I only have a moment before I run, but I was reading a magazine at the doctors waiting office, and found an article on the WISE study done at Cedars Mt. Sinai hospital to detect heart disease in women, specifically microvascular problems.

It indicated that many women experienced chest pains, and palpitations, but were told they 'were fine'... but were later found to have Microvascular problems not found by the traditional battery of tests given to women.

Just wondering if you could share any other knowledge on this - and heck, maybe calm some more fears  Thanks as always!

I was a bit alarmed when I read this. I've just had a brief read up about this on the web - if I understand it, WISE (Womens Ischemia Syndrome Evaluation) was a study which looked at women who had chest pain but whom conventional testing suggested did not have heart problems.  This is because the build up of plaque on artery walls did not lead to major blockages, as instead the plaque was more evenly distributed throughout the artery wall.

The conclusion seemed to be that doctors should find additional ways of testing women. However, now I've read a bit about it I'm not too worried. These are women with chest pain and I think, high colesterol, who have tests but are told there is nothing wrong. It does not give any age ranges in the stuff I read but I am assuming it refered to older women. I am thinking that unless someone had a lot of risk factors - family history, obesity, over 50, smoking, high colesterol, poor diet, - they are probably being correctly diagnosed and any palpitations are not being mistakenly dismissed as benign. This is part of my anxiety though - what if they missed something? What if they misread it? The ecg leads were only on my chest for 30 seconds, it hasn't been done properly... and so on.. convincing myself that I really am ill. I think this is what we all do - and of course, it makes the palpitations/ectopics worse.

Also, these seem to be women who are repeatedly sent for tests because of chest pain - how many of us here have real, proper chest pain , not a funny sensation, not feeling the palpitations, but actual pain? When I am feeling really anxious about my heart I sometimes say to myself - how do you really, physically feel? The answer is nearly always - mentally I feel dreadful, but physically I feel ok.

I would be interested to hear RLR's view on this, though, as I'm not even sure if palpitations or ectopics are actually a symptom of narrowing of your arteries.

I'm sorry, I didn't mean to alarm anyone.  I did mention in my post that it was concerning women with Chest Pain and Palpitations.

I happen to be a woman who DOES have chest pain quite often, as well as some risk factors (smoker for 20 years - quit 1.5 yr ago, both parents had bypass surgery)....  but nothing was found during my tests.

So, of course, I fear that something has been missed...  that I may be one of those women with the smooth, evenly distributed plaque on my artery walls that no tests were able to reveal.  Or that I am suffering arterial spasms.  But how to know ????  

I brought up the WISE study to my cardiologist, who advised that there is no true treatment for microvascular dysfunction in women, other than taking a beta blocker, statins, aspirin, etc.    

I even contacted Cedars Mt. Sinai who said I was welcome to come there, or to the Mayo clinic, for testing.  But those tests sound invasive, and if it can't be "fixed", what's the point ???

So - even if I (or someone else) does have this problem - there's not a whole lot that can be done anyway.  So worrying about it just doesn't do us any good.

Like it or not, many women are dismissed by doctors and ER's when concerned about cardiac health.  It's just a fact.  The article I read said "don't allow yourself to be dismissed if you feel it is wrong".   but........

I try to tell myself this:  I've had basically every test I can have, short of an angiogram, which I refuse to go through at this time because it wouldn't show smooth plaque anyway.

If I'm going to drop dead of a freakin heart attack, well - can I truly prevent it, if that is my fate?    Probably not.   Don't mean to sound grim, but I realize I've lost so much of my life to living in fear because of these stupid palpitations & chest pain.    I need to set myself free & enjoy life again, somehow!

Again, I am VERY SORRY if I freaked anyone out  :'(   That truly is not my intention.    I just wanted to see what RLR's opinion was on the subject.    

I whole-heartedly agree with you on all points

I do watch my cholesterol, diet, and Blood Pressure..  the one thing I struggle with is exercise, I guess I hate the feeling of my heart pounding fast & hard.  But that is SO important to cardiac health.  

That's something I definitely need to work on.  Wonder if anyone else avoid much exercise for that same reason ?

When I was really bad with my anxiety about my heart I was terrified of any exertion whatsoever. Then about a year ago I did a bit of Pilates/very light weight training at home with my husband. I felt ok while exercising, but later realised my heart was racing and wouldn't slow down. Went to bed, but couldn't sleep - it was about 2 am before it seemed to slow to a normal pace and I felt relaxed enough to sleep. Since then I've been worried about that happening again - so I walk twice a week with my friend, usually quite briskly, and I've recently lost a stone with Weight Watchers. My friend tells me that it perfectly normal for you to have an increased heart rate when exercising (which I know), but it was such a frightening experience that I am scared of it happening again. I am building up my fitness, but very slowly - I know you can only get fit by raising your heartrate and getting out of breath, but I find it scary and it makes me anxious.

Funnily enough, one of the women on the C4 documentary the other week had this same fear - they got her to run on a treadmill and she was quite euphoric afterwards when she realised she could do it without having a heart attack. Claire Weekes actually says that exercise "abolishes ectopics", which would make sense to me as your heart would work harder and is more likely to stick to it's natural, regular rhythm.

Okay, again we find that we must take great care in the interpretation of these types of studies. When reviewing something like this from a general standpoint, one might believe that a vast range of women who are otherwise labeled as healthy are actually in danger of suffering the consequences of cardiovascular disease. Could this be possible of the group visiting this forum? Likely not and here's why.

The WISE study, which began roughly in about 1996 if my memory serves me correctly, began studying women who were experiencing diagnostically confirmed chest pain, but who also were demonstrating clear angiographic studies, later determined to be incorrect because of full-spectrum plaque across the microvascular wall rather than at specific points. Now this is very important to read carefully because we're not talking about benign palpitations or acute chest pains associated with stress of anxiety, etc, but rather consistent with ischemic heart disease. In other words, there is diagnostic evidence of actual ischemia without evidence of the underlying cause, most chiefly coronary obstruction or restriction.

I urge you not to allow your anxiety run away with you in trying to establish any possible association between your symptoms and that of the women involved in this study. All too often, patients come away with general impressions about these studies that tend to produce a good deal of alarm and apprehension because they are unfamiliar with the actual science and diagostics involved. We're not talking generalities here by any stretch of the imagination and just because a woman experiences chest pain, does not equate with the factors associated with the study. Chest pain from ischemia is specific, not broad. It can't be other things.

You'll be fine.

Best regards and Good Health