New tool can help diagnose heart disease

If you go to the hospital with chest pain, you’ll likely have a procedure called cardiac catheterization to check the arteries that supply blood to your heart.

During the procedure, a thin, hollow tube called a catheter is inserted into a large blood vessel that leads near your heart. Doctors take X-rays using a contrast dye injected through the catheter to look for any narrowed or blocked coronary arteries.

However, sometimes that process can’t tell doctors everything they need to know. The X-ray images are static, 2D and black and white, which can make it difficult to determine the extent of a blockage.

Many patients then have a second — and more invasive and risky — procedure in which a catheter is placed directly inside a coronary artery. Once there, the catheter measures pressure and blood flow within the artery. These measurements confirm how serious the blockage is, and whether a heart stent — a tiny wire mesh tube that props open an artery — is needed. This invasive procedure requires injection vasodialator drugs, which carry some side effects.

Sharp Memorial Hospital is the first hospital in San Diego to use a new digital tool to diagnose blockages in the heart without needing to perform the second invasive procedure. The system analyzes the initial X-ray images of the heart, then uses special algorithms to create a comprehensive 3D, color-coded model of a patient’s coronary arteries.

Within minutes, the system also calculates pressure and blood flow throughout all of the coronary arteries, letting doctors know just how serious the blockages are.

The technology, developed by CathWorks, received U.S. Food and Drug Administration (FDA) approval in late 2018 following a large, international clinical trial that showed the new system was just as accurate at identifying blockages as measurements directly taken from the coronary artery. The study also found that nearly one-third of patients who were initially thought to need a heart stent — based on their X-rays alone — did not need one.

“The technology helps doctors make the correct decision in how to treat coronary artery disease,” says Dr. Raghava Gollapudi, medical director of interventional cardiology at Sharp Memorial Hospital. “And the new system eliminates any possibility of complications for patients who no longer need to undergo that second procedure.”

The second procedure also requires significant time and resources, he says, including procedural rooms with advanced equipment and the need for specially trained clinicians. Patients need to take special medications such as blood thinners, and catheters must be placed inside the coronary arteries one by one in order to take accurate measurements.

“This new system is quicker, safer and just as accurate,” Gollapudi says. “Ultimately, that’s what’s best for our patients.”

Chest pain can be serious. Always seek emergency care right away if you think you're having a heart attack.

For the news media: To talk with Dr. Gollapudi about the CathWorks system for an upcoming story, contact Erica Carlson, senior public relations specialist, at erica.carlson@sharp.com.