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Review
. 2024 Aug;49(4):277-281.
doi: 10.1007/s00059-024-05253-2. Epub 2024 Jun 19.

Psychological burden in patients with angina and unobstructed coronary arteries-underestimated, underexplored, undertreated

Peter Ong  1 , Astrid Hubert  2 , Zineb Moussaoui  2 , Raffi Bekeredjian  2 , Frank Vitinius  3   4 , Karl-Heinz Ladwig  5
Affiliations
Review

Psychological burden in patients with angina and unobstructed coronary arteries-underestimated, underexplored, undertreated

Peter Ong et al. Herz. 2024 Aug.

Abstract
in English, German

Patients with angina and unobstructed coronary arteries (ANOCA) are frequently encountered in clinical practice. These cases represent a diagnostic and therapeutic challenge and are often characterized by a long patient journey until a diagnosis of coronary vasomotor disorders is established. Moreover, the unsatisfactory management of such patients leads to insecurity, ongoing symptoms, and psychological sequelae such as anxiety or depression. Currently, the psychological burden in patients with ANOCA is underestimated, underexplored, and undertreated. This review gives a new perspective on the pathophysiology of coronary vasomotor disorders including psychological risk factors and calls for comprehensive care by interdisciplinary ANOCA clinics.

Patienten mit Angina pectoris und nichtstenosierten Koronararterien (ANOCA) finden sich häufig im klinischen Alltag. Diese Fälle stellen eine diagnostische und therapeutische Herausforderung dar und sind oft durch einen langen Weg der Patienten gekennzeichnet, bis die Diagnose einer koronaren Vasomotionsstörung gestellt wird. Darüber hinaus führt die unbefriedigende Versorgung solcher Patienten zu Unsicherheit, fortbestehenden Symptomen und psychologischen Folgen wie Angst oder Depression. Derzeit wird die psychologische Belastung bei Patienten mit ANOCA unterschätzt, sie ist zu wenig erforscht und die Patienten sind unterversorgt. In der vorliegenden Arbeit wird eine neue Sicht auf die Pathophysiologie der koronaren Vasomotionsstörungen einschließlich psychologischer Risikofaktoren gegeben und eine umfassende Versorgung durch interdisziplinäre ANOCA-Zentren gefordert.

Keywords: ANOCA; Angina pectoris, stable; Anxiety; Coronary artery spasm; Depression.

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References

    1. Knuuti J, Wijns W, Saraste A et al (2020) 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J 41(3):407–477 - DOI - PubMed
    1. SCOT-HEART Investigators, Newby DE, Adamson PD, Berry C et al (2018) Coronary CT angiography and 5‑year risk of myocardial infarction. N Engl J Med 379(10):924–933 - DOI
    1. SCOT-HEART investigators (2015) CT coronary angiography in patients with suspected angina due to coronary heart disease (SCOT-HEART): an open-label, parallel-group, multicentre trial. Lancet 385(9985):2383–2391 - DOI
    1. Reynolds HR, Diaz A, Cyr DD et al (2023) Ischemia with nonobstructive coronary arteries: insights from the ISCHEMIA trial. JACC Cardiovasc Imaging 16(1):63–74 - DOI - PubMed
    1. Ong P, Rudolph TK, Wiebe J et al (2024) Angina and no obstruction on coronary angiography : new approaches to the diagnosis and treatment of vasomotor disorders. Inn Med. https://doi.org/10.1007/s00108-024-01690-7 - DOI

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