Clinico-pathophysiological considerations in coronary microvascular disorders

Around half of the patients undergoing an elective coronary angiogram to investigate typical stable angina symptoms are found have non-obstructive arteries (defined as < 50% stenosis). These younger with a female predilection. While underlying mechanisms responsible for these presentations heterogeneous, structural and functional abnormalities microvasculature highly prevalent. Thus, microvascular dysfunction (CMD) is increasingly recognised important consideration in arteries. This review will focus on primary disorders summarise four common clinical presentation pictures which can be considered endotypes - Microvascular Ischaemia (formerly “Syndrome X”), Angina, Spasm, Coronary Slow Flow. Furthermore, pathophysiological associated CMD also heterogenous. may arise from increased resistance, impaired dilation, and/or inducible spasm, ultimately causing myocardial ischaemia angina. Alternatively, chest pain hypersensitivity receptors rather than ischaemia. two major should when assessing individual picture, ultimately, question arises whether target heart or perception treat anginal symptoms.