Persistent chest pressure- finally got a diagnosis.

I recently finally got a diagnosis for what’s been causing my LC and wanted to update this community.

Symptoms: I got sick in March 2023 with my first and only known Covid infection. I started getting chest pain within 24 hours of testing positive and my chest pain never went away. It is constant, debilitating, and worsens with mild exertion/movement like standing or walking. I also developed tachycardia and shortness of breath with my heart rate reaching 120bpm at rest and feeling so short of breath I couldn’t talk. I developed numbness/tingling on my left side as well, although that resolved with magnesium supplements.

Over the last 2 years I’ve seen a wide variety of doctors, tried many different meds, and ruled out several other possibilities. We tested for lung issues, gastrointestinal issues, musculoskeletal issues, and general inflammation. I finally got a cardiology referral after collapsing from pain during a NASA lean test.

Diagnosis: My first cardiologist wasn’t great. He ran a few tests (EKG, echo) and said I was fine. Then I got a new cardiologist who suspected microvascular dysfunction based on my symptom profile and previous normal/borderline test results. He recommended a provocative coronary angiogram to test for it, and I finally got it done this past week. He was right: I have coronary microvascular dysfunction/endothelial dysfunction. If you’re not familiar with CMD, it’s a non-obstructive heart disease. Regular heart disease occurs due to buildup in the large arteries, but CMD affects the small blood vessels which supply 90% of the heart’s blood and oxygen. My small vessels don’t function properly, leading to insufficient blood/oxygen supply to my heart that causes chest pain with exertion.

Where I Am Now: I’m still processing the results myself- it’s tough to internalize that I’m 24 with heart disease and that it’s gone undetected/untreated for almost 2 years. I’m relieved and feel at peace that I finally have a diagnosis now. I’m angry at all the doctors who dismissed and invalidated me throughout this process. I’m sad that having a diagnosis doesn’t change my symptoms, but at least now I can prove that it’s real and I can stop going through the gauntlet of constant testing. My cardiologist and I are working on a treatment plan to improve my quality of life. I’m grieving the version of me that didn’t have heart disease, but I’m so grateful to have the privilege of a doctor who believes me and getting a test that confirmed my diagnosis. I really appreciate all of you, and I’m so glad to have this community to come back to as I continue on my LC journey.

TL;DR: Got Covid in March 2023, ended up with constant chronic chest pain. Was eventually referred to a cardiologist and got a coronary angiogram confirming I have coronary microvascular dysfunction.