Quicker and less-invasive diagnosis with HeartFlow

Diagnosing a blocked or narrowed artery usually involves an invasive procedure called a coronary angiogram. But St Joseph’s Hospital in Newport has become the first in Wales to use a state-of-the-art computer test which eliminates the need for patients to be cut open.

According to research by the British Heart Foundation, an estimated 121,000 people in Wales are living with coronary heart disease.

The disease, which is caused by narrowing of the arteries, is the country’s single biggest killer, claiming the lives of more than one in seven men and almost one in 10 women.

Until recently, the most accurate way to diagnose narrowing and blockages in the arteries was through a coronary angiogram carried out in a hospital X-ray or radiology department.

This involves a thin, flexible tube being inserted into an artery in the wrist or groin through a small incision.

The tube is then fed through to the heart, a dye is introduced through the tube into the blood stream and X-rays are taken as the dye is pumped around the body.

Coronary angiogram is usually safe and painless, but as an invasive procedure it does come with some risks.

And a large proportion of patients who go for an angiogram don’t need further treatment, meaning that they have this invasive procedure unnecessarily.

HeartFlow is a computer-based diagnostic tool specifically designed to address this issue.

It uses data collected during a standard CT scan to create a personalised, digital model of the arteries and uses computer algorithms to assess the impact that blockages have on blood flow.

This allows consultants to determine whether obstructions within the coronary arteries are causing a significant blockage, or whether the narrowing is less critical and does not require intervention.

St Joseph’s Hospital in Newport is the first in Wales, and one of only a handful in the UK, to have access to this state-of-the-art technology.

Colin Thomas, 66, was one of the first patients at St Joseph’s to have a diagnosis using HeartFlow.

Colin was diagnosed with angina, a symptom of coronary heart disease, four years ago and has managed his condition through medication, healthy eating and exercise.

When he noticed his symptoms getting worse, Colin made the decision to visit his local GP and was referred to a consultant at St Joseph’s Hospital to find out whether he needed further treatment.

Colin said: “In July I started to experience difficulty with anything that involved physical exertion – even simple things like taking a shower or going up stairs left me feeling breathless and I was feeling generally tired and drained throughout the day.

“Given my previous diagnosis of angina I was worried that the narrowing of my arteries might have become worse, and went to see my local GP who referred me to Dr Campbell at the Cardiology Centre of Excellence at St Joseph’s Hospital.

“I was seen within a week of referral. We discussed my previous diagnosis and the change in my symptoms, and Dr Campbell suggested that I go for a routine CT scan of my heart initially to identify any areas of concern.

“This found some problem areas, but in order to get the right diagnosis to determine what treatment would be necessary, Dr Campbell needed to find out the flow rate of blood through my heart.

“When I was originally diagnosed with angina I had my flow rate measured through a coronary angiogram and expected the process to be the same, so when Dr Campbell suggested sending my CT results for HeartFlow analysis instead I agreed right away.

“The HeartFlow team in the US sent back a colour-coded map of my heart showing where flow was restricted and, within about 10 days, Dr Campbell made an appointment to explain the results to me and discuss options for treatment.

“HeartFlow had identified some areas where flow was restricted and one area that had become completely blocked since my original angiogram. There was definitely some change since my initial diagnosis, so it was reassuring to get such an accurate report without the risk of having invasive treatment.

“Opting for the HeartFlow analysis made getting the diagnosis much quicker and easier than the first time.

“Angiograms involve more appointments and trips to hospital and, after my last one, I was also unable to drive for 48 hours.

“I try to lead an active life and I work full-time so avoiding the hassle of extra hospital appointments and taking further time off work was a huge benefit for me.

“Other health issues have delayed following up on the HeartFlow results, however I’m going to be meeting with Dr Campbell soon to discuss the plans for my treatment in more detail.

“I used to try to go swimming almost every day and I miss being active so I’m looking forward to getting back into my exercise routine after I have my procedure.”

Dr James Cullen is a consultant cardiologist at St Joseph’s Hospital. He was involved in the introduction of the technology to patients as an alternative diagnostic tool.

He said: “The HeartFlow Analysis is the only available technology that provides the certainty of an invasive test with the convenience of a noninvasive test in one platform.

“HeartFlow is also a cheaper alternative to coronary angiogram, meaning that it saves both time and money for patients and healthcare providers.

“This technology is leading the way in cardiac diagnosis and I expect to see it being adopted by more centres in the future, but it is fantastic to see St Joseph’s leading the way by being one of the first hospitals to offer it in the UK.”