The experienced staff in the Mayo Clinic Chest Pain and Coronary Physiology Clinic treats patients with challenging chest pain syndromes. For many individuals, angina (chest pain) is an acute life-threatening situation. But for those who have survived one or more heart attacks or who have other heart conditions, chest pain or angina can be a chronic disease.
The Chest Pain and Coronary Physiology Clinic is structured to meet the needs of patients who have chest pain and who cannot be treated with standard approaches. The clinic uses a multidisciplinary approach to diagnose and treat chronic chest pain. The clinic is uniquely suited to treat patients with undiagnosed, complex or unresolved conditions. The staff in the clinic uses state-of-the-art diagnostic tools and participates in cutting-edge clinical trials.
Clinic physicians promptly involve, as needed, physicians with advanced training in cardiology, gastrointestinal medicine, pain and anesthesia, vascular medicine and women's health. These specialists collaborate to diagnose and determine the most appropriate treatment for each chest pain patient.
Patients who are evaluated and treated at the Chest Pain and Coronary Physiology Clinic usually fit within one of three profiles:
- Those with non-obstructive coronary artery disease (NOCAD) or normal coronary arteries who experience atypical chest pain. Such individuals are particularly important to identify so that they can begin preventive treatment for coronary artery disease.
- Those who have had a heart attack (previous myocardial infarction), angioplasty with or without a stent, or coronary artery bypass graft (CABG) and continue to have chest pain despite medical management
- Individuals with a complex cardiac history or known coronary artery disease who no longer can be treated with conventional angioplasty or cardiac surgery.
An evaluation in the Chest Pain Clinic may involve:
Comprehensive evaluation and testing — A comprehensive evaluation may include blood tests and other tests, including an ECG, chest X-ray, echocardiogram, angiogram or stress testing. Novel tests for vascular function and mental stress may also be included in an evaluation.
Patient education — A health care professional will guide each patient in making healthy lifestyle changes to help prevent or slow the progression of heart disease. Depending on the patient's unique needs, recommendations may include:
Risk assessment and management — Patients complete an extensive health history to pinpoint individual risk factors for heart disease and for other chest pain-related diseases. Patients may also be referred to the Cardiovascular Health Clinic.
Cutting-edge treatments, with research opportunities — Patients with chest pain may be treated with medications, surgery and other therapeutic options including spinal cord stimulation and enhanced external counterpulsation.
Read more about the comprehensive evaluation and treatment options for patients with chronic chest pain at Mayo Clinic.
Continuity of care
Continuity of care is important because the patient represents a complex system of organs and functions that are best viewed by a team of experts working together from a single, complete and reliable base of information.
Mayo Clinic maintains a single electronic medical record that follows the patient from appointment to appointment. Each physician works from the same medical record, which is continuously updated throughout the course of the patient's care, including through follow-up care. Following diagnosis, patients can continue to receive follow-up care in the Chest Pain Clinic.
Chest Pain Clinic patients have full access to Mayo Clinic's state-of-the-art diagnostic, therapeutic and surgical services for heart disease and any other conditions that may be discovered.
Depending on individual circumstance, the patient may be referred in coordinated fashion to other specialties within Mayo for additional testing and therapy including:
A dynamic research program keeps Mayo Clinic at the forefront of the latest advances in medicine. Physicians in the clinic are leaders in clinical research to better understand chest pain and develop new treatment options. Current research covers the full range of diagnostic and treatment advances in coronary artery disease, from new medications to the genetics of the disease. For more information about laboratory (basic science) research, see the Cardiovascular research Web pages.
Mayo Clinic patients regularly have the opportunity to lead and participate in research studies, giving them access to the most recent and emerging information on their conditions.
For more information about ongoing National Institutes of Health (NIH), American Heart Association (AHA) and industry clinical research trials, see Mayo's clinical trials. Patients in the Chest Pain Clinic may want to especially look for clinical trials related to ultrasound delivered to the damaged areas of the heart to promote vascular growth. A variety of trials are also ongoing that are studying causes and treatments of small vessels disease and vascular dysfunction, such as endothelial dysfunction and gene transfer. Some of the clinical trials being conducted in the Chest Pain Clinic may not be listed on the website. Patients should talk with their physicians about any clinical studies for which they might be eligible.
Patients may request an appointment for the Chest Pain and Coronary Physiology Clinic or be referred by their primary physician. To discuss availability and to have a nurse review the patient's medical history, call 507-255-4244.