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Related Concept Videos

Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

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Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
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Coronary Artery Disease III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

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Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
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Coronary Artery Disease I: Introduction01:30

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Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
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Myocarditis I: Introduction01:21

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Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
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Ischemic Heart Disease: Overview01:17

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Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
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Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Updated: Dec 9, 2025

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

Federico Vancheri1, Giovanni Longo2, Sergio Vancheri3

  • 1Department of Internal Medicine, S.Elia Hospital, 93100 Caltanissetta, Italy.

Journal of Clinical Medicine
|September 9, 2020
PubMed
Summary
This summary is machine-generated.

Coronary microvascular dysfunction (CMD) affects many patients with chest pain and non-obstructive coronary artery disease. Diagnosis relies on functional assessments, as CMD impacts cardiac health and is linked to systemic diseases.

Keywords:
Coronary microcirculationINOCAMINOCAendothelial dysfunctionmicrovascular anginamyocardial ischemia without obstructive coronary disease

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Area of Science:

  • Cardiology
  • Vascular Biology
  • Diagnostic Imaging

Background:

  • Many patients with chest pain lack obstructive coronary lesions, suggesting alternative causes for ischemia.
  • Coronary microvascular dysfunction (CMD) arises from endothelial and smooth muscle cell dysfunction, impairing blood flow regulation.
  • CMD is a key factor in ischemia with non-obstructive coronary artery disease (INOCA) and myocardial infarction with non-obstructive coronary artery disease (MINOCA), particularly in females.

Purpose of the Study:

  • To review the role of coronary microvascular dysfunction (CMD) in patients with chest pain and non-obstructive coronary artery disease.
  • To discuss the clinical implications, associations, and diagnostic approaches for CMD.
  • To highlight CMD as a systemic microvascular disease affecting multiple organs.

Main Methods:

  • Review of existing literature on coronary microvascular dysfunction.
  • Discussion of diagnostic methods including invasive (e.g., CFR, IMR, acetylcholine testing) and non-invasive (e.g., PET, CMR) assessments.
  • Analysis of clinical associations with conditions like HFpEF, diabetes, and inflammatory diseases.

Main Results:

  • Coronary endothelial dysfunction contributes significantly to INOCA and MINOCA.
  • CMD is associated with systemic microvascular disease and conditions such as HFpEF, diabetes, and hypertensive heart disease.
  • Diagnosis of CMD requires functional assessment as coronary microcirculation is not visualized by standard angiography.

Conclusions:

  • Coronary microvascular dysfunction is a crucial diagnosis in patients with angina and non-obstructive coronary artery disease.
  • Functional assessment is essential for diagnosing CMD, which has broad systemic implications.
  • CMD represents a significant cardiovascular risk factor requiring further clinical attention and research.