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Coronary Microvascular disease?
I recently posted a question here regarding chest pains with exercise.
To quickly sum everything up, I'm 21 years old, 5'11, 135 pounds don't smoke and I eat healthy. BP is usually around 100/60. Normal Cholesterol. Unknown family history.
Symptoms: Chest pain with exercise and at times during rest. SOB sometimes with exercise and rest. excessive Fatigue/tiredness after a little work. Lightheadness and dizziness at rest and with exercise.
I had a normal Cardiac MRI and CT Scan. I've had several exercise stress tests, all of which showed ischemia on the ECG... but the ECHO portion of the test was normal.
I've read that Coronary MVD can be missed on all of these tests and even a Coronary Angiogram. How likely is it that I could have this disease and is it worth looking into? What can I ask a doctor to be done? My life is miserable right now.
To quickly sum everything up, I'm 21 years old, 5'11, 135 pounds don't smoke and I eat healthy. BP is usually around 100/60. Normal Cholesterol. Unknown family history.
Symptoms: Chest pain with exercise and at times during rest. SOB sometimes with exercise and rest. excessive Fatigue/tiredness after a little work. Lightheadness and dizziness at rest and with exercise.
I had a normal Cardiac MRI and CT Scan. I've had several exercise stress tests, all of which showed ischemia on the ECG... but the ECHO portion of the test was normal.
I've read that Coronary MVD can be missed on all of these tests and even a Coronary Angiogram. How likely is it that I could have this disease and is it worth looking into? What can I ask a doctor to be done? My life is miserable right now.
Hi ChicagoDude617,
Microvascular disease does cause symptoms consistent with the ones you are having. It is mostly seen in women and patients with diabetes (and is usually found in patients much older than you). It is also thought to occur by the same mechanisms as coronary artery disease of the big vessels of the heart. Therefore, it would be fairly uncommon for a young person such as yourself to have microvascular disease, unless you have some family history of early heart disease (which you don't). That being said, I don't think it's unreasonable to discuss it with your cardiologist. If they are finding abnormalities on your stress tests, it may be worth looking into. There is a special test that is done in the cardiac catheterization lab that is used to diagnose this. You are right that a routine cardiac angiogram will not pick this condition up.
I know we had spoken about possible lung etiology of your symptoms. Hopefully, you have a good primary care doctor who can also look into other causes. Fibromyalgia can sometimes do this--> Patients get pains in various areas of body, fatigue, etc. When you say you have steady pains in your neck/shoulder/hand area, it does make me think of this. There are also some other rheumatologic conditions that could be looked into. Again, the EKG changes may be a false alarm, although I can't really say without looking at the data myself.
Hope this helps!
CCFHeartMD20
Microvascular disease does cause symptoms consistent with the ones you are having. It is mostly seen in women and patients with diabetes (and is usually found in patients much older than you). It is also thought to occur by the same mechanisms as coronary artery disease of the big vessels of the heart. Therefore, it would be fairly uncommon for a young person such as yourself to have microvascular disease, unless you have some family history of early heart disease (which you don't). That being said, I don't think it's unreasonable to discuss it with your cardiologist. If they are finding abnormalities on your stress tests, it may be worth looking into. There is a special test that is done in the cardiac catheterization lab that is used to diagnose this. You are right that a routine cardiac angiogram will not pick this condition up.
I know we had spoken about possible lung etiology of your symptoms. Hopefully, you have a good primary care doctor who can also look into other causes. Fibromyalgia can sometimes do this--> Patients get pains in various areas of body, fatigue, etc. When you say you have steady pains in your neck/shoulder/hand area, it does make me think of this. There are also some other rheumatologic conditions that could be looked into. Again, the EKG changes may be a false alarm, although I can't really say without looking at the data myself.
Hope this helps!
CCFHeartMD20
Forgot to add this:
My lungs were checked out and found to be okay.
Also, is having steady pain in the neck/shoulder/hand area consistent with a heart problem? Because I also have pains in these areas.
I really appreciate your answer even though you can't give a diagnosis over the internet. Thank you!
My lungs were checked out and found to be okay.
Also, is having steady pain in the neck/shoulder/hand area consistent with a heart problem? Because I also have pains in these areas.
I really appreciate your answer even though you can't give a diagnosis over the internet. Thank you!
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