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Metformin trial study for microvascular angina: Excellent and Recommend

Sep 25, 2013 - 0 comments
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metformin

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study

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microvascular

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Angina

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microvascular angina

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Pain

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Heart

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Cardiac Syndrome X



Check out this Journal on an excellent study done on microvascular angina, healing/changing of the heart's microvessels and an old diabetic medication. Very good study results and helpful in reducing the number of anginal episodes daily.
I have been on Metformin 500 mg twice a day since May 2013 with good results showing as a reduction in overall angina/chest pain/SOB daily episodes by 25% reduction.

This is a cheap medicine that is known to impact endothelium of blood vessels. It only takes 8 weeks to show improvement but it needs to be taken as an on-going medication. Emory Cardiology in Atlanta is using this med on their microvascular angina patients with good results.

Highly recommend. My severity and a 25% reduction of daily pain is significant. Hugs to all, Joan.

"Effects of Metformin on Microvascular Function and Exercise Tolerance in Women with Angina and Normal Coronary Arteries".
Journal of the American College of Cardiology
2006 published by Elsevier Inc. Vol. 8, No. 5, 2006
ISSN: 0735-1097/06/$32.00
doi:10.1016/j.jacc.2006.04.088

Good link to CMD and angina

Sep 25, 2013 - 0 comments
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Angina

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microvascular

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spasms

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microvascular angina

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chest pain clear heart cath



Check out Dr. Juan Kaski in the UK talking about spasms and source.

http://youtube.be/3TmUvQJOhr4

Cardiac Syndrome X & Obstructive Sleep Apnea - they go together?

Mar 18, 2010 - 22 comments
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Cardiac Syndrome X

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obstructive sleep apnea

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Sleep Apnea

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apnea

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Heart



March 2010: Call me the Sleep Crash Dummy

Well, some things just work out in the strangest ways.
I have friends (respiratory therapist/doctor) who work with a Sleep Med Clinic. They are trying out a couple of different models of sleep apnea test units for 'at home' use for their patients. They asked me to try out a model and comment back to them from a nurse perspective as to the instructions and any potential issues with its use. So I tried it.
Long story short, the monitor showed 711 of hypo and apnea events in 9 hours. Obstructive Sleep Apnea. I was then referred to a Sleep Lab the next day for a more formal study where the results were worse ( 70 periods of not breathing in 2 hours) and even with CPAP ( continuous positive airway pressure) mask applied due to decreasing oxygen levels, my heart rates increased and my respirations stopped. With CPAP I had continuing events of sustained apnea up to 34 seconds.
I have had no sleep complaints, with the exception of awakening during the night with what I thought to be 'hot flashes'. During my 2008 cardiac arrest and subsequent days of care, there were no problems with oxygen levels. No history of day sleepiness or nodding off, but of course, my days are trumped by vasospasms and variant angina.
This Sleep Study result, on top of my current heart state with MVD, put me at great risk for a heart attack, stroke and mini-strokes-TIA (transient ischemic attacks) all in the absence of any CAD. This also explains why I'm so tired and with problematic chest pain even with the amount of nitro I wear each day. My heart was not getting any rest and was under a great deal of stress around the clock. I have been very careful about getting to bed early so that sleep/rest time would be my healing time. But, little did I know that I was under more stress trying to sleep!
When professionals asked about my nights I could only describe them as very good: no exertion=no chest pain. When I did complain about waking with rapid heart beats, I stated that I was also feeling like I was having 'hot flashes'. Thank goodness I had my nitro patch at night, something that is NOT recommended 24/7, but needed for me. And I was 'hot' alright; I wasn't breathing. Previous years of lung function testing were negative.
CPAP intervention could be very significant for reducing my cardiac pain  PLUS I get some rest. This has been going on for 14 months when I checked back to my notes about 'hot flashes' which turns out to be my heart racing under duress and trying to breathe.......really often!
Types of apnea are known to be associated with people with CAD problems, not necessarily the dysfunction that I might have, but my current research, with help from my friends, indicate a very strong scientific study relationship with lack of oxygen, that stressor on the vascular system and the impact on the endothelial and that dysfunction. Again, another new area of research. I am hopeful that REM ( the good sleep) sleep will reduce those complicated neural and metabolic processes on the heart and that I have relief from pain. I'm now going to join the Sleep Apnea forum and have members look at this connection.
So you see...a favor for a friend turned out to be a favor for me. After the night we learned about the first test results and we were home in bed  my husband said: “Hope to see you in the morning”, to which I responded: “Hell, I'm not closing my eyes!”
Another journey.  CPAP and nitro are my friends. I may not have stated the correct responses to my sleep habits. But to me it felt like 'hot flashes' and I'm one of billions of women with the similar complaint. I just don't know how else to have described these night time events. Joan.


