Find Answers for Chest Pain with CMD Testing at Chesapeake Regional

Your Chest Pain Is Real: Why a "Normal" Test Doesn't Always Mean You're Fine

Bios: This article is informed by the expertise of the cardiology team at Chesapeake Regional Healthcare, including Dr. Buch, the primary operator for the region's first coronary microvascular dysfunction (CMD) study. Our specialists are dedicated to bringing innovative diagnostic and treatment options to our community.

Key Takeaways:

• Identify the Real Problem: If you have chest pain but your angiograms are "clear," coronary microvascular dysfunction (CMD) could be the cause. This condition affects the heart's smallest arteries and is often overlooked by standard tests.
• Demand a Definitive Diagnosis: Chesapeake Regional now offers advanced coronary function testing, the first non-academic health system in Virginia or North Carolina to do so. This test formally diagnoses or rules out CMD, ending the cycle of repeated, inconclusive procedures.
• Get Treatment That Works: A CMD diagnosis allows your doctor to move beyond guesswork. It enables a targeted plan using medications and lifestyle changes that are proven to relieve angina and improve outcomes.
• Advovate for Your Health: Many patients, particularly women, have their symptoms dismissed. Understanding CMD empowers you to have more productive conversations with your physician and finally get the care you deserve.

Solve the Mystery of Your Undiagnosed Chest Pain

It's a deeply frustrating experience: you live with recurring chest pain, you undergo invasive tests, and a doctor tells you that your heart's main arteries are clear. While the news seems good, the symptoms persist, leaving you in a cycle of worry and uncertainty. If this sounds familiar, you are not alone. Approximately 20% to 30% of patients who have a cardiac catheterization for angina—a type of chest pain caused by reduced blood flow to the heart—are found to have no significant blockages. For years, these individuals were often left without a clear diagnosis or effective treatment plan. Many, especially women, have had their symptoms dismissed entirely. At Chesapeake Regional Healthcare, we are putting an end to this diagnostic odyssey. We are proud to be the first in our region, and the only non-academic health system in Virginia or North Carolina, to perform a coronary microvascular dysfunction (CMD) study. This innovative test provides definitive answers by looking beyond the large arteries to assess the tiny vessels that are often the true source of the problem, paving the way for targeted, effective relief.

Understand Why Standard Tests Fall Short

When you experience chest pain, a standard cardiac catheterization, or angiogram, is the go-to tool for finding the cause. This imaging test is excellent at identifying blockages in the large coronary arteries that supply blood to the heart. However, it cannot see the heart's vast network of tiny vessels, known as the microvasculature. Coronary microvascular dysfunction occurs when these small vessels fail to dilate properly, restricting blood flow and causing angina, even when the main arteries are wide open. Because a standard angiogram doesn't visualize these vessels, the results come back "normal," leading to a dead end. Patients are sometimes told their pain isn't heart-related or are given medications based on "semi-educated guesswork." This lack of a formal diagnosis leaves a significant number of people without a clear path forward to manage their very real and often debilitating symptoms.

Break the Cycle of Unnecessary Testing and Uncertainty

Without a proper diagnosis, patients with CMD often find themselves on a stressful and costly medical merry-go-round. Every episode of chest pain can lead to another emergency room visit, another stress test, and another cardiac catheterization. It's not uncommon for a person to undergo three to five catheterizations before CMD is even considered, and some have had as many as 15. This cycle takes a tremendous emotional and physical toll. 

The coronary function testing now available at Chesapeake Regional acts as a crucial circuit breaker. By precisely measuring blood flow and resistance in the small vessels, we can formally diagnose CMD. Alternatively, if the test results are completely normal, we can confidently state that the chest pain does not have a cardiac cause. This allows you and your care team to focus on finding the real source of the symptoms, providing peace of mind and putting an end to repetitive and inconclusive heart procedures.

