Patients experiencing chest pain may receive more accurate diagnoses and better treatment outcomes when stress cardiac MRI testing is incorporated into their care, according to research presented at the American Heart Association's Scientific Sessions 2025. The findings indicate that traditional coronary angiography alone may miss significant heart conditions in approximately half of patients presenting with chest pain.
The CorCMR trial enrolled 250 adults with chest pain who had previously undergone coronary angiography showing no obstructive coronary artery disease. All participants received stress cardiac MRI testing, but only half of the patients and their physicians had access to the results for diagnosis and treatment decisions. The study revealed that about 53% of participants received changed diagnoses after stress cardiac MRI testing, with approximately half showing evidence of microvascular angina affecting small heart vessels.
When physicians reviewed stress cardiac MRI images, they diagnosed microvascular angina in about one in two participants, compared to fewer than one in one hundred when relying solely on angiogram tests. More than half of those diagnosed with microvascular angina were women, highlighting the particular importance of this testing approach for female patients. The American Heart Association's health information on Angina (Chest Pain) provides additional context for understanding these conditions.
Quality of life outcomes demonstrated substantial improvements in the group where stress cardiac MRI results guided treatment. Participants in this group showed average improvements of 18 points at six months and 22 points at one year on the Seattle Angina Questionnaire, which assesses physical limitations, chest pain frequency and severity, and quality of life measures. In contrast, the angiogram-guided group improved by less than one point. The difference between groups increased to approximately 21 points after one year of follow-up.
Study author Colin Berry, professor of cardiology at the University of Glasgow, emphasized the clinical implications. "Our findings show that an angiogram alone is not always enough to explain chest pain. A functional test of blood flow should be considered before sending people home, especially women, who are more likely to have small vessel angina that otherwise goes unrecognized." The research abstract is available through the American Heart Association Scientific Sessions 2025 Online Program Planner.
The study's importance extends beyond diagnostic accuracy to addressing a significant public health concern. Chest pain represents the second most common reason adults visit hospital emergency departments in the United States, accounting for more than 6.5 million visits annually according to the American Heart Association's Heart Disease and Stroke Statistics – 2025 Update. With nearly four million outpatient visits for chest pain each year, improved diagnostic approaches could substantially impact healthcare utilization and patient outcomes.
No participants experienced serious side effects from stress cardiac MRI screening, and there were no deaths during the year-long follow-up period. The study was coordinated by an independent clinical trials unit with data analyzed by a blinded statistician to minimize bias. While the findings are considered preliminary until published in a peer-reviewed journal, they suggest potential for significant changes in clinical practice guidelines for angina evaluation and management.
