Related Experiment Video

Updated: Oct 24, 2025

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

5.4K

Diagnostic approach for coronary microvascular dysfunction in patients with chest pain and no obstructive coronary

Gaetano Antonio Lanza1, Doralisa Morrone2, Carmine Pizzi3

  • 1Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Dipartimento di Medicina Cardiovascolare, Roma, Italy.

Trends in Cardiovascular Medicine
|August 13, 2021
PubMed

Insights

Abnormalities in coronary microcirculation can cause acute and chronic cardiac ischemia. This review covers diagnosing microvascular dysfunction and classifying related syndromes, even with normal coronary arteries.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Microcirculation Research

Background:

  • Coronary microcirculation abnormalities are increasingly recognized as a cause of cardiac ischemic syndromes.
  • Microvascular dysfunction is often suspected in patients with angina and normal or near-normal coronary arteries on angiography.

Purpose of the Study:

  • To review the diagnostic strategies for patients with suspected coronary microvascular dysfunction.
  • To propose a classification for acute and chronic microvascular coronary ischemic syndromes.

Main Methods:

  • Review of existing literature on coronary microcirculation and ischemic syndromes.
  • Analysis of diagnostic approaches for microvascular dysfunction.
  • Development of a proposed classification system.

Main Results:

  • Coronary microvascular dysfunction is a significant contributor to both acute and chronic ischemic heart disease.
  • Diagnostic evaluation involves assessing microvascular function in patients with suspected ischemia.
  • A classification framework is proposed for microvascular coronary ischemic syndromes, including myocardial infarction with normal coronary arteries (MINCA).

Conclusions:

  • Coronary microvascular dysfunction is a key factor in ischemic syndromes, often presenting with normal epicardial arteries.
  • A systematic diagnostic approach and clear classification are essential for managing these conditions.
  • Further research into microvascular dysfunction will improve patient outcomes in ischemic heart disease.

Keywords:
Coronary microvascular dysfunctionDiagnosisMicrovascular anginaMyocardial infarction with no obstructive coronary arteries

More Related Videos

Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders05:58

Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders

Published on: February 3, 2021

3.8K
Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm06:18

Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm

Published on: September 17, 2021

1.6K

Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
51
Angina III: Clinical Manifestations and Assessment01:29

Angina III: Clinical Manifestations and Assessment

Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
60
Imaging Studies for Cardiovascular System I:Echocardiography01:17

Imaging Studies for Cardiovascular System I:Echocardiography

Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
532
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
74
Atherosclerosis II: Clinical Manifestations and Diagnostic Tests01:27

Atherosclerosis II: Clinical Manifestations and Diagnostic Tests

Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
94
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

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...
92