‘Better diagnosis of chest pain in women’
Healthcare is under great pressure during the corona crisis. Fortunately, there are also hopeful developments for all kinds of patients. What new treatments are medical specialists looking forward to in 2022?
Janneke Wittekoek is a cardiologist, specialized in the female heart. She is director of the HeartLife Clinic in Utrecht.
Cardiologist Janneke Wittekoek is downright ‘joyful’ about a new heart function test that can identify the cause of unexplained chest pain. This so-called spasm provocation test is mainly done on women and focuses on the small blood vessels around the heart. “I notice that more and more cardiologists see the benefit of it.”
Symptoms in women are different than in men
It has been clear for some time that the symptoms of a heart problem are often different in women than in men. A possible cause is that the small blood vessels in them do not widen sufficiently when necessary, for example during exercise. Until recently, this was difficult for a doctor to clarify. “With the spasm provocation test, which I revived two years ago together with Professor Piek at the Amsterdam UMC, we can now determine the diagnosis much better.”
The examination begins with a cardiac catheterization. The doctor visualizes the blood vessels of the heart via a thin wire containing a contrast medium. A vasoconstriction thus becomes visible. In two-thirds of the women who have this test, no abnormalities are found in the large blood vessels around the heart. The cardiologist can then do the spasm provocation test with them: a pungent substance is injected into the thread that causes the blood vessels to constrict in someone with a vascular dysfunction. This causes the characteristic chest pain. “During the test, we can see whether the large or small blood vessels are cramping, so that we can prescribe the right medication.”
Previously, a vascular dysfunction was determined on the basis of the patient’s complaints, the risk of cardiovascular disease and a favorable response to a trial treatment with drugs. “With the spasm provocation test you can tailor the medication even more. In addition, the tests provide a wealth of information, which allows us to further develop the test. For example, care is improving, especially for women with unexplained chest pain.”
Women who think this might be for them should discuss it with their cardiologist, says Wittekoek. “It’s not a simple test,” she warns. “But if the cause of persistent chest pain cannot be found, this study may be a solution.”
This article previously appeared in Plus Magazine January 2022. Want to subscribe to the magazine? You can do that in an instant!
Sources):
- Plus Magazine
