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Updated: Dec 12, 2025

Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
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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

Insights

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.

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.

Keywords:
Coronary vascular dysfunctionCoronary vasospasmGenderINOCAMicrovascular angina

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