Coronary Microvascular Angina: A State-of-the-Art Review

Angina pectoris affects about 112 million people worldwide . Up to 60–70% of patients, undergoing invasive coronary angiography due to angina and demonstrable myocardial ischemia with provocative tests, do not have epicardial coronary disease obstructive enough to explain these symptoms. The myocardial ischemia consequent to Coronary Microvascular Dysfunction (CMD) is responsible of what is defined as microvascular angina (MVA).
MVA is a frequent condition, present in up to 40–50% of patients undergoing coronary angiography for angina and/or positive ischemia tests. Patients with MVA could have similar manifestations to those with epicardial coronary artery disease, like angina pectoris, atypical angina or angina-equivalent symptoms Furthermore, it is also associated with a poor cardiovascular prognosis and reduced quality of life, Cardiologists must use the right diagnosis approach to detect these cases and improve patients outcomes.