Vasospasm

[Hestir]

Thank you to everybody who responded to my question re Minoca. It only happened 11 days ago and the reason has not been established. For you who mentioned spasm of the coronary artery, I would like to know what it feels like. For years I’ve experienced a sudden “tightness” in the area of my breastbone with no other symptoms. Almost like a bit of anxiety and in the past, when mentioning this to my GP, I’ve ended up with a prescription for anti depressants. I now wonder if this could be a spasm and I never realised it? Many thanks in advance.

[fishonabike]

I have never knowingly experienced this, but Milkfairy might be able to help when they see this

[Milkfairy Heart Star]

Hello,

Whenever there is a lack of blood supply to the heart ( myocardial ischaemia), a person usually experiences angina.

This can be felt as chest pain, a dull ache or pressure on the chest. Some women describe chest tightness as feeling like their bra is too tight.

Nausea, lightheadedness, a sense of unease, extreme tiredness, stomach pain are other possible symptoms of angina.

The BHF has an ' Understanding Angina ' booklet that you can download.

bhf.org.uk/informationsuppo....

The booklet lists all the various types of angina, including microvascular and vasospastic angina.

The umbrella term for microvascular and vasospastic is angina/ ischaemia non obstructive coronary arteries ANOCA/INOCA.

The symptoms of microvascular and vasospastic angina can overlap. However microvascular angina tends to cause chest pain on exertion, in response to emotional stress or breathlessness.

Vasospastic angina is notoriously painful with prolonged, crescending, severe episodes of chest pain, usually occurring at rest. These episodes of chest pain can last for over 20 minutes.

The triggers can be the cold, emotional, mental or physical stress.

There has until recently been a lack of awareness about ANOCA. Microvascular and vasospastic angina are often overlooked and under diagnosed.

Have you been offered any other tests such as a cardiac MRI?

This is recommended for any patient who has had a MINOCA.

The scan can in some cases detect microvascular dysfunction, or look if the heart muscle has been damaged or injured due to Takostubo syndrome or myocarditis.

Usually a echocardiogram is offered too. This ultrasound test can check to see if the walls of the heart are working properly, as well as whether the heart is pumping blood well.

Sometimes a person can have a small hole in the heart that has never been previously detected. This can lead to small blood clot forming which can block a coronary artery.

I also had my blood checked for blood clotting disorders such as antiphospholipid syndrome.

I suggest you keep a log of your symptoms and ask for further tests to determine the cause of your heart attack.

It might help sharing with your GP the information from the BHF website about microvascular and vasospastic angina.

bhf.org.uk/informationsuppo...

bhf.org.uk/informationsuppo...

It can be bewildering and emotionally challenging to be given the news you have had a heart attack, when the professionals don't know why.

Are you able to talk to your GP about how you are feeling at the moment.

Another good support is the Cardiac Rehabilitation team. Some teams include a Clinical Psychologist.

Have you been referred to the Cardiac rehab team?

[Hestir in reply to Milkfairy]

Thank you Milkfairy that was very helpful!

[Ennasti]

I answered in your other thread. Yes, I had chest tightness. I’m in a Facebook group where others have had it much, much worse than me and have ended up in hospital with heart damage.

I realised during the angio the other week what it must feel like to have a heart attack (caused by coronary artery spasms or otherwise). The pain went right up into my left jaw and the pressure on my chest made it impossible to speak. It felt like a huge metal girder was across the top of my chest!

This pain was caused by them injecting me with a substance to see if the arteries would spasm and spasm they did! Apparently they spasmed before the injection was even given and this pain was the normal pressure I was feeling leading up to the test, but the deliberate spasms were very painful.

[Hestir in reply to Ennasti]

Thanks Ennasti.

[Ennasti in reply to Hestir]

Oh, and the other thing I’d been experiencing which I now suspect may also have been spasms was pin point pain on the left bottom just under the breast to the side, and the top right closer to the heart. I haven’t had this or the chest pressure so me starting the meds just over a week ago but it’s early days.

[Arizona18]

Hi Hestir, I have been diagnosed with microvascular angina due to vasospasms and get all the symptoms you and Ennasti describe. Some come and go and others are with me constantly. The too tight bra feeling drives me nuts! I am due to have the reactive angiogram in December. Milkfairy as always is a wealth of information. There is help and I believe each day brings interventional cardiologists closer to understanding and helping patients cope with this disease.

[Heartbroke]

Hi I suffer with vasospasms and my episodes begin with really bad burning in the middle of my chest like heartburn (which I thought that's all I was suffering from for 4 months before having a heart attack)(diagnosed with vasospasms 15 months later as was still having burning chest pains leading up into jaw ,under arms around into left shoulder blade and causing a second heart attack )in and out of hospital constantly had third mild heart attack got them to adjust meds now only get pains when worried or anxious or overdo things or cold/hot weather. I was put on anxiety tablets after second heart attack and am still on them. I have a leaky valve but they haven't done anything about said it was mild. Make sure you write all your worries and concerns to ask GP and like milkfairy said keep a diary of any episodes as you may have trigger factors like me.

[Mumofsmellydogs]

Hi there, I've had two MINOCA heart attacks caused by vasospasm. Same symptoms as most heart attacks - severe chest/neck/shoulder pain, clammy, shock etc. I also had spasms after the most recent one 18 months ago, but now largely under control with Diltiazem. My spasms are across my back bra lune and are tightness/pain. If it's severe, it goes to front of chest and that's when I use nitro spray. Change of diet, losing weight, yoga and managing stress all help.