary artery spasm after my MINOCA. I can thankfully say, that these abdominal episodes have calmed down now.

[Tos92]

Hi Hestir,

I had a MINOCA in January 2022 triggered by a coronary artery spasm. I had zero obstructions to my coronary arteries, however, a myocardial bridge was found which, although, mostly considered benign, can cause problems for a few in the population. This is when one of the arteries takes an intramuscular course through the heart instead of sitting on the surface.

Has the cause of your MINOCA been investigated?

I remember the night before my MINOCA, or early hours of that morning in fact, I had experienced a very stressful and emotional event. It’s most likely that this contributed to the MINOCA. Apart from stress and emotion, the cold is also a trigger for me, very hot weather, very cold and hot drinks, lack of sleep and sometimes physical exertion. These can all exacerbate my coronary artery spasms, also known as vasospastic angina.

It’s important to find out the cause of your heart attack. In order to do this, further investigation is often required so that the right treatment can be offered.

There’s lots of useful information on this link below.

inocainternational.com

Alternatively, if you would like to talk some more, please feel free to PM me :).

All the best with your recovery.

Tos

[Hestir in reply to Tos92]

Thank you Tos. Mine happened 11 days ago and I can see my GP next week. This is all new to me and I’m learning a lot. I dont know how they’re going to find out what caused my Minoca but I have a lot of questions for him! Great to have access to combined experiences!

[Tos92 in reply to Hestir]

Make sure to write your questions down so you don’t forget and ask if you can record it too.

What medications were you released on, if any?

[Hestir]

Tos, only blood thinners. BP so low that blood pressure meds were suspended until I see the GP