Microvascular Angina as a Cause of Ischemia: An Update

  • Edina Cenko
  • Peter Louis Amaduzzi
  • Raffaele BugiardiniEmail author


Since initial reports over four decades ago, the diagnosis and the management of “microvascular angina” continue to be a troublesome dilemma for physicians. Microvascular angina is suspected in those patients presenting with angina or angina-like chest pain whose coronary angiograms show no evidence of obstructive coronary artery disease. Many of these patients often complain of chest pain and disability for years, and the morbidity is considerable. Earlier reports have questioned the presence of ischemia in such patients. Recent investigations have sought to demonstrate an association of chest pain with the occurrence of adverse events including cardiac death and nonfatal myocardial infarction. The role of coronary microvascular function remains controversial with regards to pathophysiology, diagnosis and management.


Women Coronary vasospasm Microvascular angina Coronary microvascular dysfunction Endothelial dysfunction Coronary angiography Non-obstructive coronary artery disease 



American College of Cardiology


Angiotensin-converting enzyme


Acute coronary syndromes


American Heart Association


Coronary artery disease


Coronary Artery Surgery Study


Calcium channel blockers


Coronary computed tomography angiography


Coronary flow reserve


Coronary microvascular dysfunction


Cardiac magnetic resonance imaging


Coronary vascular dysfunction




Enhanced external counterpulsation


Evaluation of Methods and Management of Acute Coronary Events


European Society of Cardiology


Fractional flow reserve


Global Registry of Acute Coronary Events


High-density lipoprotein


Heart Outcome Prevention Evaluation


Index of microvascular resistance


Intravascular ultrasound


Low-density lipoprotein


Microvascular angina


Positron emission tomography


Randomized clinical trials


Seattle Angina Questionnaire


single photon emission computed tomography


Thrombolysis in Myocardial Infarction


Transthoracic doppler echocardiography


Vascular Interaction With Age in Myocardial Infarction


Women’s Ischemia Syndrome Evaluation


Conflict of Interest Statement

We declare that we have no conflict of interest.


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Edina Cenko
    • 1
  • Peter Louis Amaduzzi
    • 1
  • Raffaele Bugiardini
    • 1
    Email author
  1. 1.Department of Experimental, Diagnostic and Specialty MedicineUniversity of BolognaBolognaItaly

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