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Has anybody been diagnosed with Microvascular Angina?

Posted , 20 users are following.

priscilla04738
priscilla04738

I have had this condition for about 4 months and it is really getting on top of me. I sometimes have it all day, with tightness, pain in chest and into my neck, now have a cough. Have trips to ED with tests, but usually normal, except for stress test which I lasted for less than 1 min. They wouldn't let me continue. Had angiogram, normal. Are now on GTN tablet and spray, Diltizem and Atenolol. Have now got Morphine at home to control bad episodes. My life is very restricted, I used to be very active with walking and running, but can now do neither. Sometimes even a flight of stairs is too much. Has anybody got any suggestions?

2 likes, 110 replies

110 Replies

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  • EllieRey68
    EllieRey68

    Posted

    I have had heartburn and had a little bit 'come up' but nothing like what you have to go through... That's awful - poor you.:-/ Did any of your family suffer the same? Maybe you were born with an abnormality.... Could this have been related to your heart problems? I bet you have asked every such question yourself!!

    Sorry if I seem silly or ignorant but can I confirm you are a woman? Your name makes me think male but so many other things you have said give me clues you are female or maybe I read something that pointed that way and not realised it. lol.

    I have to say that I have never had to go above 2-3 sprays in any 1 period but can have 5/6 attacks a day. One last week was pretty bad and I nearly threw up but I needed to go to the loo within a minute or so. It was horrible and I was close to calling the paramedics but resisted. I was on the sofa for the rest of the day though!!

    I have to see my cardiologist on the 30th and I am desperate for him to agree to let me have surgery. Surely they won't let me stay disabled knowing replacements will help me have a better, pain free life and eventually help to strengthen my heart too, as I will be able to exercise. I also want absolute confirmation that my heart is not oxygenating which is what their suspicion was. I don't know how they can decide or discover that as the angiogram has shown my heart is functioning fine now. They even did a test that could hear the arteries perfectly during that angio but can't remember what its called - so how can I convince them that the attacks come and go often months apart and that some are so bad, they bring me to my knees????

    At least I can go and say I've read up on microvascular disease & prinzmetal angina and I am armed with a little more info now. ;-)

    I feel lost and so frustrated. :-(

  • samuels
    samuels

    Posted

    Hi Ellie Rey,

    I am a male smile

    One would hope that they would do your surgery for you because what you had said in your comments above is absolutely correct , for you to be able to stay in pretty good shape you need the rest of you to function properly as well smile

    I average as previously commented one attack per week that requires me to call paramedics,the reason for me taking so much GTN is because I too hesitate in calling paramedics, it's dis-rupted my lifeI'm putting a strain on the emergency services and even though the emergency doctors (seniors) say that I'm not (I know I am sad ) they keep reminding me would UI rather be found unconscious on the floor or even worse dead. I do have the occasional attack twice a week but like you with the GTN 4 sprays tops takes care of the chest pain and doesn't annoy me for the rest of the day, I do have some extra stress going on at the moment so perhaps that's why I get this one major attack each week, I've tried all the CBT's (Cognitive Behavoir Therapy) and slow deep breaths, you know just try to chill out but none of that works. I did suffer Panic/Anxiety attacks but they don't seem to be a problem any more with the exception of Agoraphobia , that has been my sticking point, I'm perfectly fine if someone else is travelling with me but alone..no go ,I was told that having a heart attack can do this and re-training the brain is the key , I have this attitude now that if I have a heart attack so be it but I won't sit at home suffering severe pain when something can be done to relieve the pain, know what I mean ? smile

  • linda89207
    linda89207 priscilla04738

    Posted

    Hi Priscilla, I know its been a long time since you posted I have the same symptoms as you with chest pain into my throat and back pain all ECG's, troponin blood test and angiogram are normal Doctors saying it is chest muscle spasms and nothing to do with my heart I have an appointment for a drug induced stress echo (I have a back problem so cant go on treadmill) on my last stay in hospital a couple of weeks ago I had the angiogram and the Doctors said they would cancel the appointment for the stress echo they havent cancelled it so I am going ahead with it. You said you only tollerated it for a short time what symptoms did you get for them to agree it was MVA mine is next week and it would be good to know what to expect. I live in the UK but they dont seem to want to diagnose this.
  • priscilla04738
    priscilla04738

