The tests can establish issues caused by problems with the small blood vessels supplying the heart, according to research funded by the British Heart Foundation (BHF) and presented at the Transcatheter Cardiovascular Therapeutics (TCT) conference in San Diego.
The new tests are not yet standard in the NHS because, before now, there has not been enough evidence gathered about whether they would benefit patients. Now, researchers say that they should be routinely available to pinpoint the cause of chest pain.
Researchers from the University of Glasgow and the Golden Jubilee National Hospital performed the new small vessel test which involves passing a thin, flexible wire into the heart and measuring how well a blood vessel relaxes.
The team performed the new test on 151 patients with chest pain who could not be diagnosed using currently available tests. The small vessel test results for half of the patients were made available to doctors to further guide the diagnosis and treatment, whereas, in the other half of the patients, the results were not disclosed. These patients followed standard care. The team found that the new tests were able to correctly diagnose six times as many patients as standard tests.
Even more importantly, six months later, symptoms of angina were less and quality of life was better in the patients whose care was guided by the new tests.
Lead researcher Professor Colin Berry, chair in cardiology and imaging at the University of Glasgow, said it is hoped that tests can be brought into wider use soon.
He said: “Microvascular angina and vasospastic angina are under-recognised problems. As the angiogram in these patients looks clear patients may be falsely reassured. However, leaving these heart conditions undiagnosed and untreated presents a risk to patient wellbeing - these problems can lead to hospitalisation for chest pain and a heart attack – and symptoms persist in the longer term. We now hope to see this test rolled out across the country.”
Philippa Hobson, senior cardiac nurse at the British Heart Foundation, said: “People living with microvascular angina suffer from crippling and frightening episodes of chest pain that dramatically affects their day to day life. They are unable to treat their symptoms effectively as their angiogram is essentially normal. Medication currently prescribed to people with diagnosed coronary heart disease does little to resolve their pain or reduce risk of heart attack, so they are left in limbo. This study is very reassuring news for sufferers who live in the fear of having a heart attack as for many, there is currently no conclusive proof they have heart disease.”