REVIEW   

Minerva Cardioangiologica 2020 April;68(2):153-63

DOI: 10.23736/S0026-4725.20.05070-7

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Coronary microvascular dysfunction

Vincenzo SUCATO ✉, Giuseppina NOVO, Antonino SALADINO, Salvatore EVOLA, Alfredo R. GALASSI

Division of Cardiology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) “G. D’Alessandro”, Paolo Giaccone University Hospital, University of Palermo, Palermo, Italy

Patients with coronary microvascular dysfunction (CMVD) represent a widespread population and despite the good prognosis, many of them have a poor quality of life with strong limitations in their daily activities because of the angina symptoms. This article summarizes the most frequent clinical presentation pictures like stable and unstable microvascular angina. Main risk factors are discussed, followed by the latest updates on the subject about different pathogenic hypotheses, diagnosis and treatment. Not very well understood microvascular alterations, like slow flow phenomenon and no reflow are discussed and both prognosis and the impact of the disease in the quality of life are analyzed.

KEY WORDS: Microvascular angina; Myocardial ischemia; Hearth failure