What are some common heart conditions. That you often encounter in your practice?
As an interventional cardiologist specialising in coronary artery disease, I see a lot of patients with blocked heart arteries presenting with chest pain. An invasive coronary angiogram done via the wrist artery (radial artery) is often done to get a clear picture of any artery blockage. Once the diagnosis is confirmed, it is often followed by inserting a balloon and stents to remove the obstruction in the vessel.
What happens if a screening yields normal results, yet does not explain a patient’s symptoms, such as chest pain?
There are a small group of patients who come to me heart conditions with classical symptoms of heart pain (angina) and often with abnormal exercise ECG. Yet, they may have normal CT coronary angiogram scans showing widely patent (unobstructed) heart vessels.
This group of patients may have Coronary Microvascular Disease (CMD). Although the coronary microvascular system is one of the main components of coronary circulation. Its relevance has underestimated for a long time as microvessels are invisible using current imaging techniques. Their function may be assessed only indirectly. Specifically, 50 – 65% of patients with angina with non-obstructive coronary artery disease are believed to have CMD.
Many of these patients were discharge from follow up. Their conventional imaging tests were normal.
They are then left frustrated without a firm diagnosis. Their symptoms and often end up visiting many doctors across various specialties looking for a diagnosis and treatment. Worse still, many end up being admitted to hospital repeatedly with heart attacks.
There is now a new test using devices such as the heart conditions coroventis physiological system to assess microvascular disease. It is carried out at the same time invasive coronary angiogram with a special pressure wire inserted into the coronary artery. The microvascular physiology is then measure with the thermodilution technique. The measured intramuscular resistance (IMR) will provide an objective assessment for CMD. In experienced hands, it usually takes an extra 10 – 15 minutes to perform the test during the coronary angiogram.
Patients with a normal coronary angiogram. Who also have CMD ruled out. Can reassured that they do not require further cardiovascular สมัครสมาชิก UFABET วันนี้ รับเครดิตฟรีทุกวัน investigations and therapies. However, those with CMD benefit not just from having a confirmed diagnosis, but can receive tailored treatment to help manage their condition and improve their quality of life.