After having niggling angina,upon exertion for a couple of years,in the last 6 weeks I have experienced a very sudden increase in severity and frequency of attacks,to the point I cannot walk much beyond 50m without having to stop,and am having trouble sleeping.I was admitted to hospital with increased troponin,stabilised and sent home.
Ive had 2 angios showing non obstructive blockages only,and therefore have been diagnosed with probable MVD and /or spasms.Im currently on 360mg Dilitizem,40mg Nicorandil,120mg Iso sorbide mononitrate,100mg aspirin and 40mg statins daily.The first 3 have been doubled in last 6 weeks to try and get ahead of angina,but with only minimal effect.Booked in for Cardiac MRI in a few weeks and then will try and beg to see my cardioloist ASAp after that. He had said we have one more drug to try ,I am thinking probably ranolazine,and can only hope it will give me some relief.If not I will actively push for a provocotive angio and/or related tests to make sure I have accurate diagnosis and treatment.
Anyway,my specific question is that ,I am also experiencing some seemingly non related side effects,eg,a very sore tongue,aching back (upper and lower),and just general stiffness and soreness.The sore tongue I have had for a few months ,the others just since i "fell off the cliff" in December.
Any similar experiences,or ideas?
Written by
BlackFloyd
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I’m sorry to hear about what you’ve been going through. I have had Vasospastic Angina for a couple of years now, and am also presumed to have MVA, though the MVA has not been tested for.
You sound like you know what tests to push for which is good and allows you to advocate for yourself, so use the knowledge that you have to your advantage. There is a link below to a site that you may have already come across during any research you’ve conducted on the condition which has some useful information that may assist in increasing your knowledge further.
Ranolazine is often the drug of choice when treating MVA, so you are correct in saying that if the current medication regime doesn’t work, this is a possible option. I have been on Ranolazine temporarily and ceased taking it fairly quickly due to the side effects. Though Ranolazine is not commonly used in treating Vasospastic Angina as it is in MVA/MVD.
Although it took some time, I am grateful to be under the care of a leading specialist as well as a team of other medical professionals who are very knowledgeable about the condition.
Regarding your symptoms, upper and mid back pain is very common with these conditions. So is pain in between the shoulders blades. Angina can also travel to the arms and jaw. I regularly have upper and mid back pain from the angina. I had this sore tongue that you mention for months and months but never sought medical advice for it. Could your new medications be exacerbating the sore tongue? I would seek medical advice for it if it is being very bothersome.
I hope others can share their experiences with MVA with you.
I have lived with vasospastic angina for over 12 years.
I had a functional angiogram with adenosine and acetylcholine, to access how my small and large coronary blood vessels work, 10 years ago.
I had spontaneous and acetylcholine induced coronary vasospasms.
Microvascular angina tends to lead to exertional chest pain, while vasospastic angina's classic symptom is chest pain at rest, often during the night.
Along with chest pain, I have referred pain in other areas too.
I can have pain in my lower left ribs, stomach, kidney and between my shoulder blades. I have pain in my lower and middle back.
I haven't experienced tongue pain, but I do get left sided numbness and pain in my face and jaw.
A cardiac perfusion MRI can help diagnose microvascular dysfunction but not coronary vasospasms.
The research does suggest that having an accurate diagnosis can help target your treatment options.
It may well be worth asking for further testing to determine whether you have microvascular or vasospastic angina.
Originally I was assumed to have microvascular angina and prescribed beta blockers. I ended up in hospital with unstable angina.
I later discovered that beta blockers are to be used with caution if you have vasospastic angina.
I see you live on Australia, where one of the world leading experts, in caring for patients living with microvascular and vasospastic angina is based, in Adelaide.
You might be interested in the survey that he is conducting in collaboration with an international patient group, which is listed as a resource in the BHF's 'Understanding Angina ' booklet
Thankyou for that.I am in NSW so Adelaide is not an easy option,but Dr Tom Ford,another expert listed on the INOCA website is only an hour or 2 away,so Im keeping that option up my sleeve if my cardiologist does not want to go further.
Tom Ford is also listed on the International Heart Spasms Alliance's website, he trained with a world expert researcher in Glasgow, before moving to Australia.
Hi, sorry to hear of your troubles. I thought I had unstable angina, the symptoms were really weird and the GP's kept playing around with my meds. I got sick of the indecision and asked for a Heart MRI, that took a long time to come through, but in the mean time I found that the Bisoprolol I was taking was the culprit. One doctor tried to get me to take Ranolazine and I honestly thought I was going to die after just one tablet. The MRI showed I had no angina and it had been the drugs. I only take Ramipril and aspirin plus Pravastatin now.
I say this because all my problems were drug induced, even the Atrovastatin (80mg) had been causing my back and chest pain. See is your drugs can slowly be lowered a little to see how you get on. Good luck mate.
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