byAmerican Heart Association

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Chest pain may still be angina even when coronary angiogram testing shows the main heart arteries look clear. Using stress cardiac stress MRI testing to measure blood flow around the heart appears to improve diagnosis and patient quality of life. These findings were shared at a late-breaking science presentation today at the American Heart Association'sScientific Sessions 2025. The meeting, held Nov. 7–10 in New Orleans, is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science.

"People may have real angina even when the main arteries appear wide open," said study author Colin Berry, M.B.Ch.B., Ph.D., professor of cardiology at the University of Glasgow and consultant at Golden Jubilee University National Hospital. "By measuring blood flow with a stress cardiac MRI test, we found that small vessel problems were common.

"Our findings show that an angiogram alone is not always enough to explain chest pain. A functional test of blood flow should be considered before sending people home, especially women, who are more likely to have small vessel angina that otherwise goes unrecognized."

According to the American Heart Association, angina is chest pain that occurs if the heart is not getting enough oxygen-rich blood. About half of all patients with angina who undergo coronary angiogram testing have no obstructive coronary artery disease identified. This study aimed to determine if stress cardiac MRI testing (a heart scan that measures blood flow withmagnetic resonance imaging) could help improve diagnosis and treatment for people with suspected angina.

A total of 250 adults with chest pain but no blocked coronary arteries based on testing were enrolled in the CorCMR trial. All of the participants had a coronary angiogram test within three months prior to enrollment in the study, with the results indicating they had suspected angina and no obstructive coronary arteries (ANOCA). The study participants were randomly assigned to one of two groups. People in both groups had a stress cardiac MRI test.

In one group, the stress cardiac MRI results were shared with doctors and patients to help guide diagnosis and treatment. In the other group, results of the stress cardiac MRI were not disclosed to the doctors or the patients, and treatment decisions were based only on the results of the angiogram conducted before enrolling in the study. Neither the participants nor their doctors knew which group they were assigned to until after the one-year study ended.

After following all participants for at least 12 months, the analysis found:

"The results of our study open a new path for people with chest pain," Berry said. "It indicates that symptoms and well-being are worse when diagnoses are made based only on an angiogram. Clinical practice should now change to include a stress cardiac MRI test for angina, especially for women withchest painand no blockages in the main arteries. These results may also help inform future clinical recommendations for anyone presenting withangina, and help improve clinical outcomes."

Study details, background and design:

More information: Conference: eppro02.ativ.me/web/planner.php?id=AHA25

Provided by American Heart Association