    Posted

    HelloLinda,,  I had a treadmill test and my symptoms came on so fast (tightness etc) that they stopped me and wouldn't let me carry on.  I would have loved to have a stress echo, but seen I had an angiogram doctors said it wasn't necessary.  I have had the worst 'turn' I have ever had, got ambulance, hospital doctors took 4 hrs and lots of morphine to get it under control.  My symptoms were a bit different this time with faint feeling, clammy hands, racing pulse as well as tightness and pain.  Troponin came back only 0.01 & 0.02, so just monitored me for the night and let me home next day, but different staff on in the ED and they were very good and told me to come back if I had another turn like that.  Ambulance guys said the same, I did the right thing to call them, so was encouraged to do so.  I still have tightness every day and has been worse again since having that attack a couple of weeks ago.  I try to go for a walk each morning.  It seems to get worse by the end of the day.  By the way, I have morphine at home, but last attack it didn't touch it. 

    I will be interested to know how you get on with your echo,  please post results.  They called my treadmill a false positive, because arteries were clear.  In NZ MVD is becoming more recognisable and I feel like I'm not putting it on especially after this last attack.  Doctors realise it is very 'real'.

    • samuels
      samuels priscilla04738

      Posted

      Wow Priscilla... I should move over your way for treatment smile

      Only the paramedics use morphine with me, Doctors say to me that Morphine doesn't do a thing but you and I know differently smile , I think they just like to see me in pain and they think it's all in my head ! I haven't officially been diagnosed as MVD but have been told I have Prinzmetal Angina. The doctors don't know this as the nurses tell me when I ask ...on average my Trops come back anywhere from 0.01-0.04 and I get booted out the door ....lol...

      My Cardio has told me what's going on but he referred me onto another cardio as he was retiring and the new cardio seems to think it's neuropathic pain and has halved all my angina medications to no benefit , In the last 2 weeks alone I have been into emergency 3 times a week with chest pain with radiation to jaw and left arm , etc etc. I go and see my old cardio every now and then as he didn't end up retiring after all, he still stands by his diagnoses but he doesn't correct my current cardio, it's as if they don't communicate...unless he tells me one thing and then tells my current cardio another.All I know is now if they say something smart I just simply reply back with "have you had vaso spasms and the accompinying pain associated with it " 

    • linda89207
      linda89207 priscilla04738

      Posted

      Hello Priscilla, mant thanks for your reply I will certainly let you know how I get on just keeping my fingers crossed it isn't cancelled before I can have it, all my symptoms come on with rest but the pain can last for two or three days not always severe but very uncomfortable. The Angiogram showed some narrowing of arteries but not blocked also echo shows a couple of slightly leaking valves but say this is normal for my age (67). It is very frustrating and effects my quality of life. I think here in UK they prefer to refer to it as muscle spasm rather than recognise MVA
  • priscilla04738
    priscilla04738

    Posted

    Hello Samuels,

    An interesting thing was one of my last ambulance guys said he had Prinzmetal angina, so was sympathetic.  I asked him how come he was fit and able, he replied medication, so asked him and he is on amlodipine, they have never suggested it for me as they think mine is different to prinzmetal as mine mostly comes on with exercise or after it, or just too tired.  They upped my dose of diltizem since the last attack, but I don't think it has made any difference.  I am quite breathless a lot of the time since the last attack, does this happen to you??  I had contact with a very top Aussy Dr friend surgeon, and he was sympathetic too, but said there is not much you can do for it and wait for some better medication to come along!!

    The last bad attack, I had 10ml oral morphine at home, but that didn't touch it and had to have another 30ml by injection, which is about triple the strength of oral which left me just about 'out of it', had to keep talking to me to keep me awake and breathing.  I just wanted to go to sleep!!!  Not very nice feeling.

    My ECG also wasn't normal then.

    You just wish you could take a magic tablet to fix it!!!!!!!!!!!!

    I do find going for a walk helps, I get pain to start with then it goes, 'walk thru it'.

    Hope you find some relief.

