Dr Aswin Babu

Coronary artery disease (CAD) is the leading cause of death worldwide and places a heavy burden on health services. While treatment has traditionally focused on the heartʼs large arteries, more than 90% of the heartʼs vessels are small.

Problems in these smaller vessels, known as coronary microvascular dysfunction (CMD), can cause symptoms, worsen outcomes and, after a heart attack, are linked with poorer recovery. CMD is common but difficult to detect.

Current tests are invasive, complex and costly, meaning many patients remain undiagnosed and untreated. This not only impacts health but also increases the burden on the health system.

Royal Perth Hospital has established WAʼs first and only CMD service, including a registry and invasive testing program. With new techniques such as continuous thermodilution and novel approaches in partnership with the University of Western Australia, the MicroSTREAM ACS study is advancing diagnosis and care.