OP16
THE INVISIBLE HAZARD: A CASE OF MICROVASCULAR ANGINA AND IMPLICATIONS FOR OCCUPATIONAL HEALTH
- Lau, ST4, Optima Health Ltd, Nottingham, UK
Background
Microvascular angina (MVA) is a common cause of angina with non-obstructive coronary arteries. NHS diagnostic delays occur due to limited access to definitive tests. This creates an occupational health (OH) challenge in safety-critical roles where inherent job triggers (sudden exertion, emotional stress) directly provoke symptoms.
Aims
This report aimed to: 1) Illustrate MVA’s occupational implications using a prison officer case, 2) Analyse diagnostic barriers and gender disparities, and 3) Propose a pre-diagnosis OH risk assessment framework.
Methods
A comprehensive case analysis of a 60-year-old male prison officer diagnosed with MVA via private cardiac MRI was conducted. The OH risk assessment juxtaposed the unpredictable physical and emotional triggers of his frontline role against strict medical advice to avoid sudden stressors. This clinical and occupational analysis was contextualised within a review of current literature concerning diagnostic pathways and gender bias in MVA management.
Results
The risk assessment concluded that a safe return to full operational duties was unfeasible, necessitating permanent redeployment. Comparative analysis indicated that a female officer with identical symptoms might have faced greater diagnostic delays due to recognised investigational bias, thereby prolonging exposure to hazardous work triggers without protective adjustments.
Conclusions
MVA can permanently preclude safety-critical work. OH practitioners must advocate for thorough investigation despite normal initial tests, acknowledging diagnostic limitations and gender bias. Risk assessments should prioritise job demands and symptoms over test results, implementing proactive adjustments to mitigate significant occupational risk.