    • samuels
      samuels priscilla04738

      Posted

      Hi Priscilla,

      99.9% of the paramedics are very sympathetic towards me and when ever they can get a line in they offer morphine and I accept because the pain is horrid. I have one of Australia's top Cardio's(the one that was going to retire) and he has said the same thing to me, he doesn't completely agree with the diagnosis "Prinzmetal Angina"  he said, now if you can make sense of this ....lol...(I can't ) he said in theory you have "Prinzmetal Angina" but not in practise, he said what's going on with me is that it's the small blood vessels in the heart going into spasms,the vessels can't be seen by the naked eye or be picked up on an angiogram and there is simply no known cure...just like your Aussie Dr friend told you.My current cardiologist referred me to the chronic pain management team in the hope of  getting me onto a tens machine I think they call it, it's a machine that sends little electrical pulses and giving a massage effect but that was never discussed in the 5 hour accessment, wasted 5 hours of my time to be told it was just in my head and I told my new cardio this...lol...he was a bit bewildered that they didn't think of trying this tens machine so he ordered another stress test to which I haven't had done and I don't think I will have it done as I had one just over 12 months ago and as a lot of "Cardio's " say nothing would of changed much in 12 months so I don't know why he bothered to order another one when they all think like that.

      Yes I get  breathless when I have these attacks and the breathlesness has become more increased since my medication was halved, I was on the maximum dosage rate ...Diltiazem CD 360 Mg, Monodur 120Mg. Ikorel 20 Mg, the Ikorel is the only one he didn't adjust, I also have the GTN spray, that works when an attack comes on 9 times out of 10 I can bring it under control with the GTN but there is always that one severe attack on any one day a week where it starts to help (GTN) but then the spasms become stronger and the GTN only works for about 5-10 minutes and the chest pain and associated radiations get stronger, I take up to 15-20 sprays now before I call an ambulance because I'm in the emergency department on a weekly basis and you could imagine how embarrassing that is. I have been told my ECG's are normal but my troponins have been raised significantly for the doctors to say that I have had 2 mild heart attacks, on both occassions the symptoms weren't  the same, the first mild heart attack I had felt like indigestion and the second one I felt like I had been hit by a bus and the pain.I remember one trip in to emergency the paramedic was monitoring the ECG machine and he kept asking me how did I feel and how the pain was, he tended to my pain got onto the radio for some reason to get permission to turn their lights on then told the driver to put the foot down and then he phoned through to the emergency department explaining to them that he was 5 minutes away with a possible Stemmi.....fastest ride I've had in an ambulance...lol...That was from him monitoring the ECG continually, I know when you are admitted to cardiology that you are monitored  but one would think some one would have to be at the desk full time to monitor every patient on the ward or they would miss a lot of "blips" unless they are recorded via a computer etc.

  • priscilla04738
    priscilla04738

    Posted

    I have often wondered about the TENS machine.  I have tried acupuncture to no avail.  You can get TENs from Alibaba real cheap, or EBay.

    I get breathless thru the day without the pain etc.

    • samuels
      samuels priscilla04738

      Posted

      My breathlesness only comes on with chest pain even at rest, My original cardio(Prof I call him as that is his title of cardiology) did tell me that he thought the chronic pain management team wouldn't be able to offer much for me , my new Cardio is the one that made the referral so I seeked a second opinion and the Prof sat in his chair and just shook his head in a "no" fashion.....lol... he did tell me that I would get a younger "cowboy" cardiologist and will want to perform an array of tests including a possibility of opening me up , but Prof say's that's a few years off and still might not even have to happen yet.

      I see 2 cardiologists as I mentioned before I thought my original one retired ....Prof but he didn't retire in the end so I go to him if I think my new Cardio is acting a bit cranky or wants to perform tests. The weird thing is Prof doesn't work for our public health system anymore he has his private practice now with a private hospital ,my new Cardiologist is actually employed by Prof's private clinic as well as being employed by the public health cardiology unit, now my notes aren't able to be accessed by our public hospital for some reason and one would think working together they would swap notes because it's not every day a specialist gets a patient with something that they can't find anything else wrong with but is known to have a stage of CHD....

      Personally I don't think this tens will do anything for me as a paramedic was telling me it's more for people who have muscle pain or back injuries. What both cardio's have agreed upon is trying Amitriptyline   for the chest pain and spasming but I can't tolerate any family of anti-depressants sad

    • priscilla04738
      priscilla04738 samuels

      Posted

      It was amlodipine which is another version of Diltizem, not amitriptyline.

