New research gets to the heart of the issue
Plan helps solve mystery of undiagnosed chest pains
A Stirling woman has been involved in new research aimed at tackling the problem of “hidden” heart disease.
Retired teacher and education manager Mirren Robertson, 72, began suffering from chest pain and breathlessness in 2016 while visiting her son in San Francisco in 2016, and went to see her GP.
Thinking it might be angina, he prescribed medication but it didn’t seem to help so Mirren was sent for further tests.
She was referred to the Golden Jubilee National Hospital, where she was seen by Dr Tom Ford from a BHF-funded research team led by Professor Colin Berry.
They are working on a new test to improve diagnosis of ‘hidden’ heart diseases caused by problems with the smaller blood vessels supplying the heart.
Mirren was one of 151 participants who took part in a clinical trial run by researchers from the University of Glasgow and the Golden Jubilee.
Doctors performed an additional test during the standard test for angina (an angiogram).
The new ‘small vessel’ test involves passing a thin, flexible wire into the artery and measuring the artery function. All those taking part had symptoms that could not be diagnosed using currently available tests.
Mirren said: “I was so lucky to be sent there. I was involved in the research for about a year – they were looking for people like me who appeared to have angina but results of traditional tests were unremarkable.
“When they told me I have microvascular angina and it is treatable, it lifted a weight off my shoulders.
“I’ve always been a busy person and I’m back to enjoying my usual activities, walking and volunteering. I know how to look after my symptoms so I feel happier and more confident. Life is good.”
The tests that helped Mirren are not yet standard in the NHS because, before now, there has not been enough evidence gathered about whether they would benefit patients.
Now, researchers have shown that precisely identifying the cause of chest pain allows targeted treatment which improves patients’ lives.
The small vessel test results for half of the patients were made available to doctors to further guide the diagnosis and treatment, whereas, in the other half of the patients, the results were not disclosed. These patients followed standard care. Interestingly, the new tests changed half of the doctors’ final diagnosis. Over one third of patients in standard care had the cause of their angina missed by the standard tests.
More importantly, six months later, symptoms of angina and quality of life were improved in the patients whose care was guided by the new tests.
Dr Ford said: “This test was designed to help patients just like Mirren because the right treatment starts with the right diagnosis.
“Patients with angina (chest pain) and a ‘negative’ angiogram often leave hospital without a diagnosis, which leaves them in limbo. They often have persistent and scary symptoms that lead to repeat hospital visits with associated psychological distress.
“Accurate testing to fully check the heart arteries offers them a clear diagnosis, enabling personalised treatment to improve their health and quality of life. We hope to expand our research into a larger study rolled out across the country.”
James Cant, Director of BHF Scotland, added: “This is a great example of how the world-class research that’s happening on our doorsteps is helping people like Mirren right across Scotland.
“We’re hugely grateful to the public, whose generosity we depend on to continue this research.”
More details at bhf.org.uk/research.