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Coronary Microvascular Dysfunction: A Practical Approach to Diagnosis and Management

Daria Frestad Bechsgaard1, Eva Prescott2

  • 1Department of Cardiology, North Zealand University Hospital, University of Copenhagen, Dyrehavevej 29, 3400, Hillerød, Denmark. daria.frestad.bechsgaard@gmail.com.

Current Atherosclerosis Reports
|July 16, 2021
PubMed

Insights

Coronary microvascular dysfunction (CMD) affects many angina patients without obstructive coronary artery disease (CAD). Early diagnosis and tailored treatment of CMD can improve patient outcomes and quality of life.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Coronary microvascular dysfunction (CMD) is prevalent in patients with angina but without obstructive coronary artery disease (CAD).
  • CMD is linked to poorer cardiovascular prognosis and is often underdiagnosed and undertreated.
  • Current diagnostic and treatment strategies for CMD require further optimization.

Purpose of the Study:

  • To review diagnostic considerations for CMD in patients lacking obstructive CAD.
  • To outline current and emerging treatment strategies for CMD.
  • To emphasize the importance of evaluating microvascular function in angina patients.

Main Methods:

  • Review of current literature on coronary microvascular function testing.
  • Analysis of diagnostic criteria and therapeutic approaches for CMD.
  • Synthesis of evidence on the impact of CMD on patient outcomes.

Main Results:

  • Non-invasive and invasive tests for coronary microvascular function are available but underutilized.
  • Patient-tailored treatment based on microvascular testing shows promise for improving symptoms and quality of life.
  • Early consideration of CMD in angina patients without obstructive CAD is recommended.

Conclusions:

  • CMD is a significant condition in patients with angina and non-obstructive CAD.
  • Personalized treatment strategies guided by comprehensive vascular evaluation are crucial for managing CMD.
  • Further research is needed to confirm the long-term benefits of CMD therapies on cardiovascular risk reduction.
Abstract

Keywords:
Coronary artery diseaseCoronary microvascular dysfunctionINOCAManagementMicrovascular anginaStable angina pectoris

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