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Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

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...
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
Imaging Studies for Cardiovascular System V: CT01:28

Imaging Studies for Cardiovascular System V: CT

Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...

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Related Experiment Video

Updated: May 28, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Beyond Stenosis: Mechanism-Based Multimodality Imaging and Invasive Coronary Function Testing for Endotype Definition

Lucio Giuseppe Granata1, Marcello Marchetta2, Simona Giubilato3

  • 1Cardiology Division, Garibaldi-Nesima Hospital, ARNAS Garibaldi, 95122 Catania, Italy.

Medicina (Kaunas, Lithuania)
|May 27, 2026
PubMed
Summary

Ischaemia with no obstructive coronary artery disease (INOCA) is linked to coronary vascular dysfunction. A mechanism-based diagnostic strategy using multimodality imaging and invasive testing helps define the coronary endotype for targeted therapy.

Keywords:
ANOCACMRINOCAPETcoronary flow reservecoronary microvascular dysfunctioncoronary vasospasminvasive coronary function testingmultimodality imagingmyocardial blood flow

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Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction

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Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
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Last Updated: May 28, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
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Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction

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Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
13:07

Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression

Published on: January 15, 2022

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Vascular Medicine

Background:

  • Angina or objective myocardial ischaemia in the absence of obstructive coronary artery disease (ANOCA/INOCA) is common, causing symptoms and reduced quality of life.
  • Contemporary evidence identifies these syndromes as manifestations of coronary vascular dysfunction, including microvascular and epicardial issues.
  • Current diagnostic approaches often lack a structured, mechanism-based strategy for defining the underlying coronary endotype.

Purpose of the Study:

  • To propose a structured, mechanism-based diagnostic strategy for ANOCA/INOCA.
  • To integrate anatomical, perfusion, and functional testing for comprehensive coronary characterization.
  • To link diagnostic findings to targeted therapy through an endotype-driven approach.

Main Methods:

  • Review of contemporary evidence on coronary vascular dysfunction and diagnostic modalities.
  • Emphasis on multimodality imaging (CT angiography, PET, CMR) and invasive coronary function testing (ICFT).
  • Integration of anatomical assessment, quantitative perfusion imaging, and ICFT (coronary flow reserve, microvascular resistance, acetylcholine testing).

Main Results:

  • A shift from a stenosis-centred to a physiology- and mechanism-based approach is recommended.
  • Multimodality imaging and ICFT enable comprehensive characterization of coronary physiology and vasomotor function.
  • A pragmatic framework linking diagnostic findings to targeted therapy is proposed.

Conclusions:

  • Endotype-driven management of ANOCA/INOCA can close the gap between diagnosis and treatment.
  • A structured, mechanism-based diagnostic strategy improves patient outcomes.
  • This approach facilitates targeted therapy for ischaemia with no obstructive coronary artery disease.