Recognize How CMD Disproportionately Affects Women

Symptomatic coronary microvascular disease has a known female preponderance, meaning it occurs more often in women. Compounding this, women's heart-related symptoms have historically been more likely to be dismissed or misattributed to other causes like anxiety or stress. A formal CMD diagnosis provides concrete, physiological evidence that validates a patient's experience. It shifts the conversation from "we can't find anything wrong" to "now we know what's wrong, and here is how we can treat it." This is a powerful step forward in providing equitable cardiac care. With a definitive diagnosis, patients are better equipped to advocate for themselves and engage in building a treatment plan that addresses the root cause of their symptoms, ensuring their concerns are taken seriously.

Embrace a Proven Path to Feeling Better

While the concept of CMD was first noted decades ago, a recent surge in interest is thanks to more user-friendly technology and, most importantly, compelling clinical trial data. Major studies, like the CorMicA trial, have shown that using coronary function testing to guide medical therapy leads to significantly better angina relief compared to the traditional approach of guessing the cause. Once CMD is diagnosed, treatment is no longer empirical. Instead, it involves a tailored, evidence-based strategy that may include lifestyle adjustments, strict control of cardiovascular risk factors like high blood pressure and cholesterol, and specific medications such as statins, ACE inhibitors, beta-blockers, and calcium channel blockers. Research confirms that this targeted approach results in a significant improvement in angina severity and better overall outcomes, allowing patients to regain their quality of life.

Take Control of Your Heart Health

Living with unexplained chest pain is not something you have to accept. A "normal" test result on an angiogram no longer has to be the end of the road. Coronary microvascular dysfunction is a real, treatable condition, and the key to getting better starts with getting the right diagnosis. The advanced coronary function testing available at Chesapeake Regional Healthcare provides the clarity that has been missing for so many patients in our community.

This innovative study ends the frustrating cycle of repetitive testing, validates your symptoms with a formal diagnosis, and opens the door to proven therapies that can dramatically improve your life. By bringing this state-of-the-art technology to Hampton Roads, we are empowering you to move from uncertainty to action. You can finally get the answers you need and a personalized care plan to manage your heart health confidently and effectively. Don't let your symptoms be dismissed. Let us help you find the solution.

Schedule a consultation with our cardiology team to learn if CMD testing is right for you. Call 757-312-4047.

FAQ:

What is coronary microvascular dysfunction (CMD)?

CMD is a heart condition where the heart's smallest arteries do not function correctly. They fail to expand to allow adequate blood flow, which causes chest pain (angina) even when the main coronary arteries are clear of blockages.

Why doesn't a normal angiogram or cardiac cath detect CMD?

A standard angiogram is designed to visualize the large coronary arteries and can only detect significant plaque buildups or blockages in those vessels. It cannot assess the function or health of the much smaller micro-vessels, which is where CMD occurs.

Who is most at risk for chest pain with no blockage?

While it can affect anyone, symptomatic coronary microvascular disease is more common in women. Patients with traditional cardiovascular risk factors like diabetes, high blood pressure, and high cholesterol are also at increased risk.

How does the CMD test at Chesapeake Regional lead to better treatment?

The test provides a definitive diagnosis. Clinical trials have shown that when doctors use this diagnostic information to select specific medications and therapies tailored to the patient's condition, patients experience significantly better relief from their angina symptoms compared to treatments based on guesswork.

What should I do if I think I have CMD but my doctor dismissed my chest pain?

If you continue to have symptoms despite "normal" tests, it is important to advocate for yourself. Consider seeking a second opinion from a cardiologist or a center, like Chesapeake Regional, that specializes in advanced cardiac diagnostics like coronary function testing. A formal diagnosis can validate your experience.

Are there effective treatments for coronary microvascular dysfunction?

Yes. Treatment focuses on a combination of lifestyle changes, managing risk factors, and medications designed to improve blood flow and reduce symptoms. These can include statins, ACE inhibitors, beta-blockers, and calcium channel blockers.

Why is Chesapeake Regional the best place to get tested for CMD?

Chesapeake Regional is the only non-academic health system in Virginia or North Carolina offering this advanced coronary function study. Our specialized team uses the latest technology to provide a definitive diagnosis, ending the cycle of uncertainty for patients with undiagnosed chest pain.