Has anybody been diagnosed with Microvascular Angina?

I feel your pain hon and hope you get better or at least improve soon. X

As much as you won't want to hear this I think you are going to have to get used to these attacks !!! I have had these for ten years and my last attack was even more frightening then the others !!

Just try and do all the things you have to and fingers crossed for the rest !!!!

It is a horrible thought Lindy but from what I have heard/read, it looks that way.

I often wonder how much can my heart take of these attacks.... My family are always worried sick.

I,m interested to know many people are able to work and do their normal daily activities?

For me an attack can happen anytime - most often at rest or at night but its happened in public numerous times which makes me so embarrassed. :-/

Sorry that was meant to read: how many people are......

Hi Ellie Rey

It's 11.00pm Thursday as of writing these comments . I am feeling much better now thanks, I was given Morpheine earlier this morning around 1am and because I was pain free at 3am was dis-charged from emergency, As troponins came back negative on first test, however the doctor did say if chest pain returned to call an ambulance and come straight back in.

Yes I could of insisted on another blood test but I shrugged it off, I know I shouldn't have done but it was very busy in emergency and because everything checked out to the doctors satisfaction I was more than happy to come home to my own bed I got my chest pain back at around 9.30am this morning , called for an ambulance at around 11.00am the GTN was controlling the spasms to an acceptable pain tolerance for me in between 9.30 - 10.30 but as time went on the pain increased so called for an ambulance again so I ended up getting the "repeat" blood test any ways plus 2 more, I was given endone for pain relief this time as I didn't have a cannular in,some paramedics leave that for emergency nurses to do if everything checks out with the paramedics, the doctor actually took my bloods this morning and didn't bother with a cannular so I had to wait around an hour for the endone to kick in, I was dis-charged from emergency at around 6pm this evening as all blood test came back negative for significant troponin rises, I'm still pain fre and pretty drowsy A NStemi is a mild heart attack where only a small part of the heart muscle gets damaged and also not picked up by an ECG where as a Stemi is the bigger one here changes can be seen on an ECG and this one damages more heart muscles than a NStemi, that's the explanation I got when I had 2 mild heart attacks.

There was talk about stenting my right coronary artery blockage but was considered only a "baby blockage" at 50 - 60 % and "apparently" they don't make stents that big so am being treated medically for it.

I'm taking 360Mg of Cardizem once daily, I found that to be of great help but as time went on the attacks became more frequent again so I was put onto Nicorandil and that helped even more but once again as time went on the attacks became more frequent again so it was bumped up from 10Mg twice daily to 20 Mg twice daily...Very interesting seeing you are on 10 and 20 Mg of Nicorandil I was informed I couldn't go on any higher dose than 20 Mg twice a day because I really think Nicorandil really helped me, I was taken off Asterix ( Aspirin) 100Mg once a day due to a suspected TIA and was put onto 75 Mg Plavix(Clopidogrel) once a day , Monodur 120 Mg once a day and GTN as required

Lets hope this is your last visit to the hospital for a while.

I'm guessing they just take you in to check you haven't had a heart attack but do they ever keep you in to more in-depth testing or do they have any other ideas on what else they may be able to do for you?

It has to be getting you down. It sounds like you get it far more often than me and I know how frustrating it is going in and out of hospital - so I don't. I am convinced one of these days that will be a big mistake for me to make!

I was told I am on the maximum dosage of Nicornadil but I do believe it helps a lot. Like I said previously though, I wish I knew what sets off my cycles of attacks.

I had 2-5% function in my LAD artery then less then 6 months later it collapsed further up which required another one. I am sure I will need more in the future as I have other arteries that have 'plaque'.

Just curious to know if any of you are/were smokers?

Hi Ellie Rey,

Yes that's basically it make sure that I'm not having a heart attack "at the time" but so they have learnt they can't totally rely on an ECG as mine never showed up on one , was only detected by blood, I believe they are taking a big chance by sending me out into the waiting room when they are flat out. Yes Iv'e had all the extensive tests, I have a 50 -60 % occlusion in the RCA ,my cholesterol and triglycerides are now in fact higher than my cholesterol.

Yes this condition does tend to get you down, I'm at the stage of not wanting to go out by myself because I'm frightened I'm going to have another heart attack even though it was a mild one, it still knocks you around....That's the same as me I was told 20 Mg Nicorandil is the maximum strength and I have 20Mg twice a day, I believe if it came in a higher dose It may well stop these weekly visits to hospital.

Yes I am a smoker, As we speak I'm trying to give up, I did give up for a week but fell off the wagon, I'm using NRT (nicotine replacement therapy) instead of lighting up I am using a nicotine patche, chewing gum and what I call a fake smoke (nicotine inhaler ).

I was asked to keep a "chest pain " diary and after a couple of weeks I could see a pattern, Stress was a major factor , as I have a young son who is getting himself into trouble at school, reasons as to why is unknown at this stage (he's only 9 ) Cold weather sets off my attacks even just a slight breeze to the face and if I over do things , Usually my attacks come on whilst resting but there has been a few occasions where working outside in the garden , etc etc can bring on an attack.

