I answer this question as I am now into year 6 with symptoms and I know this dysfunction very well. This condition is actually quite disabling. I cannot think of any bodily function or process that does not put a demand on the heart. The greater the increase in demand, the greater the negative outcome with symptoms. Those symptoms include all the signs of a heart attack yet reliably does not leave any technological evidence to support what is felt and can be witnessed by anyone close by: clutching chest pain, shortness of breath, chest tightness, ear pain, sharp and sudden intense moments of vasospasms.
I look very well and the less I do, the better I feel. So I am left to manage this dysfunction 24/7. I love nitro and I remain on the same 0.16 mg patch daily with 0.4mg patch at night. The Cardizem helps the vasospasms.
Recent signs indicate that I have some beginning diastolic dysfunction which is reported to be in the process of the microvascular heart issue. Nitro still pulls me out of bad episodes when some demand over and beyond my management has occurred. I still have not had any ER or hospital encounters for which an intervention with IV Nitro would be needed. But without the evidence, that experience is hard for both me, the patient, and for the attending doctor who is hard pressed to treat without the evidence. But this is the type of treatment we need to pull out of a crisis that could lead to heart attack or stroke.
And without the evidence, the subject of disability is a difficult one. All signs supprt only subjective findings of the patient and very little objective, science based evidence to support disability.
I am beyond worrying about the evidence but I really feel quite badly for all those who have to fight this MVD and find support for treatment. Joan.
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