Angina pectoris 2023: With and without obstructive coronary artery disease: Epidemiology, diagnosis, prognosis, and treatment

Area of Science:

• Cardiology
• Vascular Medicine

Background:

• Angina represents a major global health burden, contributing to substantial morbidity.
• Current angina evaluation is inconsistent and complicated by numerous contributing factors.
• Diagnosis often overemphasizes epicardial disease, neglecting other potential cardiac, non-cardiac, macrovascular, and microvascular origins of chest pain.

Approach:

• Standardized diagnostic pathways are crucial for consistent angina assessment.
• Novel approaches to angina evaluation are needed to improve diagnostic accuracy.
• Personalized treatment strategies can be developed by better understanding angina etiology.

Key Points:

• Chest pain in angina has multifactorial origins, including cardiac, non-cardiac, macrovascular, and microvascular causes.
• The current diagnostic focus on epicardial disease is insufficient for comprehensive angina evaluation.
• Variability in angina assessment complicates accurate diagnosis and effective management.

Conclusions:

• Implementing standardized diagnostic pathways can enhance the understanding and management of angina.
• Novel assessment strategies hold promise for improving patient outcomes in angina.
• A personalized treatment approach, informed by a thorough understanding of angina causes, is essential for optimal patient care.