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Comprehensive Management of ANOCA, Part 1-Definition, Patient Population, and Diagnosis: JACC State-of-the-Art Review

Bruce A Samuels1, Samit M Shah2, R Jay Widmer3

  • 1Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Journal of the American College of Cardiology
|September 13, 2023
PubMed

Insights

Angina with nonobstructive coronary arteries (ANOCA) is a common diagnosis. Coronary function testing (CFT) offers a comprehensive approach to diagnosing ANOCA, improving patient care.

Area of Science:

  • Cardiology
  • Diagnostic Imaging

Background:

  • Angina with nonobstructive coronary arteries (ANOCA) affects up to half of patients with suspected ischemic heart disease.
  • Patients often experience diagnostic delays, symptom burden, and psychological distress.

Purpose of the Study:

  • To outline the diagnostic capabilities of Coronary Function Testing (CFT) for ANOCA.
  • To highlight the spectrum of conditions encompassed by ANOCA.

Main Methods:

  • Utilizes invasive coronary angiography with Coronary Function Testing (CFT).
  • Includes assessment of coronary flow reserve, microcirculatory resistance, and provocative testing.
  • Incorporates intravascular imaging and hemodynamic assessment.

Main Results:

  • CFT enables routine noninvasive and invasive evaluation of ANOCA.
  • Identifies conditions like coronary microvascular dysfunction, spasm, and myocardial bridging.

Conclusions:

  • Advances in CFT facilitate comprehensive diagnosis of ANOCA.
  • Improved diagnostic strategies can potentially alleviate patient distress and improve outcomes.

Keywords:
bridgingchest paincoronary function testingmicrovascularvasospasm

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