Key result
Coronary microvascular dysfunction remains an elusive explanation for symptoms and poor prognosis in women with INOCA.
Coronary microvascular dysfunction is a complex disease entity that may explain symptoms and poor prognosis in women with angina and no obstructive coronary artery disease, though diagnostic challenges remain.
CMD should not yet guide management in women with angina and no obstructive CAD; leaves open need for validated diagnostics and prospective trials.
A large proportion of women with chest pain have no obstructive coronary artery disease. Recent studies have demonstrated that these women continue to have symptoms and are at increased risk of cardiovascular morbidity and mortality. Coronary microvascular dysfunction (CMD) leads to an impairment of blood flow regulation to the myocardium and possible transient ischaemia. CMD is a disease entity with several pathophysiologic aspects and diagnostic modalities continue to be developed. However, due to the complexity of the disease, it remains elusive whether CMD is the explanation for the symptoms and the poor prognosis in women with angina and no obstructive coronary artery disease.
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Michelsen et al. (2017) conducted a review in Stable angina pectoris and no obstructive coronary artery disease. Coronary microvascular dysfunction remains an elusive explanation for the symptoms and poor prognosis in women with stable angina and no obstructive coronary artery disease.
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