Hello, I find this all very interesting. I am a diabetic on insulin and was diagnosed with angina 3 years ago after I started feeling a tightness in the chest during exercise. At first my GP suspected asthma but my Diabetic consultant suspected it might be angina so I ended up having various tests and ultimately an angiogramme and ultra sound e after which they diagnosed me as having microvascular angina. I was given beta blockers and a GTN spray and told not to exceed 70% of my maximum heart rate which for my age was 160bpm . So that meant 112 BPM. That's quite low and meant I was advised to cease martial art training and squash. During squash, even when playing very lightly my heart rate would go up above 150 at times and I felt the pain and difficulty breathing. I did try the GTN spray but felt ill after and so my GP prescribed some tablets that did the same thing but I didn't cope with them too well either. However I did seek alternative advise and learnt to cope with hard exercise by gradually increasing the level of exercise and keeping my heart rate below 115. This included special breathing exercises. I am now doing a high cardio fighting fit class of one hour at least twice a week and only occasionally feel any angina pain discomfort. The strange thing is that I feel angina pain more when doing some tai chi activities than when doing fighting fit high cardio classes. I also note it is worse when I have eaten. The worst I ever felt was when a lorry nearly hit my car.

I am quite alarmed to read that MVA is not directly proven by any test not even an angio-gramme but diagnosed by ruling out other problems. My recollection is that my cardiologist said the angio-gramme showed that my small arteries were narrow, not by cholesterol, but due to hereditary reasons connected to my diabetes that is also hereditary. I am not and never have been over weight or unfit.

It seems the more I read about it the less experts seem to know. I know I never really received an acceptable explanation of my problem and wondered why I was told to keep my heart rate below 115 when a friend of mine who had normal angina and eventually give several stents was given o heart rate limit at all.

All very confusing and contradictory .

Hi Gordon,

I find your comments about the heart rate very interesting, a human heart rate is 60- 100bpm resting , your comment on your heart rate is that resting ? I have been told I have bradycardia (low heart rate) whilst resting although this has not been confirmed by my cardiologist as of yet.....I use to be an athlete many many years ago perhaps this explains a low heart rate at resting , I honestly don't know.

If your heart rate is that high at rest then you definitely have an issue somewhere, have you had a lung function test ? Perhaps there was no need for the GTN hence feeling ill,did the GTN help your condition at all the times that you tried to use it ?

My understanding is that MVD can't be diagnosed with an angiogram because the blood vessels are to small for them to see any of them spasming ...sometimes they can get your coronary arteries to spasm during an angiogram using certain drugs to get them to go into spasm but not always...I.E the difficulties in health professionals to determine a cause and ultimately a cure.

God all of this is mind blowing. You are so right Gordon, there are too many contradictions and yes, they really are at a loss by the looks of things. :-/

I was told about the 'invisible arteries' but its crazy that if they are that minute, we feel so extremely unwell!!!

My resting heart rate is rarely under 95 but exercise (other than once) doesn't seem to bring on an attack - mine is classed as unstable angina. You would think that exercise would totally exacerbate the condition.

I have always tried to keep myself fit & ate relatively well but I did smoke from a very young age.

I stopped smoking Nov 2012 when I was admitted to hospital with a suspected heart attack which of course & luckily, it wasn't. I managed with nicotine gum but had tried countless times before without success. This time I knew I HAD to stop - no choice really. I haven't had a single puff since.

Can I ask how you all feel after an attack? I mean - do you get really tired and lack in energy?

I'm guessing we all present with very similar symptoms during an attack.

Other than the dragging, heavy ache and often painful chest, my arm really hurts and its almost too 'heavy' to lift. I often get that horrible lumpy feeling in my throat and my jaw aches too. Another thing i get is pain in my shoulder and even after the attacks, I can hardly bare to lean back on or put any pressure on my shoulder blade.

Interestingly though, in the months leading up to the initial attack in November 2012, I had a constant ache in my shoulder/shoulder blade and top of my left arm. This then went to both shoulders for a few weeks before the inevitable happened but, within probably the first hour of the stenting procedure - it went!!

Hi EllieRey - After an attack? I feel wrecked for the rest of the day. When I was first diagnosed and put on beta blockers and after not exercising for a few months due to the symptoms I started walking a lot. I would walk until I felt the tightness in the chest and then slow down or stop. Gradually I was able to improve my fitness and control my breathing and after 3 months I climbed the highest mountain in Skye. I took my time, mind. Anyway since then I have not really had it badly as long as i am prepared for it. The worst I had was when a lorry nearly hit me and my heart rate jumped up very quickly. A few minutes afterwards after I drove off I had to stop and rest a while. I felt sick and my chest hurt and under my left armpit and round my back. The only other times I have experienced it anything close to how it used to be is during tai chi push hands which is a sort of wrestling with a partner. I think it's the adrenalin that causes it in this instance. Although I still do fighting fit classes I have given up squash. I found the erratic nature of the game gave me chest discomfort. I wont say pain because I would stop when it became uncomfortable. I also used a heart monitor and noted the discomfort when my heart rate exceeded 140. With fighting fit I can load up on oxygen in to the muscles in the warm up and so only feel it slightly at the beginning.

