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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.

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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

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