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Review
. 2022 Mar 30:9:800918.
doi: 10.3389/fcvm.2022.800918. eCollection 2022.

Coronary Microvascular Angina: A State-of-the-Art Review

Francesco Spione  1   2 , Victor Arevalos  2 , Rami Gabani  2 , Manel Sabaté  2 , Salvatore Brugaletta  2
Affiliations
Review

Coronary Microvascular Angina: A State-of-the-Art Review

Francesco Spione et al. Front Cardiovasc Med. .

Abstract

Up to 60-70% of patients, undergoing invasive coronary angiography due to angina and demonstrable myocardial ischemia with provocative tests, do not have any obstructive coronary disease. Coronary microvascular angina due to a dysfunction of the coronary microcirculation is the underlying cause in almost 50% of these patients, associated with a bad prognosis and poor quality of life. In recent years, progress has been made in the diagnosis and management of this condition. The aim of this review is to provide an insight into current knowledge of this condition, from current diagnostic methods to the latest treatments.

Keywords: INOCA; coronary flow reserve; coronary microvascular dysfunction; microvascular angina; vasospastic angina.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Coronary macro- and microcirculation and microvascular angina endotypes.
FIGURE 2
FIGURE 2
Diagnostic algorithm for no obstructive and obstructive coronary artery disease. CAD, coronary artery disease; FFR, fractional flow reserve; CFR, coronary flow reserve; IMR, index of microvascular resistance; hyperemic microvascular resistance. Positive Acetylcholine Test: >90% reduction in epicardial coronary artery with angina and ECG modifications.
See this image and copyright information in PMC

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