Women often experience chest symptoms differently than men. The Women's Ischemia Syndrome Evaluation (WISE) study is one of the primary studies changing the way women's heart disease is detected and treated. For men, heart disease often manifests as blockage in the large arteries of the heart. One of the major discoveries of the WISE study is that many women with chest pain or other symptoms have microvascular disease, a narrowing of the small arteries and blood vessels of the heart. Blood flow to the heart is restricted by fatty plaque buildup, but the restriction does not show up in traditional diagnostic exams.

Until recently, this difference led physicians to discount the possibility of heart disease in many female patients. These women often found themselves making repeated visits to physicians and hospitals trying to unravel the mysteries of their symptoms.

The coronary reactivity test is the gold standard for diagnosing coronary microvascular disease and endothelial wall dysfunction.

The procedure is conducted in the catheterization laboratory and patients should follow the same instructions before and after catheterization explained in the cardiac catherization and angiography section.

The physician will see the patient in clinic a week before the procedure. At that time, the patient will have a pre-procedure chest X-ray, blood work and an EKG. Patients are asked to avoid caffeine 24 hours before the test and to not take beta blockers, calcium channel blockers, ace inhibitors and angiotensin receptor blockers (ARBs) during the 48 hours before the procedure. The exam lasts approximately 60 to 90 minutes, and patients are often released from the outpatient procedure area that afternoon.