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Updated: May 6, 2026
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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
7.7K
Management of microvascular angina pectoris
Gaetano A Lanza1, Rossella Parrinello, Stefano Figliozzi
1Department of Cardiovascular Sciences Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy, galanza@alice.it.
Summary
Microvascular angina (MVA), caused by small coronary artery issues, presents with effort-induced chest pain and normal angiography. Standard treatments are often insufficient, necessitating additional therapies for symptom relief.
Area of Science:
- Cardiology
- Vascular Medicine
Background:
- Microvascular angina (MVA) involves chest pain due to small coronary artery dysfunction.
- Typical MVA patients experience effort-related angina, show signs of myocardial ischemia on stress tests, yet have normal coronary angiograms.
Purpose of the Study:
- To review the current understanding and treatment strategies for microvascular angina.
- To highlight the challenges in managing persistent symptoms and refractory cases of MVA.
Main Methods:
- Literature review of studies on microvascular angina.
- Analysis of treatment approaches, including standard anti-ischemic drugs and additional therapeutic options.
Main Results:
- Standard anti-ischemic drugs (beta-blockers, calcium antagonists, nitrates) are initial treatments but often provide insufficient symptom control.
- Additional drugs like ranolazine, ivabradine, ACE inhibitors, and others show potential for managing MVA symptoms.
- Alternative therapies such as spinal cord stimulation and rehabilitation programs may benefit refractory MVA patients.
Conclusions:
- MVA requires tailored treatment strategies beyond initial anti-ischemic therapy.
- A range of pharmacological and non-pharmacological interventions can be employed for persistent or refractory MVA symptoms.
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