      I have booked in to a natural health professional which says he has had good results with MVD at the end of next month so we'll see.........!  Will post any results, may take a while to happen.  At the moment my blood oxygen level has fallen, goes between 86 - 95, don't know why?

    • samuels
      samuels priscilla04738

      Posted

      Yeah my cardiologist wanted me to go on Amitriptyline,I'm already on Diltiazam amongst other anti angina medication,My GP says I'm on the best anti angina mediacation but I think I may require stonger doses....I was on the maximum dose but my new cardio went and halved them and now I'm getting more chest pain than usual so I have to go back to my GP and bring that up with him, One would think a stronger dose would help but then I suppose the maximum dose has been rigourosly tested as being the safest does...I really don't know.

      Speaking of blood oxygen mine has done the same thing it's sitting around 87-95, I'm currently trying to give up smoking, a paramedic heard me wheeze one day and asked if I suffered asthma and I don't so he listened to my lungs ,chest and throat but couldn't hear any wheezing so he suggested I ask my cardio about "cardiac wheeze" I haven't got around to that one yet because I know what he is going to say straight away...lol.....It's not a long term thing this wheeze I just seem to get it occassionally with the chest pain and the paramedic heard it on this particular day.

    • linda89207
      linda89207 samuels

      Posted

      My GP prescribed Amitriptyline did nothing for me, when I came out of Hospital last time I was still down for Diltiazem and GTN on my discharge letter but the GP I saw at my GP Surgery stopped both I am now getting more pain and palpatatations so have started using the GTN again it eventually gives me some relief after a few doses

       

    • samuels
      samuels linda89207

      Posted

      Know where you are coming from 2Linda, my cardiologist decided to halve my angina medication and pain comes more frequently and end up in emergency on average 3 times a week , I'm actually laying here in emergency replying 😀 ...I got a good crew if paramedics tonight and am now pain free, just waiting for first troponin results and am about to have the repeat troponin done (6 hour one) 

      I'd be letting your GP know about increase in chest pain since stopping medication 

    • linda89207
      linda89207 samuels

      Posted

      wow Samuels, thanks for reply, good way to kill time though, my troponin levels have been raised a couple of times but second normal I think it is just a cop out saying mine is chest muscle spasms. I will just have to keep pestering them, I am trying to resist emergency visit until I have had my stress echo done next week. I hope they get you sorted soon, good luck and keep me posted.
    • linda89207
      linda89207 samuels

      Posted

      Hi Samuels, well I didnt get my stress echo done arrived for my appointment and told I didnt need it as I had an Angiogram couldnt budge them at all still insited it was muscel spasm and when I suggested Microvasular angina he said we cant see the small arteries or test them your pain is not heart related. I have since been to see my own GP and he is sure that I have MVA and said to carry on with Diltiazem and use theGTN spray to relieve the symptoms I have to use it twice, 2 puffs then 15 mins later 2 puffs to relief but it works sometimes it returns after half an hour so use it again its the only way I can cope with it. Hope everthing went ok for you in emergency.
    • samuels
      samuels linda89207

      Posted

      Hi Linda,

      Yes my younger cardio is thinking the same thing with me, not being heart related, he thinks it's "neuropathic pain" and has halved all my angina medication, biggest mistake he could of done I think, since I last commented on here I have had at least a dozen trips into our emergency sad I'm now back on maximum dosage but I still have that "one " bad day a week (not a set day, can be on any day)

      I was instructed to use my spray once every 5 minutes for up to 20 minutes so if pain doesn't go after 4 sprays I have been advised to call an ambulance but for me this is all getting beyond a joke and totally embarrasing for me. My original Cardio had diagnosed me with the small blood vessels in the heart that can't be seen by the naked eye or picked up by an angiogram as you have stated but he said the spasming is a real condition and his only advice was as it's not curable was to learn to live with the pain as I'm not going to have a heart attack.....well 3 years after he said that I had an AMI and I had another one at the beginning of this year, emergency doctors have labelled  my condition as vaso spasms( Prinzmetal Angina)  I went back to my original cardio to ask questions ( I thought my original Cardio had retired as he told me he was going to) he  told to keep my referral to the "public systems" Cardio because of his upcoming retirement and he also warned me that the new cardio will most likely want to perform all the tests I have already endured and some more...lol.. I'm glad I had the third angiogram as this time they found what they call a "baby blockage" in one of my arteries....50/60% occlusion but not flow limited so no stents were needed.

