Microvascular angina

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Hi, since my nitrate medication was increased my symptoms and triggers have changed. Beforehand either my blood pressure and or pulse rate were raised from minimal exertion and this would trigger chest pain. Or it could be triggered by stress. But I also always at least got neck pain.

Now I am a bit better, but fatigue is a major issue for me. When walking particularly I feel as though I could lay down on the road side and sleep. Just feel so tired!

My pulse or blood pressure are not always raised when I get chest pain now. Does anyone else get chest pain without problems with pulse or blood pressure issues?

I don't always get neck pain now. But when I do it usually comes on before my chest hurts. If it's bad I use my gtn before the chest pain kicks in. Does anyone else do the same? Should I wait to see if I get chest pain before using gtn spray? I also get pain in my stomach now when I get angina pain which is new for me.

I am only on nitrate tablets and have a gtn spray. I might be put on Verapamil eventually but this may not be for another month yet. Imdur helps but shame after a while it stops working.

Anyone else on nitrate tablets that work for a while then stop? They keep increasing the dose for me, but wonder if you think I would be better in the long run being put on calcium channel blockers such as Verapamil?


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14 Replies

  • Posted

    I have both Microvascular & COronary Artery Spasm. I have angian when I am asleep & it wakes me up. I take Verapimil, Nephedipine long lasting & more short acting under tongue for spams. I take IMDUR 120 am and 30-60 more later in day as needed. If that does nto hold me I do Nephedipine cracked under tongue if sitll angian Nitro spray every 5 min as need for 3 times followed by Nephedipine. If those all fail I have ot go to ER for Nitro Drip. Have they checked to see if you possibly have CAS (cornary Artery SPams?  Dec 29 I had to go tto ER and there wa a 2 hour delay in gettign me on Nitro drip and I had NSTEMI. After that MI I am exhausted beyond beleif and cannt walk far. My triggers are a) nothing can be totally at rest b) cold c) any caffine d) excertion sicne MI d) scares liek Sci fi movies can give me e) when serious illness in family I trigger


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  • Posted

    OH forgot yes TAch or Brady & low or High BP set me off as well. Low Potasium as well

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    • Posted

      Hi Cher

      I have had quite a few tests and only have been diagnosed with microvascular angina. All my tests actually are negative, so it looks as though I'm fine. But the issues I have described and am having makes my cardiologist believe I have microvascular. I struggle to walk any distance and this has been going on for approximately 8 months.

      I haven't been back to work since and was hoping to go back part time in a month. My triggers are more unpredictable now. Just standing can raise my pulse and set off chest pain.

      But what all doctors have said is that once im on Verapamil I will be fine and it will solve my chest problems. I know you also have CAS, but the Verapamil doesn't seem to have resolved your problems. Do you still feel better for being on Verapamil, would your symptoms be worse otherwise?

      I know no two people will respond exactly the same to most drugs, but its great to hear how other people find these medications.

      I have also been seen at A&E several times when things got out of hand for me. My gp isn't very confident with dealing with my concerns, just tells me to speak to my cardiologist. But my appointments to see my cardiologist can be 4 months apart.

      Very debilitating condition. I sometimes have 1-2 good days, but then be really bad thereafter.

      About 8 months ago I was put on a calcium channel blocker for very high blood pressure. I ended up in hospital with suspected heart attack. It wasn't though, I just reacted badly to the tablets. Then all my problems started and I haven't been well since. I'm very nervous about going on another calcium channel blocker, particularly if my health isn't really going to improve much.

      Anyway, thanks for your reply and wish you all the best!

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  • Posted

    Hi gracey,

    You should use your GTN as soon as you feel the niggle becoming slightly uncomfortable, don't leave it until it is uncomfortable, by rights you should use a spray as soon as you feel any niggles.

