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Heart disease is the leading cause of death for women, yet chest pain in women largely remains an enigma for doctors. While chest pain typically stems from blockages in arteries carrying blood to the heart, women are more likely to experience reduced blood flow to the heart without blockages, known as ischemia and nonobstructive coronary arteries (INOCA). A range of diseases causes INOCA, but they typically go undiagnosed because standard testing focuses on checking for blockages.
Yale assistant professor Samit Shah and professor of cardiology Alexandra Lansky are seeking to remedy this by conducting a multi-center research study called DISCOVER INOCA. Shah and Lansky developed a protocol to diagnose under-recognized causes of INOCA that uses X-rays to visualize blockages, tests to assess the function of the blood vessels, and state-of-the-art imaging to detect plaque buildup inside the arteries.
This set of tests is highly effective at diagnosing the diseases behind INOCA. More than ninety percent of people in the study, previously misdiagnosed or undiagnosed, had a changed diagnosis. With more precise diagnoses, more than three-quarters of people changed medications to better address their disease. “The average time that somebody suffers from symptoms before getting a diagnosis is seven years,” Shah explained. DISCOVER INOCA cuts down this time to a sixty-minute protocol that can be performed in most hospitals.
Ultimately, DISCOVER INOCA may help researchers better understand how these understudied diseases affect outcomes like depression, anxiety, and hospitalization. The researchers’ work brings us closer to a future where everyone, including women, can be diagnosed and effectively treated for chest pain without delay.