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Coronary Microvascular Dysfunction: A Practical Approach to Diagnosis and Management

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@article{f334815162e140d3afd218efb74e4bfc,
title = "Coronary Microvascular Dysfunction: A Practical Approach to Diagnosis and Management",
abstract = "PURPOSE OF REVIEW: The purpose of this review is to provide an overview of diagnostic and treatment considerations in patients with coronary microvascular dysfunction (CMD) in the absence of obstructive coronary artery disease (CAD).RECENT FINDINGS: The prevalence of obstructive CAD in unselected patient populations referred for evaluation of angina is less than 10%. A significant proportion of patients with angina and no obstructive CAD have CMD, a condition associated with impaired cardiovascular prognosis. Non-invasive and invasive evaluation of coronary microvascular function is feasible and widely available, yet CMD is underdiagnosed and undertreated. A patient-tailored treatment approach guided by coronary microvascular testing shows promising results for patient-reported outcomes of symptom burden and quality of life. Coronary microvascular testing should be considered in angina patients with no obstructive CAD, before other causes of chest pain are explored. A patient-tailored treatment approach guided by a complete evaluation of epicardial anatomy and macro-and microvascular function may help optimize treatment strategy and prevent unnecessary medical interventions. More research is needed to establish the long-term effect of patient-tailored therapies on risk reduction in CMD.",
keywords = "Coronary artery disease, Coronary microvascular dysfunction, INOCA, Management, Microvascular angina, Stable angina pectoris",
author = "Bechsgaard, {Daria Frestad} and Eva Prescott",
note = "{\textcopyright} 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",
year = "2021",
month = sep,
doi = "10.1007/s11883-021-00947-y",
language = "English",
volume = "23",
pages = "54",
journal = "Current Atherosclerosis Reports",
issn = "1523-3804",
publisher = "Current Science Inc",
number = "9",

}

RIS

TY - JOUR

T1 - Coronary Microvascular Dysfunction

T2 - A Practical Approach to Diagnosis and Management

AU - Bechsgaard, Daria Frestad

AU - Prescott, Eva

N1 - © 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

PY - 2021/9

Y1 - 2021/9

N2 - PURPOSE OF REVIEW: The purpose of this review is to provide an overview of diagnostic and treatment considerations in patients with coronary microvascular dysfunction (CMD) in the absence of obstructive coronary artery disease (CAD).RECENT FINDINGS: The prevalence of obstructive CAD in unselected patient populations referred for evaluation of angina is less than 10%. A significant proportion of patients with angina and no obstructive CAD have CMD, a condition associated with impaired cardiovascular prognosis. Non-invasive and invasive evaluation of coronary microvascular function is feasible and widely available, yet CMD is underdiagnosed and undertreated. A patient-tailored treatment approach guided by coronary microvascular testing shows promising results for patient-reported outcomes of symptom burden and quality of life. Coronary microvascular testing should be considered in angina patients with no obstructive CAD, before other causes of chest pain are explored. A patient-tailored treatment approach guided by a complete evaluation of epicardial anatomy and macro-and microvascular function may help optimize treatment strategy and prevent unnecessary medical interventions. More research is needed to establish the long-term effect of patient-tailored therapies on risk reduction in CMD.

AB - PURPOSE OF REVIEW: The purpose of this review is to provide an overview of diagnostic and treatment considerations in patients with coronary microvascular dysfunction (CMD) in the absence of obstructive coronary artery disease (CAD).RECENT FINDINGS: The prevalence of obstructive CAD in unselected patient populations referred for evaluation of angina is less than 10%. A significant proportion of patients with angina and no obstructive CAD have CMD, a condition associated with impaired cardiovascular prognosis. Non-invasive and invasive evaluation of coronary microvascular function is feasible and widely available, yet CMD is underdiagnosed and undertreated. A patient-tailored treatment approach guided by coronary microvascular testing shows promising results for patient-reported outcomes of symptom burden and quality of life. Coronary microvascular testing should be considered in angina patients with no obstructive CAD, before other causes of chest pain are explored. A patient-tailored treatment approach guided by a complete evaluation of epicardial anatomy and macro-and microvascular function may help optimize treatment strategy and prevent unnecessary medical interventions. More research is needed to establish the long-term effect of patient-tailored therapies on risk reduction in CMD.

KW - Coronary artery disease

KW - Coronary microvascular dysfunction

KW - INOCA

KW - Management

KW - Microvascular angina

KW - Stable angina pectoris

UR - http://www.scopus.com/inward/record.url?scp=85110103459&partnerID=8YFLogxK

U2 - 10.1007/s11883-021-00947-y

DO - 10.1007/s11883-021-00947-y

M3 - Review

C2 - 34268637

VL - 23

SP - 54

JO - Current Atherosclerosis Reports

JF - Current Atherosclerosis Reports

SN - 1523-3804

IS - 9

M1 - 54

ER -

ID: 67015289