Sarena La

What are the NOCA Syndromes?

Angina is the term used for chest pain or discomfort due to myocardial ischaemia (inadequate supply of blood and oxygen to the myocardium). This usually arises from build up of plaque (atherosclerosis) in the coronary arteries which results in a demand-supply mismatch of oxygen. Those with atherosclerotic blockages are diagnosed with coronary artery disease (CAD), which is the leading cause of death globally. 

However, the term NOCA Syndrome describes patients with chest pain but non-obstructive coronary arteries. These disorders include the chronic form ANOCA (Angina with Non-Obstructive Coronary Arteries) and the acute form MINOCA (Myocardial Infarction with Non-Obstructive Coronary Arteries). The chest pain these patients experience still arises from myocardial ischaemia, but from conditions other than CAD, such as coronary vasomotor disorders (i.e. vasospastic angina or coronary microvascular dysfunction). Due to the absence of CAD, those with NOCA are often overlooked clinically and are often discharged with 'non-cardiac chest pain' despite the possibility of having underlying coronary vasomotor disorders. This issue can be seen around the world, as reflected by the International Heart Spasms Alliance which is a global NOCA patient-led advocacy group. 

The NOCA Syndromes may afflict up to 15,000 Australians each year, and although research on this topic has recently gained rapid interest, there remain large gaps in knowledge on these NOCA patients. Our group is recognised as an international leader in this field.

Sarena is available to supervise undergraduate and honours students.