Causes
How We Can Help You
When caring for symptoms like chest pain, our doctors know when to look beyond the blocked arteries that define obstructive coronary artery disease (CAD). They recognize that your heart’s arteries sometimes suffer from non-obstructive coronary artery disease.
This less common form of CAD occurs when your heart’s arteries inappropriately constrict, malfunction after branching into tiny vessels, or are squeezed by the overlying heart muscle. While much work remains to fully understand non-obstructive coronary artery disease, our doctors lead the way in providing answers through ongoing research to improve diagnosis and treatment.
We treat non-obstructive coronary artery disease through the Interventional Cardiology Program.
WHAT WE OFFER YOU FOR NON-OBSTRUCTIVE CORONARY ARTERY DISEASE
- Nationally recognized expertise in non-obstructive coronary artery disease, with one of the country’s most comprehensive programs.
- Advanced diagnostic testing for those with chest pain but no blockages, including testing for endothelial dysfunction, microvascular dysfunction, and myocardial bridging.
- Team-based care that bring together specialists from interventional cardiology, cardiac surgery, and imaging.
- Comprehensive treatment options, including lifestyle changes, medication, minimally invasive options, and surgery.
- Care tailored to the needs of women and men, who often experience heart disease differently. Our program is one of the few able to provide this level of care.
- Extensive lifestyle support to lower stress, improve diet, and promote health. Our psychological support program for heart care is one of the nation’s largest.
- Active clinical research into new diagnostic and treatment approaches. Our program continues to provide much of the data validating today’s treatment options.
INTERESTED IN AN ONLINE SECOND OPINION?
The Stanford Medicine Online Second Opinion program offers you easy access to our world-class doctors. It’s all done remotely and you don’t have to visit our hospital or one of our clinics for this service. You don’t even need to leave home!
Visit our online second opinion page to learn more.
What Is Non-Obstructive Coronary Artery Disease?
Treatment for Non-Obstructive Coronary Disease
Treatment for non-obstructive coronary disease depends on the type of disease you have:
- Endothelial dysfunction is a problem with the lining inside the artery causing inappropriate constriction.
- Coronary vasospasm (Prinzmetal’s angina) is a constriction due to the smooth muscle cells.
- Microvascular dysfunction is a malfunction of the small branches of the coronary arteries.
- Myocardial bridging is a congenital variant in which overlying heart muscle squeezes an artery. Myocardial bridges are common and most cause no problems, but some can cause chest pain and arrhythmia.
DID YOU KNOW?
Non-obstructive coronary artery disease affects women more frequently than men. Stanford’s Women’s Heart Health Clinic offers the specialty care women need.
Our doctors use the most effective and current approaches. We listen to your concerns and evaluate your entire coronary circulation. Our doctors test until they find the cause of your chest pain or other symptoms, and work with you to develop a treatment plan, which may include one or a combination of the following:
Lifestyle Changes
Lifestyle changes to control risk factors may provide appropriate treatment if non-obstructive coronary artery disease is caused by endothelial or microvascular dysfunction. Our team of psychologists, dieticians, and other specialized heart care staff will support you in adopting a heart-healthy lifestyle.
Medications
Most people with non-obstructive coronary artery disease will need medical therapy to improve their symptoms. Our doctors may recommend medication alone, or in combination with stress reduction and other lifestyle changes.
Surgery
Surgery is an option for myocardial bridging, offered only as needed when medications fail. During a special operation called unroofing, our surgeons remove the heart muscle sitting over the artery. They use a detailed map, created during a cardiac catheterization, that shows the precise location of the bridge. Our surgeons have completed the most unroofing surgeries in the country.
Clinical Trials
Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest, advanced clinical trials.
Open trials refer to studies currently recruiting participants or that may recruit participants in the near future. Closed trials are not currently enrolling, but similar studies may open in the future.
Frequently Asked Questions
We participate in a wide range of insurance plans. View the list of insurance plans accepted by Stanford Health Care »
Have insurance or pre-authorization questions? The Patient Financial Clearance team is available Monday – Friday, 8 a.m. – 5 p.m., to answer your questions. Please call 650-724-4445 or 1-877-291-7335 (toll free).
When choosing a doctor, it is important to consider the doctor’s clinical training, experience, and expertise in a specialized area that matches your health care needs.
You can find the right Stanford doctor for you by using our doctor directory and filtering the results based on a medical category, specialty, or doctor’s last name. View a list of Interventional Cardiology doctors »
We offer a number of support services at the Heart and Vascular Center, including a Lifestyle Modification program, support groups, integrative medicine, nutrition services, a health library, and a variety of classes and events. Learn more about our support services »
You can call the Interventional Cardiology clinic directly to schedule an appointment with a Stanford Health Care doctor. Call 650-725-2621 to make an appointment.
We constantly search for better ways to protect your heart and blood vessels. The following are some examples of our ongoing clinical innovation.
- Using the radial artery: Programs like ours traditionally reach the heart through an artery in the groin. We were among the first to use the wrist’s radial artery, for greater comfort, less bleeding, and quicker recovery. Many people undergoing angioplasty can safely go home the same day.
