Microvascular Angina

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  • Microvascular dysfunction is now known to be responsible for morbidity and mortality in many different cardiovascular diseases. Besides its role in angina, it is likely to play a role in heart failure with preserved ejection fraction, Takotsubo syndrome and various inflammatory diseases associated with ischemia and atherosclerosis.

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    Microvascular dysfunction is now known to be responsible for morbidity and mortality in many different cardiovascular diseases. Besides its role in angina, it is likely to play a role in heart failure with preserved ejection fraction, Takotsubo syndrome and various inflammatory diseases associated with ischemia and atherosclerosis.

    Coronary microvascular disease can be diagnosed by means of invasive coronary reactivity testing and noninvasively by echocardiography, CT, MRI and PET. Unfortunately, treatment has been more empiric, and is not well evaluated by randomised trials. Beta-blockers, nitrates and calcium channel blockers have all been used with varying degrees of success. Given its prevalence, particularly among women, its increased recognition and importance mandates further research into prompt diagnosis and more robust studies of its treatment.

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