Coronary stents: interventions that come with a cost

by Carolyn Thomas       @HeartSisters

Remember last month when I covered the topic of stretch pain” in heart patients who have had a coronary stent implanted?

To recap, temporary post-stent stretch pain in the chest is considered to be due to the dilation (stretching) of an artery while a metal stent is being implanted inside that artery, and it typically occurs in about 40 per cent of stent patients.  A number of you wrote in with some variation of this question: “Is it still stretch pain if it’s happening months afterwards?”

And now a new study published in the Journal of the American College of Cardiology  suggests that something entirely different might be going on.2          Continue reading “Coronary stents: interventions that come with a cost”

Is coronary microvascular disease serious? Is the Pope Catholic?

by Carolyn Thomas    @HeartSisters

It’s time for physicians to stop telling patients that a diagnosis of coronary microvascular disease (MVD) is no big deal. Or alternatively, to accept that the diagnosis is real in the first place. As one of my blog readers learned to her horror, this awareness is not yet universal. When she asked her own physician, for example, if her debilitating cardiac symptoms might be due to coronary microvascular disease, he replied: “I don’t believe in microvascular disease!” – as if they’d been discussing the damned Tooth Fairy.

But here’s how Dr. Stacey Rosen, a cardiologist and spokeswoman for the American Heart Association’s Go Red For Women campaign, answered a question about microvascular disease in the New York Times recently:

Q: “I have been diagnosed with microvascular heart disease, which I was told mostly affects women and is not considered serious in and of itself. How long can it exist before it turns into serious heart disease?”

A:  “MVD can lead to heart attacks, heart failure and death. It’s serious.” Continue reading “Is coronary microvascular disease serious? Is the Pope Catholic?”

No blockages: Living with non-obstructive heart disease

by Carolyn Thomas    @HeartSisters

Annette PompaAnnette Pompa of Pennsylvania lives with a cardiac diagnosis I’d never even heard of until I, too, was diagnosed with it several months after surviving a heart attack. It’s called Coronary Microvascular Disease (MVD) or Small Vessel Disease. Unlike the classic Hollywood Heart Attack I’d initially experienced – which is typically caused by a significantly blocked major coronary artery – those of us diagnosed with MVD or coronary spasm disorders have few if any detectable blockages obstructing flow in the major blood vessels feeding the heart muscle. Yet we can experience the same distressing symptoms of a heart attack. Annette is a former art teacher who was barely 41 years old when MVD “came barging into my life”, as she explains. With her permission, I’m reprinting this transcript of an American Heart Association presentation that Annette gave recently about living with a non-obstructive heart condition.

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“This is my story. I represent an often misunderstood population living with a very different type of heart disease. Sadly, there are many more like me with MVD who are simply not being recognized – and indeed even dismissed. Symptoms often persist even without any visible blockage or reason for the angina, shortness of breath and fatigue which often accompany the condition. It is crazy, right? Here I was seemingly healthy – yet ended up battling heart disease.  Continue reading “No blockages: Living with non-obstructive heart disease”

Coronary Microvascular Disease: a “trash basket diagnosis”?

by Carolyn Thomas  @HeartSisters

Dr. Juan Carlos Kaski, Head of the Cardiovascular Sciences Research Centre, St. George’s University of London in the U.K., explains an unusual cardiac diagnosis that I happen to share: Inoperable Coronary Microvascular Disease (MVD).

When I was at Mayo Clinic five months after my heart attack, cardiologists there referred to MVD as a “trash basket diagnosis” – not because the condition doesn’t exist, but because this disorder of the tiniest blood vessels in the heart is so often missed entirely. A correct diagnosis usually happens only after all other possible diagnoses are thrown out. It’s far more common in women and in people who have diabetes. It’s treatable, but can be very difficult to detect. Continue reading “Coronary Microvascular Disease: a “trash basket diagnosis”?”

Welcome to your new country

by Carolyn Thomas    @HeartSisters

My doctor recently compared my uneasy adjustment since suffering a heart attack to being like a stressful move to a foreign country.

I used to be pretty comfortable in my old country, pre-heart attack. I was healthy, active, outgoing, and a former distance runner. I had a wonderful family and a whack of close friends, a meaningful career I really loved, a crazy-cute cat, a condo renovated top to bottom in a charming leafy neighbourhood of the most beautiful city in Canada – and a busy, happy, regular life.

Then on May 6, 2008, after being misdiagnosed and sent home from the Emergency Department despite textbook cardiac symptoms, I was hospitalized with a myocardial infarction – what doctors still call the “widowmaker” heart attack.

And that was the day I moved far, far away to a different country.  Continue reading “Welcome to your new country”