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Acute Coronary Syndrome III: Diagnostic Studies

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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...

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Updated: Oct 7, 2025

Non-invasive Assessment of Microvascular and Endothelial Function

Non-invasive Assessment of Microvascular and Endothelial Function

Published on: January 29, 2013

Invasive Assessment of Coronary Microvascular Function.

Fabio Mangiacapra¹, Michele Mattia Viscusi¹, Giuseppe Verolino¹

¹Unit of Cardiovascular Science, Department of Medicine, Campus Bio-Medico University, Via Álvaro del Portillo, 200, 00128 Rome, Italy.

Journal of Clinical Medicine

|January 11, 2022

Summary

Coronary microvascular dysfunction (CMD) poses a diagnostic challenge. Physiology-guided management may improve symptoms in ischemic heart disease patients, but its prognostic impact requires further study.

Keywords:

coronary atherosclerosis coronary physiology microvascular function

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Last Updated: Oct 7, 2025

Non-invasive Assessment of Microvascular and Endothelial Function

Non-invasive Assessment of Microvascular and Endothelial Function

Published on: January 29, 2013

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

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

Published on: March 15, 2022

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats

Published on: June 28, 2019

Area of Science:

Cardiology
Vascular Biology
Diagnostic Imaging

Background:

Myocardial ischemia often occurs without epicardial disease, highlighting the importance of the coronary microvasculature.
Coronary microvascular dysfunction (CMD) is difficult to diagnose due to the small size of the vessels, preventing direct visualization.
Invasive functional assessment tools are crucial for evaluating coronary microvascular function.

Purpose of the Study:

To review the current diagnostic challenges and available tools for assessing coronary microvascular function.
To explore the potential clinical benefits of physiology-guided management for CMD.
To identify the unmet need for further research on the prognostic implications of CMD management.

Main Methods:

Review of current diagnostic tools for invasive assessment of coronary microvascular function.
Analysis of physiological indices for evaluating epicardial and microvascular coronary circulation.
Synthesis of evidence regarding physiology-guided management of CMD.

Main Results:

Invasive assessment tools, combined with physiological indices, offer a comprehensive evaluation of coronary circulation.
Physiology-guided CMD management may lead to symptom improvement in patients with angina and ischemic heart disease.
The prognostic effect of this management strategy remains debated and requires further investigation.

Conclusions:

Comprehensive assessment of coronary circulation involves evaluating both epicardial and microvascular components.
While symptom improvement is suggested, the long-term prognostic benefits of physiology-guided CMD management are not yet established.
Further research is essential to clarify the prognostic role of managing coronary microvascular dysfunction.