Hi all, so I ended up in A&E at 5.30 this morning, the pains I had in my back where the same as when I had the HA, 10 hours and ECG’s and Xray and blood tests later they let me home as they couldn’t find anything.
The Dr said it could be wind, I think I have seen people say they experienced this with their meds.
Hello,
I am sorry you are having a tough time at the moment.
I have read through your original post about your heart attack .
Did the Cardiology team discuss the causes of heart attacks that occur without any permanent blockages of the coronary arteries?
This type of heart attack is known as Myocardial Infarction non obstructive coronary arteries MINOCAs.
The common causes of these types of heart attacks are microvascular dysfunction, coronary vasospasms, spontaneous coronary artery dissection or when a small piece of plaque breaks off or a blood clot blocks a coronary artery.
MINOCA s are thought to cause about 10% of heart attacks and occur more often in younger women.
I suggest you keep a diary of your symptoms and ask your Cardiology team to consider whether microvascular or vasospastic angina are the possible cause of your symptoms.
I live with vasospastic angina which is caused by transient constrictions of my coronary arteries, coronary vasospasms.
I will experience not only chest pain, but pain in my upper back especially in the area between my left shoulder blade and spine.
Vasospastic angina is difficult to diagnose but can cause heart attacks and ongoing angina.
It is often misdiagnosed and overlooked as a result.
Hi milkfairy thank you for the info. No one has explained anything to be honest, I’m still waiting for the MRI results and a follow up appointment with a consultant,
How do you deal with the condition? Which medication do you take ?
I acknowledge how bewildering it can feel if nobody is explaining anything to you.
I am unfortunately badly affected by Vasospastic angina.
I have to try and manage my triggers which are the cold, mental, emotional and physical stress.
I pace my activities and manage my stress.
I am also prescribed high doses of medication to help prevenr my blood vessels going into spasms.
Diltiazem, nicorandil, Isosorbide mononitrate along with rosuvastatin, clopidogrel and Ivabradine.
Perhaps before your appointment write down all your questions and if you can take someone with you?
Hi milkfairy did anyone advise what to do when you do experience chest pain? I’m
Already talking the usual meds and aspirin but if I get chest pain again should I take more aspirin?
Hello
This is the advice I was given by my Cardiologist.
If my chest pain changes in anyway, the pattern, severity and length of my chestpain especially if the chestpain comes in crescending waves, or two sprays of sublingual GTN spray do not relieve my chest pain,
I am to ring 999.
I suggest if you have any concerns to always ring 111.
If you can take someone with you had advocate for you to hospital.
Take your discharge papers with you that should give details of your heart attack.
Keep asking to be seen by a member of the Cardiology team.
Maybe ask the doctor you see are they aware that many women have their heart attacks and angina misdiagnosed as anxiety or panic attacks.
I will ask a doctor or nurse, what is their understanding of microvascular and vasospastic angina as well as MINOCAs.
I refer them to the BHF website
My important self help, to manage my anxiety about going into hospital, is to listen to calming music and do the breathing and relaxation techniques, that I used when I was in labour.
Hi milkfairy thanks again for the advice, I’ve left a voicemail for the cardiologist secretary asking for the follow up appointment asap as I’m still experiencing chest and back pain, let’s see what happens !
In addition to the possibility of a MINOCA, Takotsubo also causes symptoms like an MI - but it is caused by a temporary stunning of part of the heart muscle.This can be difficult to diagnose and misdiagnosed as reflux, wind or anxiety.
See: Takitsubo.net at takotsubo.net/information/a...
I hope you are feeling a bit better now. I had a similar repeat of HA symptoms in January, so about 3 months after the STEMI, and inconclusive diagnosis of those symptoms (A&E doctor said probably angina, but GP and later cardiologist said probably not angina). I still don’t know why I had a repeat of HA symptoms, or what to do if it happens again.
The STEMI was due to a large clot from a plaque rupture completely blocking the LAD, but I only have minor atherosclerosis so cardiologist has just concluded that I was unlucky as there is no real reason for it to have happened at all.
It is only now, about 5 months after, that I am starting to feel less ‘wobbly’ about it all. The medication still makes me feel tired, with low blood pressure, but at the final cardiologist appointment he basically told me to put up with it - no decrease in any dose (of Bisoprolol, Ramipril, Atorvastatin, aspirin) allowed. Ever. And that’s it. I’m signed off. On my way with the rest of my life, with no real answers as to why, or how to make sure it doesn’t again, or even, why I had repeat HA symptoms with slightly elevated troponin.
So, I suppose what I’m trying to say is - you may not get answers, or all the answers you’d like, but you may find with time that you can cope with the uncertainty. Because who’d want to spend whatever life is left worrying about something there is no answer for?
Hi CookieI had exactly the same experience as you last week.
I was sitting watching tv, and suddenly experienced an excruciating pain just below my left shoulder blade. I didn't connect this with a heart issue, so I went to bed, about 1.30 I woke up and the pain was just as bad, soit then ocurred to me it might be a heart problem, thought maybe use the GTN spray given to me 31/2 years ago after an actual heart attack and 1 spent.
I have never used the GTN before and don't remember what any side effects might be anyway it's immediate effects were nausea, feeling faint, and generally very bad, so I rang for an ambulance.
The emergency operator was very good and advised me to take another shirt of GTN and an aspirin. The ambulance took an hour and a half to arrive by which time I was feeling much better.
So a trip to a busy A&E and several ecgs, bloods and chest xray resulted in no problems found so would you please go home
Hi Dorset John thank you for your reply, I’m absolutely petrified of what is happening, I’m too scared to go to A&E again as they didn’t even triage me as an emergency. Have you previously had a heart attack?
Yes as I said three and a half years ago I had what I think they call an nstemi, with 1 stent inserted, and I've been OK since then, hence not needing the GTN spray until last week's episode.It was interesting to read Milk Faries replies and I now wonder if I had a MINOCA.
I need to follow up via my GP to see if I need a follow up and meds change.
I can quite understand how worried you are and can o ly suggest you follow up with your GP and find out what what actually caused the problem.
A&E day trip (plus a thank you) 
A&E visit question 
Experience of A&E
A&E Targets
Update since my A+E visit Saturday 
