Anyone have Small vessel spasms in their heart?

@txbunny67, did your cardiologist say that you have small vessel heart disease (also known as coronary microvascular disease)?

Experts think that the causes of small vessel disease are the same as the causes for diseases affecting the larger vessels of the heart, such as high blood pressure, high cholesterol, obesity and diabetes. Small vessel disease is more likely to affect women than men. This is especially true in people with low estrogen levels, which occurs around menopause.

Other risk factors for include:
- Autoimmune disease, including vasculitis.
- Having overweight/obesity.
- Diabetes.
- Eating a diet that’s high in salt, saturated fat and processed foods.
- High blood pressure.
- High cholesterol.
- Rheumatologic disorders, such as lupus or rheumatoid arthritis.
- Sedentary lifestyle with low levels of physical activity.
- Smoking.

Were you given any guidance on how to avoid the spasms?

Thank you for replying and actually no they never said that it could be the same thing, but I'm wondering if it is. My very first cardiologist (in Louisiana) said "that's weird" when she started to do my first angiogram (as she was inserting the guide in the groin). Apparently, my artery started to spasm (I had fallen asleep by this time). She later told me I have what the call Prinzmetal Angina.
I had never (that I know of) had problems with the small vessels until I started on Simvastatin. I seem to have reactions to all stations.

I was just diagnosed with that. A lot of other things were ruled out first as this is a relatively rare condition. It also goes by variant angina and coronary spasm. My doctor prescribed nitroglycerin. I can take up to three pills, one every five minutes, before calling 911. If the pills stop the pain I can stay home. It usually occurs when I’m sleeping or relaxed. My doctor said the nitroglycerin is good for heart attack too. It’s the same medication the EMT’s would give me if I called 911. It’s not too bad of a diagnosis but things can get complicated if you have other heart conditions. I was very relieved to get this diagnosis because I have been to the ER s five times with chest pains, with no heart attack and no explanation. Now instead of automatically going to the ER I can try the nitro pills and hopefully stay home. Best of luck to you and please post again and let us know how you are doing.

The sad part of all of this is that when I had my light heart attack I did the same (I took 3 nitro) and I've done the same with this and the nitro doesn't really work. I'm on Imdur on a daily basis (30 mg). I'm just so tired of hurting.

My doctor also told me that if the nitro doesn’t work, it would be diagnostic. I took that to mean that I won’t have printzmetal angina after all.

I am currently in the hospital (St. Luke's) in St. Louis, MO. The blockage, right at the edge of my by-pass graft, is the one that the doctors won't touch and the one that we all think is causing me problems, as well as the spasms in my small vessels. I just wonder if any of the Mayo Clinic doctors have any other options, but I have no idea how to get in touch with them.

My understanding is there can be actual blockages causing vascular problems or there can be spasms that can happen without any blockages but have the same impact on blood flow. I am trying to figure this out myself.

I am on statins to help vascular lining, calcium channel blockers that I understand help the small vessels, daily nitrates to help expand vessels that prevent spasms, and sublingual nitro pills as needed to stop angina/pain on the spot that occasionally happens. I have not been diagnosed but Mayo cardiology told me, “some people have heart spasms”. I think it is difficult to diagnose. I have complained about problems for several years and it was only when they got unmanageable that I figured out I was not getting treated appropriately locally, and my current treatment has been game-changing for me.

https://www.internationalheartspasmsalliance.org/ has been a good resource for me. I made a connection in their community group and asked for a mentor, a decision that has helped me try and figure all this out.

I found out that the blockage is literally right at the edge of my by-pass graft, which is why they are scared to touch it. So, as I told them, I have to hurt or let this block until I have another heart attack. They told me that they are hoping that the Rapatha will lower my "bad" cholesterol and that it will stop blocking up. I will not see results for 6 weeks. My doctor actually called Barnes, but that hospital does not take my insurance, so his friend that works at that hospital can't see me and see if he will attempt to fix the blockage.
I told my cardiologist's partner (he's [my doctor] Jewish so he won't be in until Monday, if I'm still here) that I'm just a problem child. Nothing about my body is normal.

The waiting is difficult. I keep repeating what my doctors tells me, “this is a marathon”. You can do this!

I have been resistant to cholesterol drugs and currently go in to have the LDL cleaned out (kinda like a dialysis process) every other week. My LDL rebounds quicker than normal from that process as well. My untreated LDL of 300 is not under control and it has been difficult to find a comfort level with knowing what that leads to.

I tried Repatha twice and learned that while it takes 6 weeks to see the full impact it does show up in bloodwork sooner. You could let your doctor know it would help your stress level to check sooner. Repatha is darn effective at reducing LDL a bunch and you may have seen new 5-year results have just come out. I believe findings are it reduces events and deaths by 25%.

@txbunny67, if you would like to consider a second opinion at Mayo Clinic, you can get started by submitting a request for a consult either by phone or using the simple online form. See more information here: http://mayocl.in/1mtmR63