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Health & Fitness How tests are 'missing deadly peril of angina'

04:15  27 may  2021
04:15  27 may  2021 Source:   dailymail.co.uk

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Thousands of people with angina could be at risk of deadly heart attacks and strokes, research suggests. Until now, microvascular angina (MVA) was widely thought to be a benign disease that mainly occurs in women and is often blamed on hormonal changes caused by the menopause. The illness, also called cardiac syndrome X, is caused by problems with arteries in the heart muscle that play a crucial role in regulating blood supply to the heart. But the blood vessels are too small to show up on standard tests such as scans, electrocardiograms (ECGs) and angiograms, making the condition

Angina (ischemic chest pain) causes include heart disease, coronary artery spasm, and other conditions. Risk factors include high blood pressure, smoking, diabetes, high cholesterol, family history, aging, a sedentary lifestyle, and stimulant use. Emergency personnel are trained to recognize angina and to treat it rapidly and safely. If the person has had angina before, they may not need to seek medical care if the symptoms are the same as they always are . If the person has already been evaluated by a health-care professional and received advice about how to react to these symptoms

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Thousands of people with angina could be at risk of deadly heart attacks and strokes, research suggests.

Until now, microvascular angina (MVA) was widely thought to be a benign disease that mainly occurs in women and is often blamed on hormonal changes caused by the menopause.

But experts have found the condition – thought to affect up to 100,000 men and women annually in the UK – can lead to deadly heart attacks.

The illness, also called cardiac syndrome X, is caused by problems with arteries in the heart muscle that play a crucial role in regulating blood supply to the heart.

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But the blood vessels are too small to show up on standard tests such as scans, electrocardiograms (ECGs) and angiograms, making the condition difficult to diagnose.

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A study involving 686 patients from seven countries, including the UK, US and Japan, found 78 (the equivalent of eight per cent of patients annually) either died, suffered a non-fatal heart attack or stroke or were hospitalised with the condition over a three-year period.

Researchers warned the lack of diagnosis is costing lives, adding there is a 'massive unmet need' of patients worldwide.


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Professor Hiroaki Shimokawa, of the International University of Health and Welfare in Japan, who led the study, said: 'Currently, many doctors are not aware of the importance of coronary microvascular dysfunction.

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Millions of people with angina get a stent put in to widen their arteries. A study by Imperial College London found the operation has a huge risk of damaging the arteries but does not improve quality of life. Doctors widely believe the stent 'unquestionably improves angina ', according to the researchers. But when the effect on patients' ability to exercise was examined, the stent group showed little difference. Lead author Dr Rasha Al-Lamee, from Imperial's National Heart and Lung Institute, said: 'It seems that the link between opening a narrowing coronary artery and improving symptoms is not as

'As a result, many patients with MVA are misdiagnosed as having postmenopausal disorders or an imbalance of conscious and unconscious nervous system, for instance.

'However, previous research has suggested that the number of patients with MVA is three to four million in the USA, which is equal to or greater than the number of patients with breast cancer, so it is an important global problem.'

Patients can experience chest pains similar to those of a heart attack and shortness of breath.

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Those with suspected angina are given an angiogram – a heart X-ray – to identify the cause and work out the best treatment.

Some 250,000 are carried out in the UK every year – but these only spot blockages or narrowing in the large arteries that supply blood to the heart. About two in five patients are found not to have this problem and told they have a healthy heart, which may not be the case.

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It also means people often have to go through multiple tests over a prolonged period of time before a condition is diagnosed.

Professor Shimokawa told the European Heart Journal the findings also helped to explain why fitting stents or heart bypass surgery was not always successful, with around 40 per cent of patients still experiencing chest pains following the procedures.

Patients are usually treated with drugs to prevent blood clotting or dilate blood vessels. But experts say more should be done to tailor treatment to the condition.

Filippo Crea, professor of cardiology at the Catholic University of the Sacred Heart in Rome, said millions of people are affected worldwide and 'deserve to be carefully identified and treated. In addition, these data should stimulate the development of drugs that specifically target coronary microcirculation.'

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