Episode 58: Provocative Testing for Myocardial Bridges and Effect on the Heart. Encore Edition.
This is an encore episode as I believe we cannot stress the significance enough for this type of testing to confirm the effects of a myocardial bridge on the patient. The more that's known, the more likely it is that the proper course of treatment can be taken. If you missed it the first time, don't miss it this time. This is a must listen episode.
Unlock the secrets of properly understanding and diagnosing myocardial bridges with insight from Dr. Jeffrey Fowler, a leading interventional cardiologist at University of Pittsburgh Medical Center. Our conversation promises to illuminate the often perplexing process of diagnosing these cardiac anomalies and their impact on heart function. Through the lens of minimally invasive procedures and advanced imaging techniques like coronary CT angiograms, Dr. Fowler demystifies why myocardial bridges are not always the main culprits behind chest pain and the definitive testing now being done to ascertain the significance of the myocardial bridge.
We're going to explore the intricate world of invasive testing, as we detail the provocative testing process used to evaluate myocardial bridges, their severity and their contribution to angina, or chest pain. Dr. Fowler explains how starting with an empiric trial of medications can lead to more invasive procedures like heart catheterization if necessary. Learn about the steps of the provocative test and the role of acetylcholine in testing for endothelial dysfunction and vasospasm, with reassurances about the safety and reversibility of these tests. This episode is our first on the detail and best practice for diagnosis of the bridge through the provocative test we've heard so much about. It's meant for the education and knowledge for both patients and professionals, enhancing understanding of the nuanced approaches in relatively rare process of diagnosis.
Celebrate the spirit of collaboration among cardiology experts as Dr. Fowler shares the necessity of communication and advice. He's consulted with many others along the way including Dr. Shaw at Yale and Dr. Tremmell at Stanford, highlighting real-world case studies like that of patient David Vollmer. Join me in this compelling narrative of breakthroughs and dedication in the realm of cardiac care, and discover how ongoing advancements promise a brighter future for patients everywhere.
You can email Dr. Fowler directly at: fowlerja@upmc.edu
To reach Dr. Fowler call 412-647-6000 and ask for him specifically. Or you can visit the hospital website HERE
You can learn more about the Microvascular Network in the link HERE
Chapter Summaries:
(00:00) Understanding Myocardial Bridge Diagnosis Process
Interventional cardiologist explains use of coronary CT angiogram to detect and manage myocardial bridges in chest pain cases.
(10:04) Invasive Testing for Heart Conditions
Diagnosing and treating myocardial bridges through coronary CTA and provocative testing, including an empiric trial of medications and invasive procedures.
(22:05) Collaboration in Myocardial Bridge Diagnosis
Leading cardiologists collaborate to refine best practices for treating myocardial bridges, using personalized approaches and expert insights.
(27:47) Imaging and Diagnosis of Myocardial Bridge
Acetylcholine, dobutamine, cold saline, and adenosine are used to assess endothelial and microvascular function in chest pain and exertional symptoms.
(37:07) Complex Testing and Treatment Options
Evaluating myocardial bridges using diagnostic tests to guide surgical interventions, while balancing personal wellness in a high-stakes medical career.
(49:16) Cardiac Surgeon Discusses Myocardial Bridges
Dr. Bonnati's unroofing procedure for David at UPMC, with insights from Dr. Fowler and upcoming perspectives from Dr. Bonatti, enriched by David's journey.
