microvascular Ischemia

[Princessmummy]

Hi I’m new on here and just wanted to know if you can show microvascular ischemia on a Mibi scan but it then be clear after an angiogram ?

can you still have it or would this have shown on the angiogram?

Thankyou

[PadThaiNoodles]

It won't show on an angiogram.

bhf.org.uk/informationsuppo....

[Princessmummy in reply to PadThaiNoodles]

sorry to ask but is microvascular angina the same as ischemia ?? It’s all new to me as Ive got all this since catching covid 19mths ago

Thankyou

[PadThaiNoodles in reply to Princessmummy]

In this case, essentially yes. Ischaemia is a lack of blood/oxygen to some tissue; in this case the heart. Angina is the pain caused by ischaemia of the heart muscle.

[Princessmummy in reply to PadThaiNoodles]

Thankyou that’s really helpful ……. I’ve never struggle with heart problems before so it’s all new to me

I appreciate very much your response

[Milkfairy Heart Star in reply to PadThaiNoodles]

Do you have a lived experience of microvascular or vasospastic angina?

[Milkfairy Heart Star in reply to Princessmummy]

You can gave angina/ ischaemia non obstructive coronary arteries ANOCA, INOCA which is caused by either microvascular dysfunction or coronary vasospasms.

ANOCA conditions are due to the blood vessels of the heart not working properly reducing the bloid supply to the heart, myocardial ischaemia.

I have transient constrictions of my coronary arteries and small vessels, vasospastic angina.

With microvascular angina, the small blood vessels of the heart are unable to dilate or stay dilated in response to extra demands like exercise.

A routine angiogram just detects pernament blockages, obstructions rather than ANOCA/ INOCA.

If your Mibi scan shows you have myocardial ischaemia and your angiogram shows no obstructions, I suggest you ask your Cardiology team to carry out further testing to see if microvascular angina or vasospastic angina are causing your symptoms.

[Princessmummy in reply to Milkfairy]

Thankyou for your response , it’s only been something I have been left with after having covid …..I got myocarditis after the covid In February 2023 , i am under Royal Papworth Hospital and am seeing them in a weeks time again, so will speak with them …… it’s all very new to me but I am now unable to do so much of what I did before ……. Even walking up the stairs causes me pain , the cold weather I’ve noticed is a huge trigger as is exercise….. I’m extremely frustrated…… they also think I have POTS so am having tests for that separately.

[Milkfairy Heart Star in reply to Princessmummy]

I am sorry to hear you have ongoing issues because of covid. Covid is a nasty virus.

Coming to terms with heart disease especially less common or poorly understood conditions can be bewildering at first.

The Royal Papworth is a cetntre of excellence and has several Cardiologists who are knowledgeable about microvascular and vasospastic angina.

I suggest you keep a diary of your symptoms including what triggers your symptoms.

It can help to write down all your questions too, it helps to keep on track during your consultation.

My triggers for my vasospastic angina are the cold, emotional, mental and physical stress.

I am really struggling with this cold weather at the moment 😩

I had myocarditis many years ago. My advice is to rest, rest again and then rest some more. It can take months to recover.

It was difficult for me to distinguish between the pain from my coronary vasospasms or myocarditis.

Cardiomyopathy UK has some information about myocarditis which maybe helpful.

cardiomyopathy.org/about-ca...

There is also a patient support group for POTS.

potsuk.org/

This patient group is listed in the BHF 'Understanding Angina ' booklet.

internationalheartspasmsall...

[Princessmummy in reply to Milkfairy]

Thankyou so much this has been so helpful x

[Crystal614]

Hi, I had a MIBI scan done earlier this year and I asked if microvascular disease would show on the scan. The answer I got was and I quote, "only if it is a concentrated area, if it is scattered around the heart, then no it won't" I also have a letter from my previous cardiologist who again said a "MIBI scan can not fully rule out microvascular disease."

[Princessmummy]

thankyou …… I’ve just got a letter saying it was seen on the scan …..

[Crystal614]

The angiogram won't show the microvessels.

[Princessmummy]

thankyou

[Roseleigh]

hi I’ve also been diagnosed with micro vascular Angina. I had been having chest pains for a long while on dog walks and it finally came to a point where I couldn’t walk further than 100 yards whilst on a weekend away for my birthday last year. I’ve been put on a lot of medication as I have high blood pressure and high cholesterol (runs in my family). I had an angiogram and like you it didn’t show up but the symptoms started whilst it was being done and they had to give me GTN spray. I was then meant to have a further 15 min test using where they inject something else injected that shows up micro vascular problems. Can’t remember what it was called. Anyway that had to be abandoned because of an emergency but after pushing I’m getting that done sometime next year. I think that shows it up more, I’m hoping it will anyway. Is this a possibility for you? Sorry I’m sure someone else will know what the procedure is, Milkfairy seems really knowledgeable and I’ve learnt a lot just being on here. I haven’t been offered an MIBI scan at all.

