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Updated: Sep 8, 2025

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Coronary microvascular dysfunction: Phenotype-specific targeted therapies.

Gianluca Mincione1, Matteo Maurina2, Alice Benedetti3

  • 1Department of Cardiology, Maasstad Hospital, Rotterdam, South Holland, the Netherlands; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Cardiology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.

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Summary

Coronary microvascular dysfunction is frequently underdiagnosed and lacks effective treatments. This review details its pathology and associated syndromes to guide tailored diagnosis and therapy.

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Area of Science:

  • Cardiology
  • Vascular Biology
  • Internal Medicine

Background:

  • Coronary microvascular dysfunction (CMD) is a significant clinical challenge.
  • It is often underdiagnosed, leading to delayed or inappropriate patient management.
  • Limited therapeutic options currently exist for CMD.

Purpose of the Study:

  • To provide a comprehensive overview of coronary microvascular dysfunction pathology.
  • To correlate CMD with specific linked syndromic presentations.
  • To propose tailored diagnostic and therapeutic strategies for CMD based on its clinical associations.

Main Methods:

  • Literature review focusing on CMD pathology and clinical manifestations.
  • Analysis of syndromic presentations associated with CMD.
  • Synthesis of diagnostic and therapeutic approaches.

Main Results:

  • Detailed description of the underlying pathophysiology of CMD.
  • Identification of key syndromic patterns linked to CMD.
  • Outline of evidence-based diagnostic criteria and treatment modalities.

Conclusions:

  • Understanding CMD pathology and its syndromic links is crucial for accurate diagnosis.
  • Personalized diagnostic and therapeutic strategies can improve outcomes for patients with CMD.
  • Further research is needed to expand therapeutic options for this condition.