Trial helps determine underlying causes of angina

An intensive study into the treatment of angina has found that the use of tests for small blood vessel function in the heart clarify the underlying cause of the condition. Patients referred to hospital by their General Practitioner (GP) for assessment of chest pain were invited into the study if a heart scan had ruled out blocked heart arteries. The trial showed that the common underlying cause of chest symptoms in angina sufferers was myocardial ischaemia with no obstructive arteries (INOCA), which wasn't diagnosed by a standard CT heart scan. The diagnosis was clarified using the tests where INOCA was 4 times more likely, while 'normal' results were half as less likely to detect small vessel disease. The study, funded by the British Heart Foundation and the Chief Scientist Office of the Scottish Government and sponsored by the NHS Golden Jubilee, was carried out by heart specialists from the University of Glasgow and took place in 3 hospitals within NHS Scotland - the Golden Jubilee University National Hospital in Clydebank, Glasgow Royal Infirmary and Forth Valley Royal Hospital in Larbert, Falkirk. One of the trial's leads, Professor Colin Berry - a Cardiology Consultant at NHS Golden Jubilee and Chair in Cardiology and Imaging at the University of Glasgow said: "In patients experiencing angina in the community, it is not known whether INOCA is a common cause of angina and, in addition, if it is diagnosed, the treatment of INOCA is also uncertain. "We assessed whether the addition of tests of small vessel function might change the diagnosis based on the CT scan and, if so, would changes in treatment lead to improvements of symptoms, health-related quality of life, satisfaction with care and onward referrals for medical care.