Microvascular disease (is it the same as microvascular angina?) ... cause, prognosis, 'self-help' and more

[LilySav]

Following on from Flamingheart's earlier post, I'm interested (for my other half, not myself) in hearing others experiences after being diagnosed.

To give a very brief background, if that's possible ...

After suffering from a single but serious instance of perimyocarditis back in 2017, and with a background of parental heart disease, after a lot of back-and-forth to GP and eventual A&E admission in Oct 2022 with chest pain, breathing difficulty, my OH was discharged with a diagnosis of unobstructed CAD and microvascular disease.

So, looking ahead, my thoughts are :

- how much a part did the perimyocarditis played or are they not linked he was just bloody unlucky?

- How much is genetic?

- did the 2 bouts of covid make things worse?

- Is microvascular disease another term for microvascular angina? Or are they two distinct things? Can you have one but not the toher

... and the other things that are whirling around in my head are:

- could weighloss help matters more than medicines - is the weight gain playing a much bigger part than he thinks?

My OH lost a heck of a lot of weight in 2017/18 due to an active job but put it mostly back on during covid and more afterwards due to changing to an extremely sedentary job.

During the 2022 hospital stay where unstable angina shows on his admittance notes, he's never had a repeat of the pain, only the ongoing breathlessness. Isosorbide nitrates (twice a day) seem to have little effect. He's on the usual preventative/protective heart meds cocktail (ramipril/furosimide/rostuvastatin/aspirin/isosorbide nitrate).

Exercise tolerance is poor, again breathless but no pain. And no clear pattern. Not worse on lying down.

Interestingly, a CPAP machine at night for the last 3 month has made a huge difference to daytime tiredness. It's more or less vanished as has the sleep apnoea. So, that's another thing I'm trying to work out how we express clearly to the doc in next week's appointment. Does is tell anything more than the CPAP is keeping his airway nice and open whereas previously, his weight and snoring was causing it to close. Or, does it reveal something more about oxygen levels/microvascular matters?

Most recent blood tests and echo show his ticker is working pretty well considering his family background and weight, so we're back to the GP again next week and I'm wondering how to get the best out of the appointment.

I'm pretty sure the issue is not simply one thing but 'a bit of this and a bit of the other' and getting that across in a 10 minute dr appointment is quite a challenge.

Thank you in advance for any thoughts or ideas how I can help things improve for him.

I'm doing all I can in the cooking department - we eat loads of veg and salad and chicken and fish but he's fond of a bacon butty (and bread in general) not an avid fan of the humble lentil

Lily Sav