0000000000708790
AUTHOR
Sucato V.
[Coronary microvascular dysfunction: past, present, and future of an evolving disease].
Coronary atherosclerosis is the main cause of myocardial ischemia. Nevertheless 10-30% of patients with angina has angiographically normal coronary arteries. In the last 30 years, several studies showed that in these patients the symptoms can be caused by dysfunction of the coronary microcirculation. Coronary microvascular dysfunction (CMVD) occurring in patients affected by specific cardiac or systemic diseases may be due to mechanisms of the underlying disease. On the other hand, in several patients affected by angina with angiographically normal coronary arteries, there is no specific disease, and CMVD only is responsible for the clinical picture. This condition can be defined as leading…
[Ischemia with no obstructive coronary artery disease: microvascular angina and vasospastic angina].
About 40% of patients undergoing coronary angiography for chest pain with anginal features have angiographically normal or near-normal coronary arteries. It was necessary to standardize all myocardial ischemia scenarios in stable patients in the absence of coronary artery disease, therefore the term INOCA (ischemia with non-obstructive coronary artery disease) was coined. The aim of this article is to summarize and to clarify the vast and controversial chapter of INOCA, in order to better understand the pathophysiological, nosographic, diagnostic and therapeutic aspects.