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Microvascular Angina: Diagnosis and Management
Haider Aldiwani1,2, Suzan Mahdai2, Ghaith Alhatemi3
1Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center Los Angeles, California, US.
European Cardiology
|December 24, 2021
Summary
Microvascular angina, a cause of chest pain without obstructive coronary artery disease, lacks clear treatment guidelines. This review details updated diagnostic criteria and evidence-based treatments for this condition.
Area of Science:
- Cardiology
- Vascular Biology
Background:
- Ischaemia with no obstructive coronary artery disease (INOCA) is increasingly recognized.
- Microvascular angina is a significant contributor to INOCA, posing higher risks for major adverse cardiac events.
- Current diagnosis and treatment lack evidence-based guidelines, leading to empirical management.
Purpose of the Study:
- To present an updated approach for diagnosing microvascular angina.
- To discuss evidence-based pharmacological and non-pharmacological treatments for microvascular angina.
Main Methods:
- Review of recent literature and proposed standardized diagnostic criteria by the Coronary Vasomotion Disorders International Study Group.
- Inclusion of both invasive and non-invasive diagnostic approaches.
- Synthesis of current evidence for treatment strategies.
Main Results:
- Standardized diagnostic criteria for microvascular angina have been proposed.
- A gap exists in high-level evidence for treatment, necessitating an updated review.
- Pharmacological and non-pharmacological treatment options are being explored.
Conclusions:
- Accurate diagnosis of microvascular angina is crucial for risk stratification.
- Evidence-based guidelines are needed to optimize management.
- This review provides an updated perspective on diagnosis and treatment options.
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