Angina is a condition that affects over 112 million people around the world.1 Many patients with angina undergo coronary angiography to assess the epicardial arteries and identify the root cause of angina.1 Unfortunately, angiography cannot assess the microcirculation—responsible for much of the regulation and distribution of blood flow to the myocardium.2 This means the majority (59%) of patients assessed for angina are found to have no angiographic abnormalities, but still have symptoms of a coronary disorder.3,4
Additionally, 20-30% of patients continue to experience persistent angina even after percutaneous coronary intervention (PCI), making repeat visits to the cardiologist’s office, where a lack of a clear diagnosis can make it difficult to determine a clear plan for disease management. These patients with ischemia and no obstructive coronary artery disease (INOCA) and/or post-PCI angina may be suffering from Coronary Microvascular Dysfunction (CMD),5 defined as impaired blood flow to the microcirculation.2
Hear Prof. Divaka Perera, a consultant cardiologist from London, UK, discuss why measuring microvascular function for CMD can improve patient management.
INOCA is not benign2 or a final diagnosis. Up to 50% of stable patients undergoing angiography have INOCA who may be suffering from CMD.4
Additionally, these patients have an increase in diastolic dysfunction and cardiac death2
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