For heart attacks with clear arteries, does personalized treatment help? New trial shows it improves chest pain.

Imagine having a heart attack, but doctors tell you your heart's arteries aren't blocked. This confusing condition, called MINOCA, leaves many patients struggling with chest pain and a high risk of future hospital visits, with no proven treatment plan. For the first time, a randomized trial tested a new approach. Instead of a one-size-fits-all treatment, doctors gave some patients a comprehensive workup to find the specific cause of their heart attack, then tailored their therapy. After one year, patients who received this personalized treatment reported significantly better chest pain symptoms and quality of life than those who got standard care. The trial was stopped early because the benefits for the personalized group were so clear, and there was concern the standard care group might be at a disadvantage. While the study was small, it provides the first solid evidence that finding and treating the root cause matters for people with this often-misunderstood heart condition.