Cardio Syndrome X

Hi

I’m waiting to have a type of rest & stress test. Apparently it may not confirm definitely whether it’s Microvascular Angina but it could do. It looks at the flow of blood to the heart muscles.

I’ve had scans and been on the treadmill but that all came back as normal. I have also been told there is no definite diagnostic test, but this one is an option

Hope that helps.

Hi,

?I dare say that test will come back normal as well if they can't find anything definite with your heart and arteries, I was diagnosed with this around the age of 30, as the years went on they changed the name to prinzmetal angina, but all these types of angina's are closely related, the rarer types, MVD, Syndrome X and prinzmetal angina.

What other tests have you had done ?

Hi

Just the treadmill and then a CT scan, all normal so ‘case closed’ and referred back to GP. This was about 2 years ago. Then because I was still getting chest tightness on exertion my GP prescribed calcium channel blockers which worked. The symptoms returned though so higher dose of tabs and I asked to be referred back to cardio, hence more tests. 

It does seem likely to be cardio syndrome x, based on symptoms and medical history. I am 65yrs, so a lot older than you but other than this I’m pretty fit and active. What tests have you had? 

L 

Hi,

?I wouldn't say a lot older than me, but yes you are older. I have had the works as in test wise, I have had 2 heart attacks, NSTEMI's as mine were called, only until then did they start taking me seriously, they found a blockage but wasn't enough to be stented, around 60% occluded in the RCA, 2 years later they decided to have another look and found 50% stenosis in the LAD. Prinzmetal angina is still the primary diagnosis from 2 cardiologists because of my weird lipid profile, my retired professor of cardiology still says it's the small blood vessels spasming and just like the PM angina, there's no cure and I will develop a tolerance to all the nitrates, he wasn't wrong there, I could drink a bottle of GTN spray and it wouldn't have any effect during a bad attack. 

?When I was younger and it first occurred I was like you I was fit, always active until these spasms got me, I tried to keep as fit as I could but it takes it's toll on you these spasms. 

?Do you use the GTN spray, the spray under the tongue ? does that help ? If caught in a timely manner it will control mine but if the spasms get away from me it loses it's full effect and only lasts 1-5 minutes before I have to take another spray, and the pain can last up to 2-3 hours if pain relief is not available.

?Yes that's generally the way cardiologists work, if tests come back normal 'case closed' for them, it's a matter of us convincing them. I'm positive I can feel my coronary arteries spasm, when it opens for those split seconds is when the pain is most painful, I'm guessing it's because of the sudden built up blood allowed to flow quickly once the artery opens for that split second.

I tried the spray, made me feel so awful I won’t use again unless it gets to the point I don’t have a choice. I’m fortunate, I only get the spasms when out walking and can stop or slow down to relieve the symptoms quite quickly. Can’t walk up hills anymore! Stick to flat walks. 

L

The way you are describing your symptoms in your last comment sounds like 'stable angina', have you had an angiogram, are your arteries in good condition, no plaque build up ? Maybe the stress test will show something if you get chest pain on exertion, the rarer types of angina aren't triggered by exercise, they occur at rest, sure they can come on while out walking but most probably started off when rested and flared up when a patient goes for a walk after getting the spasms under control, well thought they were under control. I know it makes you feel awful but that bottle of GTN could one day save your life. Here's something to try, 5 - 10 minutes prior to going out for your walk have one spray of GTN, see if that keeps your chest pain / tightness at bay.