It’s all a lot to come to terms with I really understand how you feel and Covid is dismissed so much now too. Look after yourself, I know that can be a big change too.

[Princessmummy in reply to Roseleigh]

Thankyou for your kind words ….. I was absolutely fine , no heart issues at all …then in February 2023 I caught covid and had myocarditis after this ….. since then it’s been a long 19 months of repeated visits to hospital , ecgs etc ….. I was diagnosed with long covid which there is no help anyway so this wasnt helpful …. I can’t do much now without getting chest pains and ectopic beats which come in bouts which ground me completely as I can’t even talk during these at their worst ….. it’s affecting me mentally too as I’m so frustrated, I’m 45 and spend much of my time sleeping (as I’m constantly exhausted) or on the sofa ….. I have young children too so it’s tough….. I will ask papworth when I go next week ….. they also think I have pots so wanted to start me on midodrine but can’t because of the microvascular ischaemia as my consultant said it can make it worse.

I just miss having a normal life !!!

Thankyou for replying…. Just having contact on here has helped no end !!

Thankyou x

[Roseleigh in reply to Princessmummy]

Aww I completely understand I’m 60 now and have a few friends who sadly have health problems so I’m not completely alone in not being as active as others but it’s very isolating mentally and I imagine worse the younger you are. I miss not having to think about all this before I go out the door, have I got my spray etc etc so I can’t imagine how much worse it is for you with young children.

I’ve been offered adjustment therapy with wellbeing, probably takes a year to get where I am but that’s maybe something helpful? It’s a tough one to suddenly be faced with something you can’t just work past. Be as kind and nurturing to yourself as you would if it was a friend in this situation, hard I know but it’s the only way forward I think.

I’ve found this community the most helpful thing and up until now I’ve just been reading posts etc. people are so kind and knowledgeable.

Look after yourself.

[Princessmummy in reply to Roseleigh]

Thankyou .. to be honest I’ve never posted on here before but it’s really helped , I’ve just read others posts …… it just helps to know you’re not alone !

I just miss doing things that I loved , I loved running before I got ill and was working at a stables which was obviously a very manual job and I’m obviously not able to do it now and I miss it so much … just making my children’s beds in the morning is an exhausting process!

I don’t have any extended family either so it’s been very tough not having any support at all , but never mind ….. I’m just writing everything down for when I’m next at hospital…… I’m just grateful to be at the Royal Papworth hospital and they have been amazing x

I’m sorry you struggle too much….. so many are in different ways but it helps so much to read and get support on here …. So thankyou x

[Kind51 in reply to Princessmummy]

Hello Princess Mummy, I have just read your article. I'm sorry to hear about the problmes you are experiencing. They sound very similar to my own. Its interesting what you say about Covid because I had Covid twice.(The first time severe). All my problems started about six months after the second bout of Covid. Initially episodes of burning type of pain, reduced stamina, pain walking up inclines - symptoms were infrequent for the first couple of months. I went to the doctors and when my blood pressure was checked it was through the roof. I have a busy life job, children still at school. No time to be ill. As last winter progressed, symptoms worsened to the point where I was short of breath doing small tasks around the home and became housebound due to the cold temperatures. I was waking up from a nap with chest pain and choking. This was terrifying. I thought I was taking a heart attack. I couldn't even venture outside to put rubbish in the bin because the minute I stepped out into the cold and breathed in the freezing air my chest immediately tightened and I was in pain. I began to get short of breath talking. This all started within months of having a fully active life - walking up inclines, up flights of stairs etc. I was started on Isosorbide Mononitrate at a low dose which was then gradually increased to a much higher dose. I stated to improve getting well enough to get back to running my home in a more normal way albeit, still with ongoing chest pain. I require further testing to identify exactly what is wrong but it is thought that I have Vasospastic Angina. I respond quite well to GTN during attacks however, the beneficial effects I experience are short lived. My arteries were found to be clear after a CT scan however I failed the treadmill test. I still require further testing. Prior to all these problems I was very well with no ongoing health issues. I can relate to what you are saying about missing having a normal life. I've felt myself getting worse in recent weeks with the cold. The last couple of days have been the most challenging so far this winter. I have to set my theromstat each night so that if the temps fall too low during the night my heating will click back on. If I don't do this then I wake up with worse angina pain. I have been told that in some people this condition can go into remission. did improve during the summer, so warmer temperatures help me so long as it's not too warm.

[Roseleigh]

it’s an Acetylcholine test. Just looked the word up!

[Princessmummy in reply to Roseleigh]

Brilliant Thankyou x

[nilmonisikdar40]

Hi there, Welcome to this forum. What does Mibi stand for ? Microvascular angina means narrowing of small blood vessels which is unlikely to show up in angiography. However there are other test like CT scan, MRI and others which may throw up some light.

[Princessmummy]

myocardial perfusion scan