[Angina in non-obstructive coronary artery disease: some examples from daily practice]

Area of Science:

• Cardiology
• Internal Medicine

Background:

• Angina in non-obstructive coronary artery disease (ANOCA) affects 20-50% of patients undergoing coronary angiography.
• Despite 2024 European guidelines, ANOCA is frequently underdiagnosed and undertreated.
• ANOCA management differs from obstructive coronary artery disease, requiring specialized assessment.

Purpose of the Study:

• To provide a practical guide for managing ANOCA patients.
• To emphasize comprehensive coronary functional evaluation.
• To highlight optimal risk factor management for ANOCA.

Main Methods:

• Review of current literature and clinical guidelines.
• Focus on diagnostic interpretation and tailored treatment strategies.
• Emphasis on individualized patient care based on accurate clinical assessment.

Main Results:

• ANOCA diagnosis may involve microvascular dysfunction or vasospasm.
• Individualized treatment is crucial for symptom regression and improved quality of life.
• Timely diagnosis and therapeutic approaches are essential.

Conclusions:

• Effective ANOCA management requires a shift from traditional obstructive disease approaches.
• Comprehensive coronary functional evaluation is vital for accurate diagnosis.
• Optimizing risk factors and tailoring treatment significantly improves patient outcomes and quality of life.