    I usually get jaw pain with my spasms, can't honestly say that I have had neck pain but it certainly is a symptom of  angina or an MI

    Yes I am on a few pills to stop the spasms, they don't always work, we tend to build up a tolerence to them. They say clacium channel blockers are the gear but  once again you end up developing a tolerence , Im on a daily dose of 600mg of Cardizem (diltiazem ) that's a calcium channel blocker it helped initially, I use to have the 600 mg in one dose but they decided to break it up during the day, I have 360 mg of a morning and 240mg of an evening, same thing, worked for awhile, just I still get the weekly attacks bought on from nowhere or doing nothing, cold weather, stress and extreme heat. I also take Perhexiline 100 mg X 2 daily, Ikorel (Nicorandil ) 20 mg 2 X daily and Monodur (Imdur ) 120 mg once daily plus the GTN spray when required, if I can't get mine under control after 30 minutes I have been told to call for ambulance, usually I leave it for around the 40 - 60 minute mark because I know what it is and by then I have had anywhere up to 15 - 20 sprays of GTN it only relieves it for a minute or 2 at the most then spasm pain returns, even after 15 - 20 sprays of GTN my blood pressure usually sits around the 160/90, it's starting to vary now, it's been back to normal at times during an attack at 130/80 but my heart rate drops down to between 42 - 49 bpm, I know I could be playing russian roulette by leaving it for up to an hour but you know I get embarrassed about calling an ambulance and being carted off to the ED, I'm what you call a frequent flyer and pretty well known and in some case not in a nice way by some doctors or paramedics  smile  I've been caught twice so far, all my attacks feel exactly the same as when I have had my NSTEMI's , I just can't tell the difference and the paramedics ECG machine always spits out a pretty good picture of squiggles, sometimes it's abnormal but not enough to say it's a STEMI, NSTEMI's aren't picked up on an ECG, well some say they can and others say you can't, the troponin blood test is the golden rule in these  types of cases.

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    • Posted

      Hi Samuel

      Thanks for your reply. It's so strange that my cardiologist didn't point out to take my gtn when I get first signs of an attack. I know it's probably obvious to some, but I wasn't really sure. They trickle feed you with information and unless you ask specifics questions they dont offer much information.

      Frustrating that medication can have a good effect and then become so ineffective. Things looked so positive last week for me but obviously didn't last. Like you, I feel embarrassed calling for an ambulance, particularly knowing I am probably going to be ok. I use my gtn up to 4 times before calling, I'm not so brave to wait any longer. Like you the ecg is fine. My tropolin has raised on occasions I have been to A&E but they feel the amount although above borderline, is negligible.

      I have put on a lot of weight because of being inactive. I'm gradually building on my fitness and presume keeping fit is a difficulty for a lot of sufferers.

      This illness is quite frightening but I'm getting used to it, suppose you have to. I'm going to try and work two days a week...... we will see how long this realistically can last!

      Anyway the best of luck to you, and thanks again.

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  • Posted

    I get the same symptoms as you do but I have not gone without imdur 60 milligrams every morning I to get neck pain arm pain and sometimes back pain once in awhile upper stomach since I've had Printz Metals angina or I guess you call it microvascular heart disease I am tired a lot but I take Norco for 5 herniated discs in my neck and back and they make me feel a little better before I start on the pain meds I was down down down I have tried antidepressants I take klonopin for anxiety it is just a circus of Medicine my blood pressure goes up I take Lisinopril and Atenolol sometimes have to take an extra 10 milligrams when it goes up in the middle of the night I have symptoms with my high blood pressure I take 20 milligrams in the morning and 20 at night of Lisinopril usually doesn't cause chest pain but it's still dangerous and causes anxiety more than usual this disease is a nightmare but my doctor cardiologist says his lifelong I have had it for 5 years and I'm still here thanks to the Lord and wish you all the best in dealing with your symptoms there are many of us out here and we just have to keep on keeping on like the old saying goes life is worth living I have found happiness is such little things now and lots of love for my family I love to watch TV and love movies I have a very good friend to spend time with me there was a time when I used to call hotlines I was so scared spend lots of time in the hospitals with test and test and test I don't know what else to say you will be ok I hope you have some anxiety medicine and as long as you have your Nitro and your blood pressure meds you will be ok we will all be okay all my best to you I am always here if you need to talk and I hope I'm here for many many years more 💕💙💜💛?

