Endothelial Cardiac Dysfunction- has anyone received this diagnosis

Hi, @jkrcan.

I am tagging @upartist who has discussed endothelial dysfunction and may be able to share more about treatment.

I am so also sharing an overview from Mayo Clinic. If you have not reviewed it you may find it helpful. https://www.mayoclinic.org/diseases-conditions/small-vessel-disease/symptoms-causes/syc-20352117

If you are comfortable sharing it may help to know more about what you are dealing with so others know how to comment. Have you received a diagnosis of Endothelial Cardiac Dysfunction, and if so what has led you to this? What symptoms have you been experiencing, and what is your doctor recommending?

Thank you for your assistance! I am a 66 yr old active woman (equestrian) that started experiencing symptoms in May. I was being followed up by an internist and have now had my first cardiology visit. I am waiting for an angiogram (maybe 3 months where we live) and have had 3 stress test, MIMBE, Echo, ECGs and bloodwork over the last 6 months. Until last weeks stress test I have always passed tests with flying colors. This past stress test I was light headed and tend to get posterior discomfort about 15 min post test.
Symptoms - first episode was over 5 days at a horse show- general unwellness/weaker/light headed, pain into back at shoulder blades and burning in the chest. Diagnosed with hypertension 220/120 at that time. Once then numerous cycles of localized left sided burning, will now go into shoulder, jaw, and recent episodes are less into the back. Episodes appear to be associated with increased physical work and emotional pressure (horse shows). If I just do regular house work I’m usually fine. Recently went into a sauna which brought on pain and flew at 45000 ft- worst episode of pain… no elevated enzymes at this time. CK Enzymes were elevated with first episode in May, none since. Minor change in last ecg with the stress test.
Cardiologist says using angiogram to rule out blockage and then potential exists for Endothelial cardiac dysfunction.

Hello Jkrcan. I have endothelial dysfunction and was diagnosed a few years ago. My first recommendation for you is to get the angiogram moved up to happen as soon as possible. Any possible blockages need to be ruled out before it is treated as endothelial dysfunction with coronary micro spasm. I assume you have started the baseline treatments of a statin and a calcium channel blocker through your internal medicine Doc. The angiogram should be performed by an experienced team (timing of the contrast is everything) and read by a cardiologist who does cardiac radiology. This is not a simple diagnosis. It can be dangerous and debilitating if not treated appropriately. You want to maintain your active lifestyle safely and without fear, so accuracy is very important. Good luck with this, and get that angiogram soon.
UPartist

Thank you for responding! I am on a calcium channel blocker but do not have abnormal cholesterol.
Did you require an angiogram with acetylcholine or a regular angiogram for diagnosis?
Thank you!

@jkrcan hi Jkrcan. Yes i had the acetylcholine angiogram for definitive diagnosis. This confirmed the coronary micro spasm. I have used both the atorvastatin and the amlodipine since, to address inflammation of the vascular walls from the endothelial dysfunction. I have always run a low blood pressure, normal cholesterol, and zero CAD. I am also treated with a maximum daily dose of L-Arginine (per cardiology). This directly addresses the nitrous oxide exchange to reduce vascular SPASM, which is the source of my angina. (Ischemia vs blockage) The dysfunctional endothelium interferes with the nitrous oxide exchange. So you should get a definitive diagnosis in order to know what you are dealing with. They should be able to grade your level of spasm, if that is what you end up having. Feel free to send any questions my way, and I will be happy to help if I can. Good luck!!!
UPartist

@upartist with the medication management that you are using, are you able to be physically quite active? Wondering how much adaptation to my lifestyle I may be facing. I know that’s a bit preliminary but love to have a plan. (Currently a few more horses than I may need ).

@jkrcan I am absolutely able to maintain an active life style.
UPartist

@upartist thank you!!