Cardiac Microvascular Dysfunction

Dec 20, 2008 - 63 comments
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nitroglycerin

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cardiac microvascular dysfunct

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shortness of breath on exertio

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Cardiac Syndrome X




I'm on a mission to get this word out. I had a cardiac arrest in May 2008. I'm ok now but not fine. I did not have any disease in my heart ( no heart attack, no clot, no valve problem, no stent to place or vessel to by-pass) but a rather new to medicine diagnosis of severe cardiac endothelial microvascular dysfunction otherwise know as cardiac syndrome X.  After 2 ½ years of problems ( mainly shortness of breath on exertion) and after many interventions and tests which were all negative, including two left and right cardiac caths, I was referred to Emory University Hospital interventional cardiology. I underwent another cath as a way of a diagnosis by exclusion. They were pretty confident of the diagnosis they were to confirm. In the process of testing ( which consisted of adenosine, then recovery/opening with acetylcholine) I arrested and it took them a couple of minutes to get me back. I  was awake/conscious for most it and was even pleased when the docs were able to reproduce my symptoms! Unfortunately the recovery drug just didn't work therefore the confirmation of cardiac microvascular dysfunction. Emory, Mayo and U-FL,all researchers working on the same NIH study protocol for this dysfunction had not seen a case so severe. Needless to say a rough few days at Emory until they got my meds correct..............loads of IV nitro.
I had been quite a mess since January 2008, but could never say I was ill or sick, just plain short of air to the point of losing my ability to sustain speech. Lots of chest tightness, angina like pain and coronary spasms.  I am thrilled that this thing has finally got a name and  that I am on the best treatment for me. Altho' the prognosis is fairly good with aggressive nitro I realize that this may be as good as it gets....... this is very debilitating.  Because these microvascular vessels do not dilate when they should (from exertion-any type) I must keep continued excellent control of lipids as any blockages of these vessels would not be good. Plus I am quite dependent on nitro patches 24/7.  I am no longer in pain, have no shortness of breath unless I reach some level of exertion, rare coronary spasms, mild to moderate chest pressure and occasional  chest tightness that requires nitro SL in addition to the 24/7 three 0.4 mg nitro patchs I need to wear. My heart and other body parts are extremely healthy. I have my moments where silly minimal exertion brings on chest tightness and slams me up against the wall! It's all about exertion and stressors.
To my women friends-pay attention to your symptoms and keep written track of them. To doctors in primary care and speciality care, consider this diagnosis in your patients when otherwise healthy people present with vague cardiac type complaints but always shortness of breath and chest tightness with exertion. My doctors have been just been puzzled by my consistent, persistent, and well articulated complaints. This thing is not real rare, just difficult to diagnose therefore uncommon. It is not defined within any race and  seems to hit post- menopausal women. Researchers are looking for the 'why' while looking for a treatment. I'm glad it's 2008; if this had been several years ago the NIH protocol studies would not have been out there for researchers to concentrate on and I would certainly be in worst shape.  I am the Poster Child at Emory for this dysfunction and the researchers are therefore learning a lot from my experience. I know this dysfunction well and like many other long term diagnoses this requires management. HUGE lifestyle changes. Emory and similar researchers do not know why this happens, if it is hereditary, viral or anything else at this point.
October 2009: This condition is getting progressively worse. Since Aug.1st 2009 I have had increasing episodes of chest tightening, vasospasm and chest pain only relieved by up to two sprays of nitro. In most episodes it is not brought on by physical exertion but by some other cardiac demand out of my control. The rare but familiar sharp, quick spasms that go up the heart to jaw and thru to the back I assume involve the LAD. The spasming in the microvessels seem to be the chest tightening and SOB that can accompany this. Still no research on this as to cause or treatment. I'm just happy that I pull out of these episodes, tho' very tired, with the nitro sprays. I am still wearing two 0.6mg patches daily 24/7.  
February 2010: Now I'm up to 0.16mg daily nitro patch and two calcium channel blockers.There may be some nitro tolerance involved here but it's still the nitro that brings me out of the pain. The pain is assumed to be from the profuse spasms that I have, referred to as variant or vasospastic angina. It only occurs in the prescence of a tight feeling left chest. My ability to do any minimal exertion is very low.
To my readers: I do not want to instill fear or anxiety in anyone trying to figure out their symptoms. I am very outside anything close to what is being seen by doctors with patients with this microvessel involvement. So keep track of your signs and keep involved with your doctors and if you can, get to a large well known heart center; they are best when it comes to knowing about the odd cardiac things that are out there.