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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
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Ischaemia with no obstructive coronary arteries.

R E Konst1, J G Meeder2, M E Wittekoek3

  • 1Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.

Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
|August 12, 2020
PubMed
Summary

Ischaemia with no obstructive coronary arteries (INOCA) is a common heart condition often missed in diagnosis. Early diagnosis and treatment of INOCA are vital for symptom relief and improved cardiovascular health.

Keywords:
Coronary vascular dysfunctionCoronary vasospasmGenderINOCAMicrovascular angina

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Area of Science:

  • Cardiology
  • Vascular Biology

Background:

  • Ischaemia with no obstructive coronary arteries (INOCA) is a prevalent form of ischaemic heart disease, predominantly affecting women.
  • It is often caused by coronary vascular dysfunction, including microvascular dysfunction and epicardial coronary vasospasm.
  • Current diagnostic methods and coronary angiography are insufficient for detecting these underlying vascular issues, leading to INOCA being frequently overlooked.

Purpose of the Study:

  • To provide a comprehensive overview of INOCA.
  • To discuss clinical presentation, pathophysiology, and diagnostic strategies.
  • To outline available treatment options for managing INOCA.

Main Methods:

  • This review synthesizes current literature on INOCA.
  • It examines diagnostic challenges and emerging approaches.
  • It discusses therapeutic interventions for INOCA.

Main Results:

  • INOCA is underdiagnosed due to limitations in standard diagnostic tests.
  • Coronary vascular dysfunction is the primary driver of INOCA.
  • Effective diagnostic and treatment strategies are available.

Conclusions:

  • Despite diagnostic challenges, INOCA can be adequately diagnosed.
  • Timely treatment of INOCA is crucial for symptom management and potentially improving cardiovascular outcomes.
  • Further research, including outcome trials, is needed to advance the field.