Heart wire test detects ‘hidden’ angina

A NEW routine test could help diagnose common heart problems in thousands of British patients.

The 15-minute check, in which a wire the width of five twisted strands of hair is inserted into the heart via the arm, spots a hardto-detect form of angina. The condition is the result of reduced blood flow to the heart and is an early warning sign that a patient might go on to have a heart attack or stroke.

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

About 250,000 are carried out in the UK every year. But angiograms only spot blockages or narrowing in the large arteries that supply blood to the heart.

About two in five patients who have an angiogram are found not to have this problem and told they have a healthy heart. But problems with the smallest arteries that supply the heart – which are too tiny to be checked in a standard angiogram – are also known to cause angina. This is known as microvascular angina.

Now researchers at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London have identified a way to check large and small arteries in one hospital visit.

‘Microvascular angina isn’t a straightforward condition to identify,’ says Professor Jeremy Pearson, associate medical director at the British Heart Foundation, which funded the research.

‘People often have to go through multiple tests over a prolonged period of time. This new test has the potential to speed up the wait from symptoms to diagnosis, giving people quick access to the treatment they urgently need.’

During a standard angiogram, a dye that makes the large arteries show up on an X-ray is injected. The new microvascular angina test could be carried out immediately afterwards if no problems with the large arteries are detected.

It involves a very fine wire being inserted into the coronary artery via the arm. The wire contains a sensor that can detect changes in blood flow to the heart muscle. Patients are then given a drug called adenosine, which, in healthy arteries, causes dilation and the increase of blood flow. If this doesn’t happen in the smallest arteries supplying the heart, it suggests a problem.

The research also found there are different types of microvascular angina, which may respond to different treatments.

It could give quick access to treatment you urgently need