      I'm glad that my cardio didn't retire as I can go back to him for further advice , he can still swap and change my meds but he tells me to go back to my other cardio as our public health system is free and if further testing is required he writes to my GP who then can organise it through the cardio in the public system...I was suppose to have another stress test but I refused because I only had one mid last year  and as the cardio's say...nothing much would of changed in 12 months  , I couldn't understand my new cardio organising another stress test especially when they have told you earlier as mention above about no changes would occur..hence my refusal to have another stress test smile

    • linda89207
      linda89207 samuels

      Posted

      Hi Samuels, It's like banging your head against a brick wall, because they cant see it, it doesn't exist, but if that was the case someone with a bad headache could be told "You dont have a headache because rhere is no way of seeing it" stupid really, some days I feel I cant or dont want to go on like this anymore, then I have a couple of days pain free and am annoyed with myself for feeling like this. I dont bother with emergency departments now as there isnt much point as it is in my medical records that it is not heart related pain so cant see the point of lying on an uncomfortable couch  for several hours and to then sent home. What is needed is more research on this mattter.
    • samuels
      samuels linda89207

      Posted

      Hi Linda.

      It certainly is, In fact 2 trips ago I was that fed up I told the doctor that I found my gun locker keys were starting to look very attractive, this doctor was one of the good doctors and understood Vaso spasms, that night everything came back negative but she didn't want me to go home they wanted me to stay there so they could keep their eyes on me because of what I had said (gun locker keys looking attractive) I said no I'm fine in that department it was the pain talking because I was in there the day before with the same thing and just had enough, she was adamant that I stay but I kept refusing and she accepted in the end.

      I couldn't agree more, more research should be done  into debilatating conditions like ours, It also states in our Ao      ustralian Heart Foundation PDF that Prinzmetal Angina would/could

    • samuels
      samuels

      Posted

      Sorry my computer is acting up...Yes it stated that , well Im pretty sure it was in that document that it can lead to AMI's and full blown cardiac arrests because it can cause damage over time and yet last week they were successful in reviving a dead heart for transplant or what ever they did , break through medical technology they  called it.

      I was told by cardio rehab that if you suffer the minor heart attacks your heart can actually start repairng itself so with that being said I assume they know that Vasospasms can cause AMI's...Who knows,  the new generation of doctors don't seem to be interested in cardiology whilst in training as I've experienced a lot of the younger doctors asking ME what Prinzmetal angina is.

    • andrew22534
      andrew22534 samuels

      Posted

      You are right it does say that, also the heart does do some self repair work, hence the need to do some exercise to encourage it... i agree the docs these days dont seem able to take on board the aspects of vasospasm its seems to me most of medicine is about meeting targets - can we fix it? yes, then ok we will treat, then there is the no we cant treat ah well not our problem we dont get good marks, bonus points for treating somethig we cant treat...not that i am cynical but, it seems as with most things if it cant be fixed then it wont be attempted as there is no reward for helping someone live a better life.  treatment  - problem solved is the way to go, we dont fit into that bracket....  - rant over...ish... its obviously our fault for not fitting in...... darn, sorry... but i get very frutrated, my (and your) lives have been changed by something we have no control over and those that could help dont seem very interested... yet!!  
    • linda89207
      linda89207 samuels

      Posted

      Hi Samuels,

      Since we last spoke I have had an overnight stay in hospital, I am lucky where I live as it is between two hospitals so can go to either A&E dept so decided to try the other one as there was no point going to the one I have been going to as my records are saying it is not heart related,

      What a difference was seen by a doctor in less than 15mins unlike the 2-3 hour wait at the other one injection similar to GTN blood test and told I would be kept in overnight all test were normal but was discharged next day with a diagnosis of unstable angina and prescribed a long GTN tablet Isosorbide Monotrate took a few days to take effect but have now been pain free for three days now I am keeping my fingers crossed it continues like this. I hope you are feeling ok

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