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Updated: Jan 11, 2026
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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
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Invasive Endotyping of Angina Pectoris with Nonobstructive Coronary Arteries
Veronika Gašpárková1, Radka Adlová1, Petr Ošťádal1
1Department of Cardiology, Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.
Summary
Angina in patients with nonobstructive coronary arteries (ANOCA) stems from microcirculation or epicardial artery issues. Comprehensive coronary function testing aids accurate diagnosis and tailored treatment for ANOCA.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Chest pain is a common symptom, often diagnosed as angina pectoris with nonobstructive coronary arteries (ANOCA).
- The underlying causes of ANOCA involve impairments in coronary microcirculation and/or epicardial arteries.
- Accurate diagnosis is crucial for effective management of ANOCA patients.
Purpose of the Study:
- To review the diagnostic approaches for ANOCA.
- To emphasize the role of comprehensive coronary functional testing in ANOCA diagnosis.
- To provide a framework for endotyping and targeted treatment strategies.
Main Methods:
- Review of current literature on ANOCA pathophysiology and diagnosis.
- Focus on comprehensive coronary functional testing methodologies.
- Inclusion of theoretical basis and practical aspects with illustrative examples.
Main Results:
- ANOCA pathophysiology is multifactorial, involving microvascular and/or epicardial coronary artery dysfunction.
- Comprehensive coronary functional testing enables precise endotyping of ANOCA.
- This detailed characterization facilitates personalized treatment plans.
Conclusions:
- Accurate diagnosis of ANOCA is achievable through detailed coronary functional assessment.
- Targeted treatment based on specific endotypes improves patient outcomes.
- This review provides guidance for clinicians on diagnosing and managing ANOCA.
Keywords:
acetylcholine testingangina with nonobstructive coronary artery diseasecomprehensive coronary functional testingcoronary microcirculationcoronary thermodilutionmicrovascular anginavasospastic anginaMore Related Videos
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