Combined cardiac imaging diagnoses heart attack in women left wondering after initial testing
Additional diagnostic heart imaging can help root out the underlying cause of heart attack in women who show no signs of artery blockage on their angiogram, according to a new study.
NYU Grossman School of Medicine researchers shared results from the international, multicenter Women’s Heart Attack Research Program, or HARP, on Nov. 14 at the American Heart Association’s virtual meeting.
Among the more than 300 participants included in the study, coronary optical coherence tomography (OCT) and cardiac MR imaging results explained why symptoms and blood tests were consistent with a heart attack in 84% of cases.
Ordering follow-up cardiac imaging may guide treatment to prevent additional heart attacks in those with myocardial infarction with nonobstructive coronary arteries, or MINOCA, researchers noted.
“Our findings are important because women (or men) with MINOCA have historically been told that since the angiogram is OK, they never had a heart attack,” Harmony R. Reynolds, MD, director of NYU Langone's Sarah Ross Soter Center for Women’s Cardiovascular Research, said in a statement. “This is entirely wrong for about two-thirds of the women who had both imaging tests, and misleading for one-quarter of the women because we found they had another problem that was not related to blood flow and could be diagnosed via cardiac MRI.”
Up to 1 in 10 heart attacks is diagnosed as MINOCA, and women are three times more likely than men to experience this adverse event.
The authors studied 301 women—median 60 years old— who suffered a heart attack but showed no indication of prior obstructive coronary artery disease and had no blockages on their angiogram.
Cardiac MRI and OCT imaging spotted heart damage from limited blood flow in 75% of women. And in 21% of participants, MRI revealed participants did not have a heart attack at all, instead showing myocarditis or another reason for heart dysfunction.
In 16% of patients, OCT and MRI scans were normal and the cause of their heart attack remained unknown.
“Our findings demonstrate that even if the angiogram does not show substantial artery blockage, when women have symptoms and blood test findings consistent with a heart attack, it is likely a true heart attack and not heart inflammation,” Reynolds added. “Additional imaging tests can get to the root of the problem and help healthcare professionals make an accurate heart attack diagnosis for women and to ensure they receive timely treatment.”
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.