Coronary microvascular dysfunction: Considerations for diagnosis and treatment
Benita Tjoe, Lili Barsky, Janet Wei, Bruce Samuels, Babak Azarbal, C. Noel Bairey Merz, Chrisandra Shufelt
Abstract
Ischemia and no obstructive coronary artery disease (INOCA) is an increasingly recognized cause of angina, and it is more commonly diagnosed in women. Coronary microvascular dysfunction (CMD), or the abnormal dilation and constriction of the small vessels of the heart, is the underlying cause of INOCA in one-half of cases. This review discusses coronary microvascular pathophysiology, considerations for invasive coronary function testing and noninvasive diagnostic modalities, implications for management, and remaining knowledge gaps.
Topics & Concepts
MedicineCardiologyCoronary artery diseaseInternal medicineAnginaPathophysiologyFractional flow reserveIschemiaEndothelial dysfunctionConstrictionDilation (metric space)Myocardial ischemiaCoronary angiographyMyocardial infarctionMathematicsCombinatoricsCardiac Imaging and DiagnosticsCoronary Interventions and DiagnosticsAcute Myocardial Infarction Research