Related Experiment Video

Updated: Jul 11, 2025

A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
09:33

A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology

Published on: February 7, 2015

16.4K

Beyond Coronary Artery Disease: Assessing the Microcirculation

Sonal Pruthi1, Emaad Siddiqui1, Nathaniel R Smilowitz2

  • 1Division of Cardiology, Department of Medicine, NYU Langone Health, 550 First Avenue, New York, NY 10016, USA.

Cardiology Clinics
|November 10, 2023
PubMed

Insights

Ischemic heart disease (IHD) affects millions, but many patients lack blockages in major arteries. Microvascular angina due to coronary microvascular dysfunction (CMD) is a key cause, highlighting the need for better understanding and treatment of CMD.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Internal Medicine

Background:

  • Ischemic heart disease (IHD) impacts over 20 million US adults.
  • Atherosclerosis of epicardial coronary arteries is the traditional cause of IHD.
  • Nearly half of patients with stable angina and IHD lack obstructive epicardial coronary artery disease.

Purpose of the Study:

  • To explore the significance of ischemia with nonobstructive coronary arteries (INOCA).
  • To highlight coronary microvascular dysfunction (CMD) as a frequent cause of INOCA and microvascular angina.
  • To emphasize the potential of understanding CMD pathophysiology, diagnosis, and treatment for improving IHD patient outcomes.

Main Methods:

  • Review of existing literature on IHD, INOCA, and CMD.
  • Analysis of clinical data from patients undergoing coronary angiography.
  • Pathophysiological and diagnostic approaches to CMD.

Main Results:

  • A significant proportion of patients with IHD and angina do not have obstructive epicardial coronary artery disease.
  • Coronary microvascular dysfunction (CMD) is a primary driver of microvascular angina in these patients.
  • INOCA represents a substantial clinical challenge requiring further investigation.

Conclusions:

  • Coronary microvascular dysfunction (CMD) is a critical, often overlooked, contributor to ischemic heart disease.
  • Improved understanding and management of CMD are essential for enhancing care for patients with IHD.
  • Further research into CMD pathophysiology, diagnosis, and treatment is warranted to improve clinical outcomes.

Keywords:
Coronary flow reserveCoronary microvascular diseaseCoronary microvascular dysfunctionCoronary physiologyHyperemic microvascular resistanceINOCAIndex of microcirculatory resistanceIschemia with nonobstructive coronary arteries

More Related Videos

Non-invasive Assessment of Microvascular and Endothelial Function05:41

Non-invasive Assessment of Microvascular and Endothelial Function

Published on: January 29, 2013

16.3K
Author Spotlight: A Pharmacodissection Approach to Uncover Mechanisms in Cardiovascular Disease Risk Populations08:21

Author Spotlight: A Pharmacodissection Approach to Uncover Mechanisms in Cardiovascular Disease Risk Populations

Published on: July 21, 2023

1.3K

Related Concept Videos

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
14
Atherosclerosis II: Clinical Manifestations and Diagnostic Tests01:27

Atherosclerosis II: Clinical Manifestations and Diagnostic Tests

Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
10
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

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...
9
Assessment of the Cardiovascular System II: Inspection01:29

Assessment of the Cardiovascular System II: Inspection

Inspection is the initial step in assessing the cardiovascular system. It involves a detailed visual examination that provides crucial information about a patient's circulatory and cardiac health. This systematic process, conducted from head to toe, helps identify signs of cardiovascular conditions by observing physical appearance, skin and mucous membranes, jugular and carotid pulsations, chest symmetry, and the condition of the extremities.
Head and Neck
267