A middle-aged person is admitted to the emergency room with acute chest pains, which is later diagnosed as a massive heart attack. The same patient had a few months back complained of indigestion and pressure in his neck and teeth, but a routine angina showed no arterial blockage, so the problem was considered low-risk and non-cardiac in nature. But this time round, after more detailed evaluation, he was diagnosed with nonobstructive coronary artery disease (CAD), which according to a new study can increase the risk of chronic cardiac conditions like heart attacks by 28 to 44 percent.

The study, which will be presented Wednesday at the American Heart Association's Quality of Care and Outcomes Research 2014 Scientific Sessions, highlights the risk of heart diseases that occur without coronary plaque build-up. Generally, plaque buildup that leads to arterial blockages is considered to be the primary cause of coronary diseases. But in case of nonobstructive CAD, there may be no blockage or partial blockage. In case of partial blockage, the arteries still supply blood to the heart but not as much as it needs to function efficiently.

The endothelial cells that line the insides of arteries may get damaged and result in this condition. The study tracked 40,872 veterans, who underwent elective cardiac angiography from October 2007 to September 2012. The patients' condition was categorized as normal, nonobstructive, and obstructive CAD. The researchers found that the rates of heart attack and death within one year following angiography increased progressively with increasing CAD severity, even among those patients with nonobstructive CAD.

In a press release, Dr. Thomas M. Maddox, the study's lead researcher, a cardiologist for the VA Eastern Colorado Health Care System, and associate professor of medicine at the University of Colorado School of Medicine in Denver said:

Unlike obstructive CAD, which blocks blood flow, non-obstructive CAD may initially appear less threatening on angiography tests since it doesn't result in decreased blood flow, but it appears to have significant risk for heart attack and death. Dismissing non-obstructive CAD as harmless could be dangerous. Our findings show there is indeed a risk, that non-obstructive damage can lead to heart attacks just like obstructive disease, and that we should consider preventive therapies for these patients.

Patients with non-obstructive CAD should make significant changes in their lifestyle to take care of their heart. These changes, according to the American Heart Association include:

· Physical Exercise

· Proper nutrition

· Stress management

· Weight management

· Quitting smoking

· Workplace wellness

Taking preventive medications such as statins and aspirins is also recommended.

Source: Maddox TM et al. American Heart Association's Quality of Care and Outcomes Research 2014 Scientific Sessions. 2014.