If you had a stent then you must've had a proper blockage or restriction in an artery. Is that correct?

My angiogramme showed up what the dr called irregularities in my arteries but not enough to warrant a stent. So he attributed my pains to microvascular narrowing probably hereditary.

Hi Samuel I missed your comment. My heart rate resting is usually less than 60. Not sure how you interpreted my comments as meaning at rest lol. Heck!

I was advised by my cardiologist to keep my heart rate below 115 during exercise. Give up high cardio stuff and just go walking. In actual fact I try to keep it below 130 after which I start to feel chest discomfort. using breathing techniques learnt at my MA school I manage to do Fight Fit classes without pain. See my other post responding to Ellie.

Hi Gordon,

Yes most probably the way i interpreted your comment.

Yes after an attack I feel wrecked for a day or 2,the symptoms you both have described above are classical symptoms of all kinds of angina and heart attack when I had one of my mild heart attacks I had what I thought was indigestion and only a couple of other symptoms mentioned previously by your comments Ellie Rey.

When my attacks have finished that's the end of them until next time, I don't have pain after the event as you have described Ellie Rey

Sorry about the delay in responding.

I can imagine that fright with the lorry would have given anyone a near heart attack anyway Gordon, it must have been terrifying!!

I do think that our, well I know my emotions often affect me. If I'm very upset, excited etc, this can bring on attacks but not often at that time - often the next day.

Yes I had something like 2-5% function in the LAD and they said I was very lucky I didn't have a heart attack.

I had cardiac rehab for some months but the progress was so slow because of my hips. I wanted to join a swim class to build on my cardio but they said it was too risky until I got up to their level 5 fitness. I managed to get to level 2 then had to have the other stent which set me back.

I always believed swimming would be the absolute best thing for anyone and was so surprised when they said it was too dangerous. The pressure of the water could be too much for my heart - but I could swim as long as the water didn't go above my waist.... Well I can't say that would be swimming lol and saw it as pointless.

I am praying I get the go ahead for hip surgery soon as my 1 year is up in may. My doctor doesn't think they will with the heart problems I am experiencing but I cannot see anything improving my health until i have my hips replaced. I can then build up on my fitness, go back to work and get my life back on track.

Samuels - I have heard about the indigestion symptoms and that's what they kept asking me. I was getting so mad because i knew it wasn't bloody heartburn or indigestion. It took a lot to convince them there was something else wrong and I suffered a lot during those 6 days. I'm surprised I'm still here, let alone the doctors!!

You are lucky to not get the ongoing symptoms and I wish (other than not having it at all) I just had the pain then nothing else. It's not nice for any of us and I guess just something we have no choice but to learn to live with.

Hi Ellie Rey,

Sorry to hear about your other problem(s) from preventing you from attaining a higher fitness level. The reason they had to listen to me in regards to the indigestion symptom when I was having/had the heart attacks is because I am on treatment for it and it is controlled by Nexium,I have suffered indigestion all my life even as a child, they haven't been able to find anything what so ever in what's causing my indigestion so I have been put into "the to hard basket " for that as well. If I forget to take my Nexium boy do I know about it, I can feel the burning and the acid and it's contents rising up from my belly up into my throat then flow out of my mouth...lol....Yuk....

Yes that's right surgeons don't like to do any kind of procedure involving anaesthetic to knock you out to perform major surgery when you have any kind of heart problem(depends how bad a heart problem you have of course), they will only do life saving surgery with letting you know that you may not survive, That's how it works down here anyrate.

Yes I hear you Ellie Rey...My cardiologist has told me it is something I have to learn to live with and call ambulance as required and over the last 3 years I've had that many visits to our ED I've lost count, I'm sure you can relate to this...When the chest pain and some of the other symptoms arrive and the GTN has minimal effect after around 18 sprays you have no other choice in thinking is this another heart attack because we have had heart attack previously and we know or at the very least know the possibility that we could be having another one even though ECG looks normal and we have to wait for the first bloods to come back to tell us definitely and usually MVD and Prinzmetal Angina sufferers have a negative troponin rise then we have to wait for the repeat one 6 hours after the last most painful event. I have had the first bloods come back negative and the second one come back positive, I had a doctor a fortnight ago tell me that there is no point in doing the second troponin test because the 6 hour period was nearly up and they would take the first test as conclusive, this had me a tad worried as they actually took the blood 2 hours before the 6 hour time frame for the second blood test, I made an enquiry with someone else after dis-charge and I was told that a repeat should have been done.