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Coronary Microvascular Angina: A State-of-the-Art Review

Francesco Spione1,2, Victor Arevalos2, Rami Gabani2

  • 1Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.

Frontiers in Cardiovascular Medicine
|April 18, 2022
PubMed

Insights

Many patients with angina lack obstructive coronary disease. Coronary microvascular dysfunction is a common cause, impacting prognosis and quality of life, with recent diagnostic and treatment advances.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Diagnostic Imaging

Background:

  • A significant percentage of patients undergoing invasive coronary angiography for angina and ischemia show no obstructive coronary artery disease.
  • Coronary microvascular dysfunction (CMD) is identified as the cause in nearly 50% of these cases, leading to poor prognosis and reduced quality of life.
  • Despite challenges, recent advancements have improved the diagnosis and management of CMD.

Purpose of the Study:

  • To review the current understanding of coronary microvascular angina.
  • To provide insights into contemporary diagnostic methodologies for CMD.
  • To discuss the latest therapeutic strategies for managing this condition.

Main Methods:

  • Literature review of recent studies on coronary microvascular dysfunction.
  • Analysis of diagnostic techniques for assessing coronary microcirculation.
  • Synthesis of current treatment guidelines and emerging therapies.

Main Results:

  • Coronary microvascular dysfunction is a prevalent condition in patients without obstructive coronary artery disease.
  • Diagnostic tools for CMD are evolving, offering better characterization of microvascular function.
  • Therapeutic options are expanding, focusing on symptom relief and improving long-term outcomes.

Conclusions:

  • Coronary microvascular angina is a significant clinical entity requiring recognition and appropriate management.
  • Further research is needed to optimize diagnostic accuracy and therapeutic efficacy for CMD.
  • This review highlights the progress in understanding and treating patients with microvascular dysfunction.

Keywords:
INOCAcoronary flow reservecoronary microvascular dysfunctionmicrovascular anginavasospastic angina

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