- Improving stent treatment: We helped develop and quickly adopted specialized cardiac catheterization testing to measure the pressure and flow of blood and see inside clogged arteries to precisely place stents. We offer the first stent that dissolves after opening your artery, with no metal used or left in your body.
- Combining angioplasty with bypass: Before, blocked arteries often required open-heart surgery when angioplasty was not possible. Our hybrid coronary revascularization provides a new alternative, stenting some arteries and bypassing others. We do not open your chest or stop your heart.
- Advancing valve treatment: We were the first hospital in Northern California to perform transcatheter aortic valve replacement (TAVR). We also have extensive experience with transcatheter mitral valve repair (TMVR). We provide options for people who cannot undergo surgery, with the potential to expand these treatments.
- Lowering stroke risk: We were the first center in Northern California to offer the WATCHMAN™ device once it gained FDA approval. We use it for left atrial appendage closure, reducing stroke risk for atrial fibrillation. We plan to study other stroke-reducing devices as they become available.
Yes, Stanford Health Care offers financial assistance for patients who are uninsured or underinsured. Meet with one of our financial counselors to find the best approach to paying for your health care. Financial counselors are available Monday through Friday from 7:00 a.m. – 6:00 p.m. Learn more about financial assistance services »
We strive to see new patients within one to two weeks.
Each of our doctors is scheduled to see patients only one day a week in the clinic. Other time obligations include performing procedures, routine patient management, and research and academic commitments.
Managing treatment for heart disease is a highly personalized process. Our care team guides you every step of the way. If your medical records have not yet been received by our office, one of our staff will advise you on how to obtain them, including:
- A complete list of medications and allergies
- Laboratory work within the last year
- Echocardiogram and/or stress test (report and CD)
- Open heart surgery report
Managing treatment for heart disease is a highly personalized process. Our care team guides you every step of the way. If your medical records have not yet been received by our office, one of our staff will advise you on obtaining them, including:
- A complete list of medications and allergies
- Laboratory work within the last year
- Echocardigram and/or stress test (report and CD)
- Open heart surgery report
Palo Alto Location
The Interventional Cardiology Clinic is located at the following address. Self-parking options are available for a fee. For more information, please see:
Heart and Vascular Center - Heart Clinic 1
300 Pasteur Drive
3rd Floor, Room A31
Stanford, CA 94305
Phone: 650-725-2621
Please plan to arrive 30 minutes prior to your appointment time due to construction near the main hospital campus. This will allow you plenty of time to park, locate your clinic, and complete any additional paperwork.
Please print, fill out, and return the Medical Record Release Form to your new patient coordinator. The medical release form is an authorization form for external facilities to release medical records to Stanford Health Care.
Please call our clinic receptionists at 650-725-2621. They are available Monday through Friday, 8:30 a.m. to 5:30 p.m. to help you with rescheduling or canceling your appointment.
Always feel free to bring someone with you to your appointments. A family member or friend can help ask questions, remember the information your care team gives you, and provide support.
By California state law, you must let your care team know that you would like to record your conversation if you would like help remembering your discussion with your care team.
Write down your questions before your appointment and rank them in order of importance, beginning with the most important ones. If there is not enough time to have all of your questions answered during your appointment, ask your doctor who you can speak with to get your remaining questions answered.
You have multiple options when it comes to paying your bill.
- Pay Online:
- You can log in to MyHealth or the MyHealth mobile app to see and pay your bill.
Already have an account but need help logging in?
Contact the MyHealth Help Desk
- You can also pay as a guest to pay your bill without logging in.
- Pay by mail:
- Stanford Health Care
P.O. Box 740715, Los Angeles, CA 90074-0715
Los Angeles, CA 90074-0715
- Stanford Health Care
- Pay by Phone:
- You can call our Patient Billing Customer Service Office
1-800-549-3720.
- You can call our Patient Billing Customer Service Office
For our latest business hours and for more information about billing, visit our Billing page.
We offer a number of support services at the Heart and Vascular Center, including a Lifestyle Modification program, support groups, integrative medicine, nutrition services, a health library, and a variety of classes and events. Learn more about our support services »
Please call our clinic receptionists at 650-725-2621. They are available Monday through Friday, 8:30 a.m. to 5:30 p.m. to help you reschedule or cancel your appointment.
To determine if a clinical trial is right for you, talk to your doctor. He or she can refer you to a research coordinator for more information on studies that may be right for your specific condition.
You can also find the guidelines for who can participate in a particular clinical trial online. However, it is best to work with your doctor to decide the right care approach for your needs.
View list of open interventional cardiology clinical trials at Stanford
Many of our programs are available to international patients.
Our International Medicine Services team can help you find the right doctor, estimate medical costs, book travel, and get you information about Stanford programs and services. Please call +1 650-723-8561 or email IMS@stanfordhealthcare.org to get started.
To schedule an appointment, please call: 650-723-6459
Our Clinics
The Stanford Interventional Cardiology program is a leader in diagnosing and treating coronary artery disease, offering minimally invasive procedures and treatments.
300 Pasteur Drive 3rd Floor, Clinic A31
300 Pasteur Drive3rd Floor, Clinic A31
Stanford, CA 94305
Phone: 650-725-2621 Getting Here
RELATED CLINICS
3rd Floor, A32
Stanford, CA 94305
Phone: 650-723-6459