Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Sep;13(3):108-111.
doi: 10.15420/icr.2018.15.2.

'Primary' Microvascular Angina: Clinical Characteristics, Pathogenesis and Management

Gaetano Antonio Lanza  1 , Antonio De Vita  1 , Juan-Carlos Kaski  2
Affiliations
Review

'Primary' Microvascular Angina: Clinical Characteristics, Pathogenesis and Management

Gaetano Antonio Lanza et al. Interv Cardiol. 2018 Sep.

Abstract

Microvascular angina (MVA), i.e. angina caused by abnormalities of the coronary microcirculation, is increasingly recognised in clinical practice. The pathogenetic mechanisms of MVA are heterogeneous and may involve both structural and functional alterations of coronary microcirculation, and functional abnormalities may variably involve an impairment of coronary microvascular dilatation and an increased microvascular constrictor activity. Both invasive and non-invasive diagnostic tools exist to identify patients with MVA in clinical practice. Prognosis has been reported to be good in primary MVA patients, although the prognostic implications of coronary microvascular dysfunction (CMVD) in more heterogeneous populations of angina patients need further assessment. Management of primary MVA can be challenging, but pharmacological and non-pharmacological treatments exist that allow satisfactory control of symptoms in most patients.

Keywords: Microvascular angina; angina therapy; clinical outcome; coronary microvascular dysfunction; myocardial ischaemia; normal coronary arteries.

PubMed Disclaimer

Conflict of interest statement

Disclosure: The authors have no conflict of interest to declare.

Figures

Figure 1:
Figure 1:. Abnormalities of Coronary Microvascular Function and Tests Suggested to Investigate these Mechanisms in Patients with Suspected Microvascular Angina
Figure 2:
Figure 2:. Figure 2: Therapeutic Approach in Patients with Primary Stable Microvascular Angina
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Patel MR, Peterson ED, Dai D et al. Low diagnostic yield of elective coronary angiography. N Engl J Med. 2010;362:886–95. doi: 10.1056/NEJMoa0907272. - DOI - PMC - PubMed
    1. Lanza GA, Crea F. Acute coronary syndromes without obstructive coronary atherosclerosis: the tiles of a complex puzzle. Circ Cardiovasc Interv. 2014;7:278–81. doi: 10.1161/CIRCINTERVENTIONS.114.001558. - DOI - PubMed
    1. Lanza GA, Crea F. Primary coronary microvascular dysfunction: clinical presentation, pathophysiology, and management. Circulation. 2010;121:2317–25. doi: 10.1161/CirculationAHA.109.900191. - DOI - PubMed
    1. Ong P, Camici PG, Beltrame JF et al. Coronary Vasomotion Disorders International Study Group (COVADIS). International standardization of diagnostic criteria for microvascular angina. Int J Cardiol. 2018;259:56. doi: 10.1016/j.ijcard.2018.02.088. - DOI - PubMed
    1. Cavusoglu Y, Entok E, Timuralp B et al. Regional distribution and extent of perfusion abnormalities, and the lung to heart uptake ratios during exercise thallium-201 SPECT imaging in patients with cardiac syndrome X. Can J Cardiol. 2005;21:57–62. - PubMed

LinkOut - more resources