Kettering Health now has CoroFlow, a minimally invasive diagnostic tool for detecting microvascular coronary artery disease. 

When patients present with chest pain, lightheadedness, and other symptoms of coronary artery disease, Dr. Damian Valencia, a cardiologist, explains that an EKG is typically ordered, followed by an echocardiogram. If that is abnormal, a stress test is performed, followed by a heart catheterization to identify heart blockages. 

“Heart cath is usually the end of the line,” Dr. Valencia shares. “There’s nothing else. The issue with this is that you can’t diagnose microvascular coronary artery disease with just a heart cath.” 

The truth is, one in four patients who experience vascular symptoms but have a clean heart cath actually have microvascular disease. 

How CoroFlow works

Typical heart catheters only examine the main coronary arteries—about 10% of all coronary arteries. 

“If you think of the coronary arteries like a tree,” Dr. Valencia says, “we only look at the tree trunk and the main branches when we do a heart cath. In reality, that tree has thousands of branches.” 

CoroFlow allows us to see the other 90% of arteries. Cold saline is injected into the heart through a tube inserted at the wrist. Then, a stress test is used to induce symptoms in the heart. 

“We see how fast the cold saline runs through the arteries. Even though we can’t see the arteries, we have a wire that can tell us how fast the saline is moving,” Dr. Valencia says. “If it’s moving too slow, we know there is a blockage.” 

Patients are under moderate conscious sedation, and the procedure takes about half an hour. 

Understanding microvascular disease

Dr. Valencia knows how frustrating it can be for those who repeatedly come in with chest pain and shortness of breath but can’t get a formal cardiovascular disease diagnosis. Microvascular disease predominantly affects younger populations, specifically women aged 20 to 40. 

“Microvascular disease, for the last 100 years, was thought to be fake,” he says. “People were told that they have anxiety. They are told nothing is wrong.” 

Those with blockages in the micro arteries are at the same level of risk for heart attack and heart failure as those with blockages in the main arteries. They continue to experience mini heart attacks, which build up scar tissue in the heart over time and cause permanent damage. 

With CoroFlow, we can now diagnose microvascular disease and properly treat it to prevent heart failure.