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Test can give hope to thousands with suspected angina

A recent study by researchers at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London has found that a routine test could help diagnose thousands with ‘microvascular angina’.

Routine test anginaThe study was funded by the British Heart Foundation and supported by the National Institute for Health Research Guy’s and St Thomas’ Biomedical Research Centre. The condition mostly affects women, who are less likely than men to have large artery blockages as the cause of angina.

Angina is a sensation of chest tightness or pressure, which typically occurs during exercise or mental stress. The research shows that using a drug called adenosine during an angiogram – a type of X-ray used to examine blood vessels, can detect microvascular angina.

Approximately 250,000 angiograms are carried out every year in the UK. Around 40% of patients who undergo angiography to diagnose the cause of angina are found not to have narrowing of the large arteries. This means that the test could give a clear diagnosis to around 100,000 people every year, who are currently left uncertain about the cause of their chest pain or are subjected to multiple tests.

The research, published in the journal Circulation, showed that the bodies of healthy individuals adapt to exercise by providing blood to the heart more efficiently. In contrast, the bodies of patients who have microvascular angina are unable to increase blood supply in response to demand. Doctors could use adenosine to mimic the effects of exercise during angiograms, to ensure that they recognise angina caused by abnormal function of the small arteries.

Professor Divaka Perera, consultant cardiologist at Guy’s and St Thomas’ NHS Foundation Trust and professor of interventional cardiology at King’s College London, led the research. He said:

We have shown that using medication, we can diagnose the presence of ‘microvascular angina’. We know that this condition is more common in women and associated with poorer outcomes for patients.
Our study has given us new and useful insight into what is happening to these patients during exercise, and we hope that this will not only help us pick up the condition better, but that it could help us develop personalised treatments.

Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, said:

This new test has the potential to speed up the wait from symptoms to diagnosis, ultimately giving people quick access to the treatment they urgently need.

To read the full story, visit the Guy’s and St Thomas’ NHS Foundation Trust website.

King’s Health Partners Cardiovascular aims to transform service delivery and generate research advances to revolutionise cardiovascular prevention and care.