Microangina missed in many patients with chest pain

Half of people investigated for suspected angina and given the all-clear may be missing out on the correct diagnosis, according to a British Heart Foundation study presented at the recent American Heart Association Scientific Sessions conference in New Orleans

The study involved 250 British people referred for a coronary angiogram after experiencing chest pain. Based on their scan results, these people did not have angina.

However, when researchers gave these people an extra MRI scan, they found 51% of people given the all-clear for angina actually had microvascular angina. Standard coronary angiograms can only detect angina caused by blockages in the large coronary arteries.

Researchers say blood flow scans should be used to follow up angiograms for every patient with unexplained chest pain.

Professor Colin Berry, senior author of the study from the University of Glasgow, said: ‘We need these extra test results because people whose angiogram results suggest their chest pain is not heart-related can be sent home without medication, on the assumption that their symptoms are due to things like indigestion, anxiety or arthritis. It is not uncommon for these people to then have to return to their GP multiple times, with continuing symptoms like chest pain and breathlessness.’

Dr Sonya Babu-Narayan, clinical director at the British Heart Foundation and consultant cardiologist, said: ‘Unfortunately, many people go undiagnosed, are misdiagnosed, or are only diagnosed after years of delay, because the diagnosis of inadequate blood supply in tiny coronary blood vessels slips through the net.’