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Related Concept Videos

Imaging Studies for Cardiovascular System III: X-Ray01:20

Imaging Studies for Cardiovascular System III: X-Ray

106
The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
106

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Challenges in diagnosing coronary microvascular dysfunction and coronary vasospasm.

Sonya Burgess1, F Aaysha Cader2, Martha Gulati3

  • 1Department of Cardiology, Nepean Hospital, Sydney, Australia; University of Sydney, NSW, Australia.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
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Summary

Chronic coronary syndromes (CCS) involve angina with nonobstructive coronary arteries (ANOCA) or ischemia with nonobstructive coronary arteries (INOCA). This review addresses diagnostic challenges in coronary microvascular dysfunction and vasospastic disease within ANOCA-INOCA patients.

Keywords:
Angina and nonobstructive coronary artery disease or no coronary disease ANOCA-INOCACoronary Microvascular DysfunctionCoronary function testingEndothelial dysfunctionVasospastic angina

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Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Chronic coronary syndromes (CCS) encompass angina with nonobstructive coronary arteries (ANOCA) and ischemia with nonobstructive coronary arteries (INOCA).
  • ANOCA-INOCA is a common diagnosis in patients presenting with angina or ischemia despite the absence of obstructive coronary artery disease (CAD) on imaging.
  • Coronary microvascular dysfunction (CMD) and vasospastic disease are increasingly recognized as significant contributors to ANOCA-INOCA.

Purpose of the Study:

  • To review current diagnostic challenges for coronary microvascular dysfunction (CMD) and vasospastic disease.
  • To highlight recent guideline updates and ongoing controversies in the diagnosis of ANOCA-INOCA.
  • To underscore the importance of investigating and treating CMD and vasospastic angina (VSA) in patients with CCS.

Main Methods:

  • Literature review focusing on contemporary challenges in diagnosing CMD and VSA.
  • Analysis of recent guideline changes relevant to ANOCA-INOCA.
  • Discussion of current controversies in the field.

Main Results:

  • Diagnostic difficulties persist for CMD and vasospastic disease in the context of ANOCA-INOCA.
  • Recent guidelines offer updated perspectives but controversies remain.
  • CMD and VSA are frequently overlooked, under-investigated, and undertreated entities.

Conclusions:

  • Accurate diagnosis of CMD and vasospastic disease is crucial for managing ANOCA-INOCA patients.
  • Further research and standardized diagnostic approaches are needed.
  • Addressing CMD and VSA can improve outcomes for patients with chronic coronary syndromes.