Advanced MRI uncovers hidden angina in patients with 'normal' arteries

A new medical study has revealed that a specialised MRI testing method can detect heart-related chest pain in patients whose main coronary arteries appear normal. The research, led by Dr. Colin Perry at the University of Glasgow, suggests that many cases of unexplained chest pain may stem from small vessel disease rather than major blockages.

The findings highlight a significant gap in current diagnostic practices, particularly for women, who made up over half of those diagnosed with angina using the advanced MRI technique.

The study involved 250 adults who reported chest pain but showed no major obstructions in their main coronary arteries during routine angiography. Researchers split the participants into two groups: one where diagnosis and treatment were guided by cardiac stress MRI results, and another where doctors relied only on standard angiography findings, with MRI data kept hidden.

Using cardiac stress MRI, doctors diagnosed angina in roughly half of the participants. In contrast, routine testing alone identified less than one percent with the condition. The results suggest that traditional methods often miss cases where smaller blood vessels are affected, even when larger arteries appear clear.

Dr. Perry emphasised that angina can occur even when arteries seem open. He recommended updating clinical protocols to include cardiac stress MRI, especially for women, who accounted for more than half of the angina diagnoses in the MRI-guided group. The technique measures blood flow during physical stress, uncovering issues that standard angiography might overlook.

The study's findings point to a need for wider adoption of cardiac stress MRI in diagnosing chest pain, particularly in cases where routine tests show no blockages. With over half of the MRI-diagnosed angina patients being women, the research underscores the importance of more precise diagnostic tools for detecting small vessel disease.

Dr. Perry's team has called for clinical guidelines to be revised, ensuring that patients with unexplained chest pain receive more thorough assessments.