microvascular angina

[Cookie1973]

morning all, thank you god all your replies, I experienced chest pain and back pain again last night, I’ve read all the info on microvascular angina and it absolutely seems to describe what I am experiencing, has anyone else been diagnosed with this? I still don’t have any follow up appointments with a cardiologist so I feel I’ve just been left to deal with this on my own without any medication to help with the symptoms

[Milkfairy Heart Star]

Hello,I am sorry you are still having problems.

Microvascular angina along with vasospastic angina are types of angina/ischaemia non obstructive coronary arteries, ANOCA/INOCA

I was diagnosed with vasospastic angina over 10 years ago. My coronary arteries go into transient constrictions causing a lack of blood supply to my heart. I also have vasospasms in my small vessels, so microvascular angina too.

Microvascular angina is more commonly caused by the inability of the small blood vessels of the heart being able to dilate or stay dilated in response to extra demands like exercise.

A stress echoc can help identify patients with microvascular angina

Microvascular angina can in some instances diagnosed by a cardiac perfusion MRI.

Unfortunately microvascular and vasospastic angina are often overlooked and unrecognised.

Only a few centres offer functional angiograms using adenosine and guidewires along with acetylcholine which is the best way to confirm a diagnosis of microvascular or vasospastic angina.

My vasospastic angina was confirmed by this type of specialised angiogram in 2014.

I spend alot of time explaining my vasospastic angina to doctors including Cardiologists.

I suggest you keep a log of your symptoms. Discuss these with your GP and ask for an urgent appointment with a Cardiologist.

Alternatively contact the Patient Advisory Liaison Service PALS of the hospital concerned, saying that you have had a heart attack, you are still having chest pain and have no follow-up appointment.

If you are having cardiac rehab tell the rehab nurses about your ongoing symptoms.

If you do need to go to A&E again, ask to see a member of the Cardiology team and keep asking them to consider whether microvascular or vasospastic angina are causing your problems.

Ask the staff to acknowledge your pain. Many patients with microvascular angina have no ECG changes or rises in troponin blood levels.

This website has some useful coping strategies.

internationalheartspasmsall...

[Cookie1973 in reply to Milkfairy]

Hi milkfairy your information is invaluable, I can relate to everything you are saying, I just do not know where to start, I am living in constant fear that my heart is going to stop. I don’t know where my care is being arranged from because the cardiac MRI was requested from a consultant in a different town to where my follow up appointments is alleged to be taking place although I don’t have any appointments yet.

[Blearyeyed in reply to Cookie1973]

If you know the name or hospital that your MRI was requested you can still contact them to request more details about test results or find out information about whom to speak to at a different hospital about when your appointment will be .When you contact the Cardiology Department you are meant to be getting an appointment with , as well as asking when you will approximately hear about your appointment dates you need to mention that it was meant to be an urgent referral and that your symptoms are active and have been getting worse.

You could even request a call back from a Consultant or the Cardiac Nurse for more advice.

When they speak to have a list at hand listing your current symptoms, how often you are getting them and for how long , what medication you already take and any other health conditions you might have and any questions you want to ask.

You can ask if there is any advice they could give you to use while you wait or if they can contact and recommend any interim treatment to your GP to give to you while you wait to be seen.

You may even find when you speak to someone that they will choose to ask you to come in to assess you or give you a fast track appointment date.

If you are not getting answers or help from the Cardiology Department you have had your treatment changed to after calling for information, you can state to them you are not happy with the delay , it seems unacceptable in the circumstances, and that you are sorry but you will have no choice but to put in a formal complaint with the Chief Executives Office .

Usually this gets action.

The CEO of the hospital is the section you need to make complaints about your care to directly as they must add them to their records . They do not like complaints and deal with them swiftly and get answers and movement from the Department you have an issue with quickly.

There's no point using PALS for most complaints as they have very little power in moving things along unless it's simple practical matters like transport or ward needs.

If your issue is about GP or Nurse care , you use the same tactic when talking to the Practice Reception or Manager , that you will sadly have no other choice but to make a complaint about the delays in your treatment to the local Integrated Care Board. Usually they will try and sort things out with you then and there rather than you making a complaint , or try to persuade you to make a complaint to them instead which you can refuse.

This is because the ICB complaint is added onto their records and dealt with externally, it's not dealt with in-house in a way that they can keep the complaint from being added to their records. The ICB questions the surgery externally and tells them which action they must take.

In the meantime you know Anxiety about your symptoms will cause more Stress and make the symptoms worse, so try to distract yourself from thinking and worrying about your symptoms as much as you can.

Distract yourself from worrying about it with a positive activity but a relaxing one.

Avoid doing activities that are triggering more symptoms or over exerting yourself in the day , as daytime activity beyond your current health level can increase the intensity of the symptoms you get at rest.

Try using relaxation techniques to help reduce Stress like deliberate, deep breathing , gentle movement, and keeping a steady room temperature and raised head and shoulders in bed to reduce symptoms caused by a change in position and environment.

It can feel like a very stressful full time job having to manage getting your appointments and getting a diagnosis at first, but once that's sorted out and your properly diagnosed with a treatment plan things do begin to feel easier , and , of course , your daily symptoms improve with the treatment you get.

You will get there , take care , Bee