What if the symptoms of heart disease are present, but the usual suspects aren't to blame? This intriguing question sets the stage for my conversation with Dr. Samit Shah, as we dive into the complex world of ischemia with non-obstructive coronary arteries (INOCA). Dr. Shah shares his groundbreaking work on invasive coronary function testing, a crucial development in the past decade that helps us understand symptoms like chest pain and shortness of breath without coronary blockages. DISCOVER ANOCA program is creating standardized protocols for provocative testing, ensuring that patients receive precise diagnoses and effective care.
Our discussion takes a closer look at the nuanced challenges of diagnosing and treating myocardial bridging, vasospasm, and microvascular dysfunction. With a compelling case study, we illustrate how provocative testing can identify the root causes of symptoms, leading to non-surgical treatment paths. Dr. Shah introduces the Discover Inoka study, which standardizes the use of intravascular imaging for myocardial bridges. By establishing these testing protocols, the medical community is better equipped to treat such conditions with newfound enthusiasm.
As we wrap the conversation, we confront the ongoing challenges and future opportunities in making provocative testing widely accessible. The importance of understanding conditions before major interventions and the role of the Microvascular Network in connecting patients to specialized care are emphasized. We also spotlight advancements in studying myocardial bridging, where surgical unroofing is now tracked in clinical trials, offering unprecedented insights into patient outcomes and enhancing cardiac care. Dr. Shah's insights are driving forward a crucial conversation on improving diagnoses and offering hope to patients with challenging cardiac conditions.
CHAPTER TIMESTAMPS
(00:00) Discover ANOCA Clinical Trial Overview
(08:41) Advance in Diagnosis and Treatment
(14:07) Improving Access to Provocative Testing
(27:24) Myocardial Bridging Clinical Trial Outcomes
Discover INOCA clinical trials application and information is available HERE.
For more information about myocardial bridging and microvascular testing, visit the microvascular network, HERE
White paper on chest pain. American Heart Assoc
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001029
https://www.microvascularnetwork.com/
https://www.jscai.org/article/S2772-9303(24)01512-6/fulltext
https://www.jscai.org/article/S2772-9303(25)01048-8/fulltext
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