Angina with Non-Obstructive Coronary Arteries (ANOCA) Program
Care for People with Chest Pain and Normal-Appearing Arteries
Persistent chest pain can be frustrating and confusing, especially when standard tests show no significant blockages in your major coronary arteries.
At Columbia, we understand these concerns and provide expert evaluation, advanced diagnostics, and personalized treatment for Angina with Non-Obstructive Coronary Arteries (ANOCA) and microvascular angina. Our multidisciplinary team is dedicated to finding the cause of your symptoms and improving your quality of life.
To schedule an appointment, please contact us at 212-326-8920. Telehealth services may be available.
Understanding Angina with Non-Obstructive Coronary Arteries (ANOCA)
Angina with Non-Obstructive Coronary Arteries (ANOCA) describes the presence of chest pain or discomfort (angina) even though coronary angiograms show no significant blockages in the coronary arteries. While the large arteries appear clear, the underlying cause of chest pain in ANOCA is often related to dysfunction in the smaller blood vessels of the heart (the microvasculature) or due to spasm of the larger coronary arteries.
Symptoms can include:
- Chest pain or discomfort (angina), which may feel like pressure, tightness, squeezing, or burning
- Shortness of breath
- Unusual fatigue
- Pain that radiates to the arm, shoulder, back, neck, or jaw
These symptoms can be triggered by physical exertion, emotional stress, or even occur at rest.
ANOCA is a real and often debilitating condition that can significantly impact a person's quality of life. It is more common than previously recognized, particularly in women, and requires a specialized diagnostic and treatment approach.
Our Services
Columbia is at the forefront of understanding and treating ANOCA. Our multidisciplinary team of cardiologists, researchers, and health professionals are dedicated to providing comprehensive, personalized care. We utilize advanced diagnostic techniques to accurately identify these conditions, including:
- Coronary Physiology Testing: State-of-the-art procedures performed in the cath lab to directly assess the function of your heart's blood vessels.
- Positron Emission Tomography (PET) Scans: Provides detailed quantitative information about myocardial blood flow at rest and during stress.
- Advanced Echocardiography: To evaluate heart function and exclude other causes of chest pain.
Once a diagnosis is made, our team develops an individualized treatment plan that may include:
- Medication Management: Tailored pharmacological therapies to improve blood flow, reduce symptoms, and manage risk factors.
- Lifestyle Modifications: Guidance on diet, exercise, stress management, and smoking cessation.
- Cardiac Rehabilitation: Supervised exercise and education programs to improve cardiovascular health.
- Emerging Therapies: Access to cutting-edge research and clinical trials for new treatment options.
What Specialists Will Be Part of my Care?
At Columbia, you’ll meet a team of specialists who work together to evaluate your symptoms, perform necessary tests, and design a treatment plan tailored to you. Each doctor brings unique expertise to your care:
General Cardiologist
A general (or Non-invasive) cardiologist can diagnose and treat many forms of heart disease. These doctors are patients' first point of contact and play an important role in managing heart health. When patients with heart disease can no longer manage their symptoms with medication and lifestyle changes, general cardiologists may refer them to interventional cardiologists for treatment. General cardiologists also work with the interventional care team to manage a patient's recovery and long-term heart health.
Interventional Cardiologist
An interventional cardiologist is trained to perform minimally invasive transcatheter procedures using a thin tube called a catheter inserted into an artery or vein to access and treat the heart and blood vessels. There are different subspecialties of interventional cardiologists, depending on what conditions they treat. Most transcatheter procedures are performed in a specialized facility called a catheterization laboratory, or cath lab for short.
Heart Failure Specialist
A heart failure specialist is a cardiologist with advanced training in treating patients whose hearts are not pumping as strongly as they should. They evaluate symptoms like shortness of breath, fatigue, or swelling and recommend tailored therapies. Their expertise is especially valuable when heart muscle weakness or stiffness contributes to chest pain or other cardiovascular symptoms.
Cardiac Imaging Specialist
A cardiac imaging specialist provides essential information for diagnosing heart problems and guiding interventional procedures. They use advanced imaging technologies like computed tomography (CT), echocardiography, and X-rays to create accurate images of the heart and blood vessels. Imaging specialists and interventional cardiologists work together to map out procedures in real time—without open surgery.
Our Team
Hannah Rosenblum, MD
Co-Director, ANOCA Care
Megha Prasad, MD, MS
Co-Director, ANOCA Care
Elissa Driggin, MD
Advanced Heart Failure, Transplant Cardiology, and Mechanical Circulatory Support Specialist
Highlights
A History of Cardiac Leadership
Columbia and its hospital partner NewYork-Presbyterian have a long history of excellence in cardiac care. We consistently rank as one of the top cardiac programs in the world, and we’ve pioneered multiple diagnostic and treatment innovations that have gone on to shape the standard of care.
A Multispecialty Approach to Care
At Columbia, ANOCA care brings together specialists across cardiology, including experts in heart failure, cardiovascular imaging, interventional cardiology, and general cardiology. Our team also collaborates with colleagues in women’s heart health, preventive cardiology, and other subspecialties to provide a comprehensive approach to diagnosis and treatment.
Columbia Virtual Visits
For some appointments, it may not be necessary to come into the office at all. We offer Virtual Visit telehealth appointments, so you can see a member of our team from the comfort of your own home. When you contact us to make an appointment, we will work with you to determine if a Virtual Visit is right for you.
Our Location
Make an Appointment
If you or a loved one are experiencing persistent chest pain or have been diagnosed with ANOCA or microvascular disease, we encourage you to schedule a consultation with our experts. We are here to help you get an accurate diagnosis, find effective treatments, and improve your quality of life.
We accept most major insurance plans and can verify your plan when you call to make your appointment.
To learn more or to schedule an appointment, please contact us at 212-326-8920.