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    • Posted

      Hi Diana

      Thanks for your reply. On one hand It's nice to know that I'm not alone out there, but on the other it's so sad to hear the difficulties people are facing themselves.

      Can I ask you, you said you had your condition for five years. Do you think that in all this time it has stayed pretty much the same? Or has it got gradually worse for you?

      I think for me in the 9 months I've had this problem, I have gradually got worse.

      I take my Imdur 60mg and blood pressure medication in the morning. In the evening I top up with 30 my of Imdur. I was also asked to take aspirin daily and use my gtn spray. Last week was the first time I had three good days. But usually I have complications daily.

      It's very easy to get depressed. I try to keep positive and like you take pleasure in the smaller things. My husband believes I will get better... wishful thinking! But I know now that this is me from now on. My doctors confuse us though. They say that the calcium channel blocker will solve my problem and I will be fine. But I haven't heard from anyone, or read any articles or read from about any suffers actually saying they have been completely healed. So I'm confused about the false hope they gave me and my husband. It obviously will help, but I will always have relapses it seems. Then be topped up with more and more medication and increased dosages.

      Wish there was a miracle cure for all of us. It's difficult for me to truly except that I can't do just a quarter of what I used to do just 9 months ago! It is very hard! But I do stay positive and am thankful for the smaller things, the support and love from family and friends. I love life and like you I hope to be here for many many years to come :0)

      Thanks again to you for your message, and wish you all the best xx

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    • Posted

      It was real bad for years it's only been in the past year that is truly gotten better so I haven't had severe pain I don't know why it's so painful some people have it worse than others I had a heart attack when I was 37 due to having Graves disease in my thyroid gland it burned out one of my AV nodes in my heart so it fires only in three chambers it is called left bundle branch block they didn't know how bad it was back then but they do know nowadays because the equipment they take EKGs with are more sophisticated and pick up every little teeny symptom or change I think that weekend my heart I took nitroglycerin Wayback in my late thirties and forties for a few years until it got better but always had tachycardia and PVCs a lot to where I was disabled from it seems like I have always had something going on with my heart but now I just turned 70 and I'm thankful that I'm still here and you will make it just have faith and be positive the doctors know if you have good ones I go to Loma Linda Medical Center in California they have very good cardiologist and they know about this disease many people with this disease have stents and it have it much worse you have to be strong and I think you are be thankful that you still have your husband I lost my husband to Aid severe heart attack when he was at work when he was only 48 years old it almost killed me back there but I got better and you will too God bless you and keep you safe always 💚💜??

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    • Posted

      Thanks Diana, you are a very strong woman! Sorry to hear about your husband.

      I live in the UK. My cardiologist is ok but I don't see them for 4 months at a time. I have no confidence in my own doctor but will change him. I have got better advice, support and understanding from this site than from the professionals who are meant to help.

      Anyway, take care and God bless you xx

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    • Posted

      Oh yes I also get tachycardia and my blood pressure is high a lot. But one or both these things are usually an issue for me, I get extremely tired!!
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    • Posted

      Hi Gracie yes high blood pressure will make you very tired and drained you and then medicine makes you tired but when you're blood pressure goes down to normal at least with me I feel much better I had such bad high blood pressure that it would make me have seizures a few and few times even be paralyzed I've gone to the hospital many times this was just recently in the past 6 months seems my electrolytes were off every little thing that happens when you have this strange disease it's very scary and can be life-threatening it doesn't hurt to go to the Hospital if you feel inside of you that you should really go only you know your primary care physician probably doesn't know too much about this disease mine doesn't but takes the word of the cardiologists I only see my cardiologists what's a year now that I have established what my diseases are and if necessary it takes 3 to 4 months to get in to see them I don't know why I guess because there is so many people with heart diseases age plays no part in this disease usually it is hereditary my parents had it especially my dad one of the ambulance drivers girlfriend has it and she is only 25 anyway I have put you in my prayers already prayed and asked the Lord to watch over you I hope you don't mind thanks for talking to me I hope I can help you it is late at night in fact it is midnight I think I will go to sleep tonight I'm glad there's this website and forum also

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