Scientists find the cause of chest pain

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

A new extensive research project has dealt with methods for the treatment of angina pectoris and has gained important insights.

The study focused on the usefulness of testing the function of small blood vessels in the heart to determine the root cause of the disease.

The participants and the process

Physicians in hospitals referred patients with chest pain for the study. The participants’ initial heart scans showed no blocked heart arteries, a typical cause of angina.

The research involved specialists from the University of Glasgow and was carried out in three hospitals under the auspices of NHS Scotland.

The court results: INOCA as the main culprit

The research results showed that a common cause of chest pain in angina patients was myocardial ischemia without obstructive arteries, also known as INOCA.

Traditional CT heart scans could not identify this condition, but the additional tests, which focused on small vessel function, could.

The study found that diagnosing INOCA was four times more likely with these tests. Conversely, “normal” test results were far less likely to detect small vessel disease.

Words from the process line

Professor Colin Berry, one of the study’s leaders and respected cardiology consultant, pointed out that the frequency with which INOCA causes angina in patients living in shared accommodation is uncertain.

In addition, treatment strategies for INOCA once diagnosed remain unclear. The addition of small vascular function tests changed the diagnosis based on CT scans.

He emphasized that this shift in diagnostic strategy significantly improved patient outcomes, including symptom control, patient satisfaction, and reduction in additional referrals for testing.

Future implications and ongoing research

Professor Berry stressed the need for further research to develop new drugs for small vessel heart disease. His team is currently leading the PRIZE study funded by the Medical Research Council.

The aim of this study is to gain more knowledge about heart diseases of small vessels. The results are expected by the end of 2023.

Gratitude and sharing of knowledge

Professor Berry thanked the patients, support staff, study sponsor and funders – the British Heart Foundation and the Scottish Government’s Chief Scientist Office.

The team presented their results at the EuroPCR cardiovascular medicine conference in Paris.

This research represents a significant advance in the diagnosis and treatment of angina pectoris and offers a promising new direction for future treatment strategies.

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