Coronary Microvascular Dysfunction: A Practical Approach to Diagnosis and Management

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.