Angina

[Oldgimmer66]

Hi, I’ve had high BP for over a year now. I’m told that I have a 50% blockage in my LAD artery and Microvascular angina. I’m on a sack load of meds for BP inc Ramipril, Aspirin, Nicorandil, Ezetimibe and Atorvastatin, as well as meds for rheumatoid arthritis.

I’ve had chest pain for over a year and they have tried Ranolazine, which made the chest pain worse, and more recently Isosorbide Nitrate. The pain has thankfully subsided, but I still have chest tightness and massive palpitations, which last all day and only subside about an hour after going to bed. I also feel highly fatigued to the point that I now don’t want to do anything.

Does anyone have any suggestions?

[Milkfairy Heart Star]

Hello,

I have now lived with vasospastic angina due to coronary vasospasms in my microvessels and coronary arteries for over 12 years.

My vasospastic angina, unfortunately doesn't respond well to my medication.

I pace my activities to try and manage my tiredness.

Have you been offered any further tests to determine whether you have microvascular or vasospastic angina?

I was presumed to have microvascular angina until my functional angiogram with acetylcholine confirmed my diagnosis of vasospastic angina.

Knowing the cause of your type of angina/ischaemia non obstructive coronary arteries ANOCA/ INOCA helps guide the treatment.

Beta blockers can help to treat microvascular angina however they can make coronary vasospasms worse.

I suggest you ask to be seen by a Cardiologist who understands microvascular angina.

There are other medications that can help manage microvascular angina such as beta blockers and calcium channel blockers.

There is growing evidence that nitrates are not as effective for some people living with microvascular angina.

https://academic.oup.com/eurheartj/article/41/37/3504/5867624

[Oldgimmer66 in reply to Milkfairy]

Hi. Thanks for that. I don’t think the diagnosis was ever confirmed. The cardio said that as I still have chest pain and yet my arteries don’t meet the threshold for a stent, ‘then it must be microvascular’. All a bit amateurish really imo. I’m thinking I may have to go private because the NHS has been dabbling with this for years now.

‘Pacing my activities’ would be wonderful!

[Milkfairy Heart Star in reply to Oldgimmer66]

I agree, not the best way to diagnose or treat a complex heart condition.Where are you based?

During my bad phases I struggle to get off the sofa!

[Oldgimmer66 in reply to Milkfairy]

That’s me every day now. Even short drives are exhausting. I live midway netween York, Scarborough and Hull and have seen cardio’s in all 3! There is a very well regarded cardio at the Nuffield, but I’d need to take out a loan to see him, which may be worth doing.

[Milkfairy Heart Star in reply to Oldgimmer66]

Can I message you?

[Oldgimmer66 in reply to Milkfairy]

Please do