Treatment of microvascular angina

Microvascular angina causes heart discomfort when the small vessels supplying the heart do not regulate blood flow normally. Larger coronary arteries may not show a major blockage, so symptoms can still need careful assessment. Chest tightness, pressure, breathlessness or unusual fatigue may occur with exertion or stress, and sometimes at rest.

An ECG and other tests help clinicians assess the heart and exclude urgent causes. Hypertension, diabetes, smoking, cholesterol problems and hormonal changes can influence risk, so your history matters as much as one test result.

Take prescribed medicines consistently and keep a record of when symptoms occur, what brings them on and how long they last. Blood-pressure medication, anti-anginal treatment or other medicines may be selected according to your symptoms and health history. Statin therapy may be discussed to lower cholesterol-related risk.

Build activity gradually within the limits your clinician recommends. Manage blood pressure, avoid smoking, choose heart-supportive foods and attend follow-up appointments. Never use someone else's chest-pain medicine or change a dose without advice.

Call emergency services for new, severe or persistent chest pressure, especially with sweating, nausea, breathlessness, fainting or pain spreading to the arm, back, neck or jaw. Urgent assessment is also needed when symptoms occur at rest, become more frequent or do not settle with your prescribed plan.

Ask what your tests show, whether you need an ECG or further assessment, which medicine is for immediate relief, and how to exercise safely. Also ask how hypertension, cholesterol, sleep, stress and smoking affect your plan.