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Updated: Jun 13, 2025

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

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[Coronary microvascular disease, vasospastic angina]

Zsolt Piróth1, Bettina Csanádi1,2, Noémi Bora1,2

  • 11 Gottsegen György Országos Kardiovaszkuláris Intézet Budapest, Haller u. 29., 1096 Magyarország.

Orvosi Hetilap
|October 13, 2024
PubMed

Insights

Microvascular coronary artery disease and vasospastic angina cause angina in patients without obstructive coronary artery disease. Invasive diagnostics and targeted therapies can improve patient quality of life and prognosis.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Angina and myocardial ischemia often occur without obstructive epicardial coronary artery disease.
  • These symptoms are frequently caused by microvascular coronary artery disease or coronary vasospasm.
  • These conditions significantly impact patient quality of life, prognosis, and healthcare resource utilization.

Purpose of the Study:

  • To review the epidemiology, prognosis, and pathomechanisms of microvascular coronary artery disease and vasospastic angina.
  • To provide a technical analysis of invasive diagnostic modalities for these conditions.
  • To discuss current and emerging pharmacologic treatment strategies.

Main Methods:

  • Review of recent publications and consensus documents.
  • Detailed technical analysis of invasive coronary thermodilution and provocation tests.
  • Summary of diagnostic criteria and parameters of microvascular function.

Main Results:

  • Invasive diagnostics objectively elucidate the pathomechanisms of microvascular dysfunction and vasospasm.
  • Established diagnostic criteria allow for the identification of patients who benefit from specific therapies.
  • Systematic application of diagnostic workup improves patient outcomes.

Conclusions:

  • Microvascular coronary artery disease and vasospastic angina are significant causes of angina.
  • Invasive diagnostic techniques are crucial for accurate diagnosis and understanding of pathomechanisms.
  • Targeted medical therapies based on precise diagnosis can improve quality of life and prognosis.

Keywords:
cardiac catheterizationcoronaria-vasospasmuscoronary vasospasmmicrovascular anginamicrovascularis anginaszívkatéterezés

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