An inflammation test that may predict cardiovascular disease

In 2010, Ingela Schnittger, MD, a cardiologist at the School of Medicine, sat in her lab examining the echocardiogram of a young man who came to the heart clinic at Stanford Health Care complaining of chest pain. She spotted a curious motion of the heart on the computer screen, one that she’d seen before while examining these kinds of diagnostic tests. “All of the sudden I had this flashback,” she said. She remembered a young physics professor at another institution who had suddenly dropped dead of a heart attack while running on a treadmill. During an autopsy, a little-known heart anomaly called a myocardial bridge was found. The term describes a condition in which a major artery runs through the muscle of the heart rather than resting on top of the organ. “I was thinking, ‘Wow, I wonder if this patient could have a myocardial bridge?’” she said. Six years later, Schnittger, professor of cardiovascular medicine, has co-authored four research studies on myocardial bridges. A fifth, published online Oct. 13 in the Annals of Thoracic Surgery, finds that a procedure called surgical unroofing is safe and provides significant relief for patients with myocardial bridges who have incapacitating symptoms, such as chest pain, arrhythmias and fatigue, that are not helped by medication alone. Schnittger is senior author of the study, and the lead author is Jack Boyd, MD, clinical assistant professor of cardiothoracic surgery. Myocardial bridging remains a mystery to much of the medical community. It’s a congenital anomaly that was discovered during autopsies almost 300 years ago, but it has long been considered benign, the study said. Bridging continues to be little understood and is often misdiagnosed, Boyd said. “It’s not taught in medical school, and there is no agreed-upon treatment,” he said. That lack of understanding about the condition is what sent Schnittger along her path of investigation. She wanted to know more: Could bridging be dangerous? Did it cause symptoms? How should it be treated? In 2011, Schnittger designed a study at Stanford to enroll patients with und i a g n o s e d Unroofing relieves symptoms of heart anomaly