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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
PubMed

Insights

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.
Keywords:
Microvascular anginacoronary function testcoronary microvascular dysfunctiondiagnosismanagement

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