A new medical study has found that a specialized MRI testing protocol can accurately identify patients suffering from heart-related chest pain — even when their main coronary arteries appear normal in routine angiography scans.
During a traditional coronary angiography, patients are injected with a dye that helps doctors trace blood flow through the arteries leading to the heart, identifying blockages in larger vessels.
However, many patients continue to experience angina (chest pain) despite normal test results, suggesting that smaller blood vessels may be affected.
“People may suffer from angina even when their arteries appear to be normally open,” said Dr. Colin Perry, lead author of the study and a researcher at the University of Glasgow.
“When the angiography result is negative, doctors should consider performing MRI scans to monitor blood flow during physical stress — particularly in women, who are more prone to small-vessel angina that often goes undetected.”
Perry explained that by measuring blood flow using cardiac MRI, the research team was able to uncover the prevalence of small vessel disease, a condition that can cause chest pain even without blockages in the main arteries.
The study involved 250 adults who reported chest pain but showed no major coronary artery obstruction. Conducted by Perry’s team and presented at the American Heart Association’s Scientific Sessions in New Orleans, the research divided participants into two groups.
One group’s diagnosis and treatment were guided by the cardiac stress MRI results, while the other group relied solely on standard angiography findings, with MRI results withheld.
The results were striking: after reviewing the cardiac MRI images, doctors diagnosed angina in about half of the participants — compared with less than one percent identified through routine testing alone. More than half of those diagnosed were women.
“Our study opens a new path for those suffering from chest pain,” Perry said. “It’s time to update clinical testing protocols to include cardiac stress MRI as a standard tool, especially for women experiencing chest pain without detectable blockages in the main arteries.”
