Different definition of microvascular angina

Area of Science:

• Cardiology
• Vascular Medicine
• Internal Medicine

Background:

• Microvascular angina (MVA) presents as anginal pain without obstructive coronary artery disease or vasospasm.
• Historically referred to by various terms like 'syndrome X', MVA definitions have lacked consistency.
• Over 40 years since its confirmation, MVA remains a diagnostic challenge.

Purpose of the Study:

• To highlight the diagnostic challenges and inconsistencies in defining microvascular angina.
• To emphasize the need for precise diagnostic criteria for MVA.
• To differentiate primary MVA from secondary MVA for better understanding of disease mechanisms.

Main Methods:

• Review of existing literature and clinical observations concerning microvascular angina.
• Analysis of the etiological factors, including endothelial dysfunction and microvascular abnormalities.
• Discussion of current treatment modalities, primarily calcium channel blockers.

Main Results:

• MVA is linked to organic and functional abnormalities in the heart's small arteries.
• Patients often exhibit endothelial dysfunction affecting both coronary and peripheral arteries.
• While generally having an excellent prognosis, some MVA patients develop severe left ventricular dysfunction.

Conclusions:

• Inconsistent definitions of MVA and related terms complicate diagnosis, prognosis, and treatment.
• Distinguishing primary from secondary MVA is essential for mechanistic and clinical studies.
• There is an urgent need to establish strict diagnostic criteria for microvascular angina.