Heart Attack with normal arteries?

[9040susanh]

Hi, I'm 62, new on here and would welcome any advice on my puzzling diagnosis.

I've had BP for years - taking 2.5mg Ramipril and Atorvastatin 20mg for raised cholesterol.

On 28 Sept I experienced the tight chest pain, cold sweat, lightheaded feeling and nauseousness and called 999. After normal ECG and bloods, the 2nd enzyme blood test 6 hours later at A&E was 2,500, so was admitted to CCU

An angiogram showed that my LAD artery had mild plague disease only, tapering of the mid to distal segment seen. Left circumflex artery: minimal plaque disease only, but was told I had significant muscle damage.

Discharged on 3rd day with Ramipril 5mg, Atorvastatin 80mg, Brilique 90mg x 2, Bisoprolol 2.5, Aspirin 75mg and a nitrate under tongue spray.

I'm due to see the Cardiologist on 16th Nov, so hoping for answers then. I'm experiencing very low mood, tiredness and weakness. I'm now worrying about going back to work in a stressful dementia care home as I'd been feeling the strain before my MI. Any words of wisdom would be welcome from anyone on here.

Thanks for reading this

[pinnelli]

It’s hard to know what to say. I had severe HA which went into Cardiac Arrest whilst out cycling. I never had BP issue or raised cholesterol. They say arteries are pristine, but of course in western societies we all have some mild plaques due to our lifestyles. In my case one ruptured & blood clotted. Possibly stress, trying to do too much including big, fast bike rides!

The fatigue is possibly the meds, I struggled with fatigue a lot even though fitness was & still is high. The meds we’re slowly reduced over last 16 months & that’s really helped along with body generally adjusting.

As for stress, yep we need to keep to a minimum. If job a problem but changing not easy look for other ways. I was obsessed by fitness, with busy job & family life that didn’t leave much time & probably led to stress. Tho as I say BP was good, so one thing I could do was slow down. General fitness keeps me healthy & when I can I enjoy bike ride / mountain walk etc.

I guess I’m saying there’s always something we can address. My wife was convinced reducing my cycling would make me impossible but it’s amazing how it hasn’t because deep down somewhere I realised I stared death in the eyes so just have to change. As for work I look at various lifestyle changes.

Take care & good luck with appointment

[9040susanh in reply to pinnelli]

Thank you so much for your wise words. It's heartening to hear others experiences of HA and from the sound of it a CA must be the most frightening experience.

Glad to hear of how you've taken on board the changes you needed to make and even if you've struggled mentally it seems you've been able to be clear-headed looking forward.

Well done, you!

Again, thanks for sharing your experience, feel so much better today. I will post on here again after my Cardiologist appointment, maybe with some answers too.

My regards

[KEN65]

Hi and I agree with pinnelli on the meds, after my CA and now 16 months on I have come off Ticagrelor/Bisoprolol and over 8 weeks I am starting to feel like my old self again so as much as the meds helped in the early days now I do not need them and are grateful to be off, amazing how they change your moods and overall feeling which for me was more noticeable as I got stronger. wish you well and take it easy as time is the healer as frustrating it can be.

[9040susanh in reply to KEN65]

Hi Ken65, thank you for your reply. At this early stage, although I'm feeling weary and weak the thought of coming off the meds seems scary! Glad to hear though of how much further on you are and I bet my anxieties resonate with how you felt from last year? I have been such a moody person these last few weeks, tearful at times and best left alone to be honest. I'm aware of how I'm being, so my struggle is mental. I'm on to it though!! Talking on here helps, even just reading others experiences helps. Keep well yourself

[pinnelli in reply to 9040susanh]

So much seems scary at first, you hear all sorts & even hospital tells you different things. A junior doctor told me I’d never cycle again! Cardiologist just dismissed him immediately as we know execercise is best route.

Once I saw cardiologist properly in clinic and now I see him privately I realised in my case no need to so scared (albeit I’ve struggled with anxiety) but at least I know everything is clear.

Good luck, give it time and rest up

[sca2013]

What you're experiencing I think is very normal, given what you went through and the medications you're having to take. Be kind to yourself. This has all been a very big shock to your system, both physically and especially psychologically. I went through similar things with my two separate, 12 years apart, cardiac events (heart attack and cardiac arrest). The doctors in both cases told me there was really no medical reason (plaque build up, clots, etc.) for me to have had these happen. I attribute both of these events to long term, poorly managed, out of control, high stress from my work life, owning and running my own accounting and tax firm, with it's insane immovable deadlines and client demands. Take it slow and take care of and be kind to yourself. No job is worth being dead or disabled. If you have other questions or want to talk further, please let me know.

[9040susanh in reply to sca2013]

Thanks for sharing what happened to you.

Looking back, now I've time to contemplate, I'm sure I've almost always been stressed or worried about something or other.

I will take your advice and consciously try to find ways of looking at life differently from now on. Deciding to stop working at the pace I've been doing or taking the scary routine of retiring early.

I hope you continue to be well and thank you for your wise

words.

[Jamesgui2]

Hi, I presume that is a troponin reading? Heart attack with segmental coronary artery disease is not that uncommon. It's highly likely you may have small vessel dysfunction or disease. This is a very challenging condition to treat. BP and cholesterol control will be essential. There are many opinions regarding small vessel disease, it the Holy grail of cardiology. The only test that really adds anyting worthwhile to this possible diagnosis is an MRI perfusion scan. Discuss with your cardiologist. Good luck 🤞