Jennifer’s story of microvascular angina
Jennifer Waller, from Surrey, had heart bypass surgery in 2006 at the age of 56. But a year later, she was diagnosed with microvascular angina. She says:
Happily, my condition is presently stable and well controlled and, apart from taking my medications and accepting some limitations on my activities, I can largely ignore it. This isn’t the case for everyone and nor was it for me before I was referred to a cardiac specialist, diagnosed and treated.
I had a quadruple bypass after the angina became bad enough to investigate. With hindsight I had been struggling for years with low stamina and unrecognised angina but as I had no obvious risk factors, had normal blood pressure, cholesterol and resting ECG, it seemed an unlikely diagnosis for a well looking person of my age. The exercise stress test was the first to show the evidence of my coronary artery disease.
After surgery I didn’t make the expected progress and the harder I tried the more setbacks I experienced. It was hard to manage daily activities when exertion brought on chest pain and breathlessness to such an extent that I thought I would become housebound. I couldn’t manage slopes or stairs without great difficulty, making travelling a problem. My problems were clearly no longer due to the main cardiac disease and were investigated as ‘complex’.
I am so lucky that I have been given my life back by the cardiologists, not once but twice
To new patients I would say that you have to be prepared for the full diagnosis and treatment of microvascular angina - once you are not considered to be high risk of heart attack - to take quite a long time. This is because there could be many different possibilities for chest pain and breathlessness, both cardiac and non-cardiac, which will need to be investigated.
Once microvascular angina is confirmed, the cardiologist has different drug options to help this condition and the first one that I was given didn’t work for me. Later, under my consultant , Professor Juan Carlos Kaski, my drugs were personalised and I was in particular allowed more slow release nitrates in increasing levels until I reached a level where I could manage.
One of the problems I had previously found was how to know when a persisting chest pain is ‘the one’ that you shouldn’t ignore but should call an ambulance. This can be a terrible dilemma. I am now more confident of knowing what is happening to me and I have been given a better understanding of the condition during the consultations.
One of the things I do is to keep active but, importantly, always within my capabilities. I appreciate the value of fitness for helping my two heart conditions and, although the microvascular angina imposes some limitations, since I have received treatment I have been able to do much more than before without bringing on symptoms.
By persevering with exercising within sensible boundaries I have found that I have nevertheless managed to slowly improve my fitness levels and quality of life.
I can’t run but I do walk two or three miles – my maximum is five or six miles – including some inclines with stops as needed. I can swim in a pool or calm seas, but water aerobics is too much.
I started cycling in 2012, which works really well for me on the level ground but I have to dismount for hills. My husband and I enjoy recreational cycling on the Thames Path. I can now cycle 6 to 8 miles, stopping for a rest and a coffee. These are not great distances, but for me it is a great achievement, as that sort of distance was inconceivable when I started cycling. I do my own housework and light gardening but pace myself not to overdo it.
I can now enjoy the company of my grandchildren, can manage pushing a buggy and have them to stay on their own. I can travel, walking at a good pace – slower with bags – and even use stairs at a fairly normal pace.
Adjusting to new limits
With microvascular angina I am a different person physically and it has taken a while not to feel frustrated by this. Rather I am happy at what I can do and at the small improvements that I have been able to make.
I tried to return to my work after the heart surgery but found it too physically demanding and so retired a bit early at age 57. That hadn’t been the plan and I really missed my work and this has taken time to accept as well. But I am now fit enough to take up new interests for my retirement.
Nowadays I have the appearance of a completely well person but the limitations and pain possibilities due to the microvascular angina are always there, but at least they are in the background.
I have complete confidence in my GP and my cardiologist. I know they are there for me if I develop new problems or have queries and that’s really important for me. I am so lucky that I have been given my life back by the cardiologists, not once but twice.