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Microvascular angina: angina that predominantly affects women

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In women receiving evaluation for suspected ischemic symptoms, a “normal”diagnosis is five times more common than it is in men. These women are oftenlabeled as having cardiac syndrome X, also known as microvascular angina (MVA). MVA is defined as angina pectoris caused by abnormalities of the small coronaryarteries, and is characterized by effort chest pain and evidence of myocardialischemia with a non-invasive stress test, although the coronary arteries can appearnormal or near normal by angiography. MVA patients are often neglecteddue to the assumption of a good prognosis. However, MVA has important prognosticimplications and a proper diagnosis is necessary in order to relieve the patients’symptoms and improve clinical outcomes. The coronary microvasculaturecannot be directly imaged using coronary angiography, due to the small diameterof the vessels; therefore, the coronary microvascular must be assessed functionally. Treatment of MVA initially includes standard anti-ischemic drugs (β-blockers,calcium antagonists, and nitrates), although control of symptoms is often insufficient. In this review, we discuss the pathophysiology, diagnosis, and treatment ofMVA.

Abstract

In women receiving evaluation for suspected ischemic symptoms, a “normal”diagnosis is five times more common than it is in men. These women are oftenlabeled as having cardiac syndrome X, also known as microvascular angina (MVA). MVA is defined as angina pectoris caused by abnormalities of the small coronaryarteries, and is characterized by effort chest pain and evidence of myocardialischemia with a non-invasive stress test, although the coronary arteries can appearnormal or near normal by angiography. MVA patients are often neglecteddue to the assumption of a good prognosis. However, MVA has important prognosticimplications and a proper diagnosis is necessary in order to relieve the patients’symptoms and improve clinical outcomes. The coronary microvasculaturecannot be directly imaged using coronary angiography, due to the small diameterof the vessels; therefore, the coronary microvascular must be assessed functionally. Treatment of MVA initially includes standard anti-ischemic drugs (β-blockers,calcium antagonists, and nitrates), although control of symptoms is often insufficient. In this review, we discuss the pathophysiology, diagnosis, and treatment ofMVA.

참고문헌 (53)

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