Related Experiment Video
Updated: Sep 16, 2025
08:35
Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
Published on: August 17, 2022
2.5K
Persistent Angina With Nonobstructive Coronary Artery Disease: Unmasking Coronary Microvascular Dysfunction
Philip Macanovic1, Kevin Cheng2, Anantharaman Ramasamy1
1Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, Chelsea, London, United Kingdom.
JACC. Case Reports
|July 4, 2025
Summary
Coronary microvascular dysfunction (CMD) can cause angina in cancer survivors. Early, systematic assessment of coronary microvascular function is crucial for identifying this under-recognized cardiotoxicity and guiding treatment.
Area of Science:
- Cardiology
- Oncology
- Medical Diagnostics
Background:
- Coronary microvascular dysfunction (CMD) is a common cause of angina in patients with unobstructed coronary arteries.
- Cancer survivors may have a higher prevalence of CMD due to oncotherapy side effects.
Observation:
- A case of refractory angina in a Hodgkin lymphoma survivor treated with radiotherapy and chemotherapy is presented.
- Advanced diagnostics, including cardiac MRI and invasive coronary physiology, identified CMD.
Findings:
- Coronary microvascular dysfunction (CMD) was identified as a likely sequela of oncotherapy.
- Mechanism-specific treatment was initiated based on diagnostic findings.
Implications:
- CMD may be an under-recognized cardiotoxicity of cancer treatments.
- Multimodal assessment of coronary microvascular function is valuable for diagnosis and stratified management.
- Further research into oncotherapy's role in CMD is warranted.
Keywords:
Hodgkin lymphomaangina with nonobstructive coronary arteriescancercardiac magnetic resonancecoronary microvascular dysfunctionMore Related Videos
Related Concept Videos
01:26Coronary Artery Disease II: Pathophysiology
40
Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
40
01:30Coronary Artery Disease III: Clinical Manifestations
37
Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
37
01:27Coronary Artery Disease V: Interprofessional Care
38
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
38
01:29Angina III: Clinical Manifestations and Assessment
37
Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
37
01:20Angina V: Nursing Management
54
Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
54
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
49
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
49