Abu Dhabi: Hospital introduces innovative test for unusual, recurring chest pain

The pioneering test evaluates for a cardiac disorder that causes angina, i.e., chest pain caused by poor blood flow to the heart

by

Ashwani Kumar

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Published: Wed 24 May 2023, 7:15 PM

Last updated: Wed 24 May 2023, 10:00 PM

Cleveland Clinic Abu Dhabi is offering a pioneering test to patients who have been suffering for years from unexplained chest illnesses. This condition can affect people even if their coronary arteries show no significant blockages on a standard angiogram.

The hospital, a Mubadala Health partner, has introduced a comprehensive invasive microvascular and coronary spasm programme testing – a groundbreaking technology. The test evaluates for a cardiac disorder that causes angina, i.e., chest pain caused by poor blood flow to the heart. In this condition, arteries that supply blood to the heart either spasm down or fail to dilate adequately, which can go undetected in routine cardiac tests.


“While the conversation about this condition is not new in the field of cardiology, it is becoming more widely discussed and investigated, and therefore we’re finding that this is not a rare condition as once thought. From what we’ve seen across the Cleveland Clinic network, it’s estimated that a significant number of patients who have angina may have some degree of microvascular disease or spasm,” said Dr Ronney Shantouf, staff physician, cardiovascular medicine in the Heart, Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi.

Photo: Dr Ronney Shantouf
Photo: Dr Ronney Shantouf

The highly sophisticated testing method calls for specialised interventional cardiologists along with specialised equipment that can screen for abnormalities not only in the large coronary arteries but also the extremely minute arteries that are undetectable to the human eye. Without sophisticated testing, this condition will not be detected by the standard coronary artery angiogram and such patients end up suffering from recurrent chest pain that is incorrectly attributed to conditions such as stress and anxiety.


“It is often missed or undiagnosed due to the nature of its symptoms and needs a specialised cardiologist and advanced technology to be identify these. In the past people may have been told it was a mental or ‘phantom’ illness and to visit a psychiatrist to understand the cause for unexplained chest pain, only to discover after specialised testing that they have this condition,” Dr Shantouf noted.

The prevalence of this condition appears to be higher in women. Those who smoke, have diabetes or hypertension, are also more likely to have microvascular angina and/or coronary spasm, which predisposes them to a higher risk of having a cardiac event.

Photo: Dr Ashraf Al Azzoni
Photo: Dr Ashraf Al Azzoni

“We are proud to bring this sophisticated microvascular dysfunction and coronary spasm testing capability to the region through Cleveland Clinic Abu Dhabi,” said Dr Ashraf Al Azzoni, staff physician, cardiovascular medicine in the Heart, Vascular and Thoracic Institute.

“While some treatments for microvascular dysfunction exist in the UAE today, this unique advanced programme provides new capabilities and the latest innovation in medical technology to ensure a specific diagnosis is provided to improve patients’ quality of life. Accurate diagnosis is then supported by effective treatment options that include medications and lifestyle changes to relieve symptoms and restore a good quality of life.”

A variety of disciplines form part of the programme, including interventional cardiology, women’s cardiology and cardiovascular imaging. The programme also draws on the expertise of a similar programme offered at Cleveland Clinic in the US.

Dr Shantouf added that if one is experiencing any unusual and recurring chest pains, they should immediately seek professional help from a specialist, specifically if they fall into any of the high-risk categories mentioned.

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