Micro vascular angina

[Fifimyangel]

Im being tested for microvascular angina. I'm having a wrist angiogram. Is there anyone out there with symptoms of microvascular angina. If so what are they?

[Milkfairy Heart Star]

Hello,

I was originally many years ago presumed to have microvascular angina.

My functional angiogram using adenosine and acetylcholine showed I have vasospastic angina, another type of angina/ ischaemia non obstructive coronary arteries ANOCA/INOCA.

Microvascular angina is due to the inability of the small blood vessels of the heart to dilate or stay dilated in response to extra.

The symptoms of microvascular angina are chest pain and breathlessness brought on by exertion or stress.

Microvascular angina seems to be more common in women, around the menopause.

Vasospastic angina is due to the large coronary arteries going into transient constrictions, causing a lack of blood supply to the heart.

Coronary vasospasms are notoriously prolonged and painful. People with vasospastic angina tend to experience their chest pain at rest especially during the night.

Vasospastic angina isn't usually triggered by exercise. Though mental, emotional and physical stress, along with the cold can trigger coronary vasospasms.

The BHF has some more information about microvascular angina.

bhf.org.uk/informationsuppo...

The BHF ' Understanding Angina' booklet lists, this group, as a resource for people who live with microvascular or vasospastic angina.

internationalheartspasmsall...

bhf.org.uk/informationsuppo...

[Fifimyangel in reply to Milkfairy]

Thankyou

[Kind51]

Hello Fifimyangel, I have been experiencing angina this last year. A CT scan showed no obstructed arteries. It is thought to be vasospastic angina however, I require further testing. I take Isosorbide Mononitrate and GTN. I respond well to GTN.

I experience both rest angina and exertional angina. My main triggers are cold, changes in temperature, wind and stress. I am at my worst during times of extreme cold weather like what we have been experiencing this last week or two.

During angina attacks my blood pressure is elevated. The angina pain I experience feels like painful chest discomfort/intense pressure/squeezing within my chest. I also frequently experience fatigue.

What are your symptoms?

[Fifimyangel in reply to Kind51]

Thankyou

[Silvertail]

My symptoms are mid chest pain - not severe - and breathlessness on exertion - usually walking up inclines, stairs etc or walking too fast and too far. These symptoms subside when I stop the activity which causes them. Occasionally I resort to GTN spray.

[Lotsirb]

Hello, I've had Micro Vascular Angina or, as it's also referred to Micro Vascular Dysfunction, for many years.

My usual symptoms are mild chest pain followed by pain in my neck, then pain in my left arm, and sometimes pins and needles in my left hand.

When the pain is more severe than normal I head off to, or get sent to, my local A&E dept. where, after taking blood tests and giving me a thorough check I get discharged or sent to the adjoining Bristol Heart Institute for more tests.

MVA (MVD) is still not very well understood so you might get discharged with a clean bill of health although you know in your own mind that things are not right.

I have been told recently by a consultant that my condition is not life shortening. However living with it is a pain (excuse the pun) and can be quite worrying at times.

[Lotsirb in reply to Lotsirb]

I forgot to mention that I also suffer from Reynauds which is miserable in this cold weather. It's either a symptom of MVA or a result of the medication. I'm not sure of which.

Also my MVA comes on under physical stress - walking up a steep hill, or under emotional stress

[Milkfairy Heart Star in reply to Lotsirb]

Hello,

Have you been offered a functional angiogram using adenosine and guidewires along with acetylcholine to confirm your diagnosis?

I have lived with vasospastic angina another type of angina/ ischaemia without obstructed coronary arteries ANOCA/INOCA, for over 12 years. I was assumed to have microvascular angina until I had my functional angiogram, 10 years.

I would suggest the Cardiologist comment is not in keeping with the latest research evidence.

I also live with Raynaud's Phenomenon and migraines which seem to be associated with coronary vasospasms.

[Fifimyangel in reply to Milkfairy]

I'm due to have a wrist angiogram . The results will be given to me the same day.

