Scientists find the cause of chest pain

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Angina is a type of chest pain caused by reduced blood flow to the heart. It’s a symptom of an underlying heart problem, usually coronary heart disease.

A new extensive research project has delved into angina treatment methods, revealing significant findings.

The study focused on the usefulness of tests for the function of small blood vessels in the heart to pinpoint the root cause of the condition.

The participants and the procedure

Doctors at hospitals referred patients with chest pain for the study. The participants’ initial heart scans didn’t show any blocked heart arteries, a typical cause of angina.

The research involved specialists from the University of Glasgow and was conducted in three hospitals under the umbrella of NHS Scotland.

The trial findings: INOCA as the main culprit

The research results highlighted that a common cause of chest pain in angina patients was myocardial ischemia with no obstructive arteries, also known as INOCA.

Traditional CT heart scans couldn’t identify this condition, but the additional tests focusing on small vessel function did.

The study found that the diagnosis of INOCA was four times more likely using these tests. Conversely, ‘normal’ test results were far less likely to discover small vessel disease.

Words from the lead of the trial

Professor Colin Berry, one of the trial’s heads and a respected Cardiology Consultant, pointed out that the frequency of INOCA causing angina in community-dwelling patients was uncertain.

Moreover, if diagnosed, treatment strategies for INOCA remain unclear. The addition of small vessel function tests changed the diagnosis based on CT scans.

He highlighted that this shift in diagnostic strategy significantly improved patient outcomes, including symptom control, patient satisfaction, and reduced additional test referrals.

Future Implications and Ongoing Research

Professor Berry emphasized the need for more research to develop new drugs for small vessel heart disease. His team is presently heading the PRIZE trial, funded by the Medical Research Council.

This trial aims to provide more insights into small vessel heart disease, with results expected by the end of 2023.

Gratitude and dissemination of findings

Professor Berry expressed gratitude to the patients, supporting staff, study sponsor, and the funders—the British Heart Foundation and the Chief Scientist Office of the Scottish Government.

The team shared their findings at the cardiovascular medicine conference, EuroPCR, in Paris.

This research represents a significant step forward in the diagnosis and treatment of angina, offering a promising new direction for future treatment strategies.

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