I in the process of testing for iscemic coronary disease. This is new

Wendy,
I am waiting to have a coronary calcium CT scan to check for possible blockages; due to my night time shortness of breath and rapid heart beats. My heart is good, but I thought I would check the arteries just in case. Part of me wants to know and part of me doesn't. I read some where, some times the test can show more build up than you have or less build up than you have. So. . .

I have something called INOCA - ischemia with non-obstructed coronary arteries. It's supposed to be rare, but I know of quite a lot of people who've gotten it either from Covid or from the vaccine. I got it from my first Covid vaccine, but it gets worse every time I get Covid.

Many people who have INOCA (sometimes called ANOCA - angina with non-obstructed coronary arteries, or more specifically microvascular dysfunction or vasospastic angina) don't show much of any results on standard cardiac tests. Mine showed up on my ECG and on the exercise stress test, but everything else was normal - X-ray, echocardiogram, coronary CT, MRI. The test that finally gave me a definitive diagnosis was provocative angiogram with coronary reactivity testing. That's because INOCA/ANOCA/MVD/VSA symptoms are a result of the arteries spasming shut rather than being blocked. The end result is similar - the heart is not getting oxygen - but since there are no blockages, treatment is different. It's supposedly a rare condition, but with Covid it's become more frequent.

Many cardiologists don't do provocative angiograms, and they may tell you it's too dangerous, but the big heart hospitals do them often, and for them it's no more dangerous than a regular angiogram. People who don't have INOCA etc won't react to the provocation agent (usually acetylcholine); people who do will have symptoms similar to what they usually get.

I hope you are able to get a good diagnosis and the right treatment for your condition. I'd love to know whether they find blockages in your case.

Many people who

Yes, I was just diagnosed with microvascular angina via cardiac catherization. All of my heart vessels are clear. Medication was started (nitro & betablocker) & the chest pain with activity I was experiencing has resolved. How do you know this is related to the Covid vaccine?

I do not know. I have long covid, 18 months now. I causes inflammation in the body. My thought is if there is no blockage, the issue with my breathing and my heart may be related to long covid rather than purely a heart issue. I don't suppose it really matters at this point, just more of a curiosity.

I'm trying to find a group for AFib, I've been put on a horrible blood thinner and it's worry me , may you receive healing

How frequent were your symptoms, and what do they feel like?

I get upper chest pains - closer to my armpits than center of chest - intermittently but usually when walking, especially when I walk for an any kind of distance or begin to increase my speed. I’ve also had it happen just sitting still. When that happens, it’s not just painful but I can’t breathe. My LC clinic doc is scheduling me for a cardiac stress test but the last one and numerous echoes and ECKs show nothing too abnormal. I do now also get laryngeal and esophageal / stomach spasms. I used to get them in the diaphragm too. My lasting issues are all in my torso.

I have been getting treatment for several years now, so my symptoms are less frequent than they were, but I still have multiple episodes of symptoms every day, mostly chest pressure/pain and shortness of breath, though I also get nausea with them sometimes.

Before I was diagnosed, I had significant chest pressure and pain, starting either a few inches under my armpit below my left breast or central under my breastbone, and radiating as it intensified, into my back and up into my neck and jaw. I was getting 20-30 episodes a day, some as long as an hour and other just a few minutes, and taking 8-10 doses of sublingual nitroglycerin a day.

In May 2022, I was given the Neovasc coronary sinus reducer at Mayo. Since then, with the reducer and additional treatment, I have more like 5-6 episodes of spasms and take 1-2 doses of nitro a day.

My symptoms happen now frequently when exercising, but also just when sitting.

Many people with microvascular dysfunction or coronary artery spasms don't necessarily have symptoms during ECGs and echos, so nothing shows up on those. Sometimes nothing shows up in any test except the provocative angiogram. But it is heart related . . .

I developed the chest pain post covid vaccine but before an actual covid infection. Because the first cardiac cath was normal, I was treated as an asmatic. I was taking a ton of albuterol. My new cardiologist thought my pain was cardiac right away. I no longer use steroid or albuterol inhalers. Can’t believe I went 2 years without the appropriate treatment.

It matters and you matter
The info you’ve shared here is helpful to everyone who reads it
I am too a long covid 2.5 years sufferer and I can understand some of what you are experiencing
It is very frustrating and lonely in the post covid landscape
So many tests don’t come out as providers are used to and they often also become frustrated and may inadvertently be dismissive of people’s very real debilitating symptoms
I think your assessment is right that it’s not predominately a heart issue it’s many tissue alterations due to covid impact on those tissues. From what I have learned from this site and reading papers from online medical libraries, the heart changes can be obvious myocarditis but more often in long covid are related to micro vascular changes to the endothelial lining of the blood vessels that cause changes to their thickness, permeability and lose some tone of structure. This can cause leakage into surrounding tissues and a cycle of inflammation and the chemicals that the body releases to deal with the inflammation. It is possibly a repeating cycle with new exposures to either covid or other substances that our bodies see as foreign now. So it’s like a cascade and the body tries to correct but the immune system
also is out of balance and can make an over response
Hopefully they can tell if something similar is happening in the lungs AND offer some relief

That sounds awful. I'm glad you were able to get a firm diagnosis - that your cardio dr. didn't give up after a few 'normal' standard tests as many do. Sigh.