Myocardial Ischemia: Differentiating Between Epicardial Coronary Artery Atherosclerosis, Microvascular Dysfunction and Vasospasm in the Catheterization Laboratory

Overview

Journal J Clin Med

Specialty General Medicine

Date 2024 Jul 27

PMID 39064213

Authors

Giovanni Monizzi

Francesca Di Lenarda

Emanuele Gallinoro

Antonio Luca Bartorelli

Affiliations

Soon will be listed here.

Abstract

Ischemic heart disease is currently the most common cause of mortality and morbidity worldwide. Although myocardial ischemia is classically determined by epicardial coronary atherosclerosis, up to 40% of patients referred for coronary angiography have no obstructive coronary artery disease (CAD). Ischemia with non-obstructive coronary artery disease (INOCA) has typically been underestimated in the past because, until recently, its prognostic significance was not completely clear. This review aims to highlight differences and patterns in myocardial ischemia caused by epicardial obstructive CAD, coronary microvascular dysfunction (CMD) or vasomotor abnormalities and to elucidate the state of the art in correctly diagnosing these different patterns.

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