[Milkfairy Heart Star in reply to Fifimyangel]

Most invasive angiograms use the radial artery in the wrist to carry out the angiogram.

To test for microvascular dysfunction, a chemical adenosine and guidewires are used to measure how the blood flows through the small vessels in the heart. From these measurements microvascular dysfunction can be diagnosed.

Then another chemical acetylcholine, is injected into a coronary artery. Normal working coronary arteries should dilate. If the coronary arteries constrict than coronary vasospasms are diagnosed.

I had spontaneous and acetylcholine induced coronary vasospasms during my functional angiogram.

The Cardiologist was able to tell me, I had vasospastic angina there and then.

I hope your angiogram goes well and you get a diagnosis.

[Fifimyangel in reply to Milkfairy]

Thankyou

[Flamingheart in reply to Milkfairy]

Hope you don't mind me asking but are the tests you mention (using adenosine, guidewires and acetylcholine) known about by GPs? Asking because I was discharged with no care plan or follow up appointments, just a "? microvascular coronary disease" in the summary.Encouraged by yourself and others I am being proactive and have an appointment this week with my GP at which I will ask him to refer me to a cardiologist who fully understands this condition and can carry out appropriate diagnostic tests.....

I just wondered if the GP is going to have any clue what I'm talking about!

[Milkfairy Heart Star in reply to Flamingheart]

I doubt your GP will be aware of functional angiograms.

The forum guidelines ask us not to name individual doctors or hospitals.

Can I message you?

[Flamingheart in reply to Milkfairy]

Yes please if you have time!!!!

[Fifimyangel in reply to Flamingheart]

I was told they were going to be using wires and contrast dye. I'm assuming this is what they use to detect microvascular angina.

[Milkfairy Heart Star in reply to Fifimyangel]

To diagnose microvascular angina. A chemical adenosine and guidewires are used during an invasive angiogram to measure how the blood flows through the microvessels.

From these measurements microvascular angina can be diagnosed.

To diagnose vasospastic angina another chemical acetylcholine is used. If the coronary arteries constrict in a vasospasm, with ECG changes with the person feeling chestpain, that confirms coronary vasospasms.

[Fifimyangel in reply to Lotsirb]

Thankyou

[Carriefarm]

I have MVA, my symptoms are chest pain or could be neck or jaw pain on exertion and also at rest. I am on a range of meds which have reduced the number of pain/ spasms. I regularly exercise and use GTN spray if needed. Best wishes.

[Fifimyangel in reply to Carriefarm]

Thankyou

[Milkfairy Heart Star]

Silvertail Lotsirb

Carriefarm

Roseleigh

There is a patient survey being carried out by a leading world expert based in Adelaide University and a patient group listed in the BHF 'Understanding Angina ' booklet as a resource for people living with microvascular and vasospastic angina.

I would encourage everyone to take part, so more knowledge can be gained about microvascular and vasospastic angina.

surveys.adelaide.edu.au/red...

[Roseleigh]

Hi Fifimyangel

I have been diagnosed with microvascular angina without coronary obstruction. This has so far been diagnosed through an angiogram. I am awaiting a further angiogram with acetylcholine to confirm this.

I have chest pain that goes down my arm on very little exertion and in this cold weather. Also brought on sometimes with stress. You are not alone. It’s quite something to get your head around but the medication I am on is helping and wrapping up very warm when ever I go outside has also alleviated the incidences. Especially the addition of a snood for walks!

There is a lot of good information on here and everyone is so helpful. It’s a real shock when you are first diagnosed, the limiting of your ability to do normal things is hard to get to grips with.

The best advice I’ve seen is to pace yourself. Before I was diagnosed I couldn’t understand why I was so exhausted if I’d even been shopping for a day out or had a night out just for dinner or tried to clean the house all in one day. On the other hand it also was a relief to find out why I had chest pain:tightness on dog walks.

Good luck with your angiogram.

[Fifimyangel in reply to Roseleigh]

Thankyou

[Qualipop]

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