Talking Tall Rounds®: Ischemia with No Obstructive Arteries

Announcer:

Welcome to the Talking Tall Rounds series, brought to you by the Sydell and Arnold Miller Family Heart, Vascular & Thoracic Institute at Cleveland Clinic.

Khaled Ziada, MD:

Good morning. I'm Khaled Ziada. I am one of the interventional cardiologists at the Cleveland Clinic and the co-director of the Coronary Artery Disease Center.

Today I want to talk about a subject that I'm very interested in, which is ischemia with no obstructed coronary arteries or INOCA. INOCA is a condition that we see a lot more of now than before. We're much more aware of it than before. There are patients who have ischemia but don't necessarily have the obstructed disease in the large arteries that we are used to seeing. Many of those patients are women, that's one of the reason why sometimes we see under-diagnosis of coronary artery disease in women.

There's a lot of advances in the field of INOCA. There's a lot of advances in the non-invasive testing and diagnosis using PET scanning and MRI. But there's also a lot of advances in the diagnosis in the cath lab, using invasive procedures.

We at the Clinic are very keen on offering this service to patients, and we are getting a lot of referrals for patients who had had this problem and are not aware of their diagnosis. When we go to the cath lab and identify the issues, whether they are increase in microvascular resistance or whether they are caused by coronary spasm, and sometimes we find this problem in patients who have myocardial bridges. It is very satisfying to the patients when they know that their symptoms are related to a specific diagnosis. And in addition, by identifying the problem, we can offer the appropriate treatment.

Announcer:

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