Refractory Angina with Myocardial Ischemia in the Absence of Obstructive Coronary Artery Disease: A Case Report
Introduction
Angina pectoris, the most common symptom of ischemic heart disease, affects approximately 112 million people globally. A large proportion of patients (up to 70%) undergoing coronary angiography because of angina and evidence of myocardial ischemia do not have obstructive coronary arteries, a condition termed INOCA – ischemia with non-obstructive coronary arteries.–
Coronary microvascular dysfunction and epicardial vasospasm, alone or in combination with coronary artery disease (CAD), are adjunctive mechanisms of myocardial ischemia. Discrimination of epicardial coronary artery vasospasm from coronary microvascular dysfunction permits specific and distinct treatment and provides prognostic information to patients and their physicians.
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