Korean J Intern Med.  2015 Mar;30(2):140-147. 10.3904/kjim.2015.30.2.140.

Microvascular angina: angina that predominantly affects women

• Park JJ
• Park SJ
• Choi DJ

• KMID: 2160676
• DOI: http://doi.org/10.3904/kjim.2015.30.2.140

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 often labeled as having cardiac syndrome X, also known as microvascular angina (MVA). MVA is defined as angina pectoris caused by abnormalities of the small coronary arteries, and is characterized by effort chest pain and evidence of myocardial ischemia with a non-invasive stress test, although the coronary arteries can appear normal or near normal by angiography. MVA patients are often neglected due to the assumption of a good prognosis. However, MVA has important prognostic implications and a proper diagnosis is necessary in order to relieve the patients' symptoms and improve clinical outcomes. The coronary microvasculature cannot be directly imaged using coronary angiography, due to the small diameter of the vessels; therefore, the coronary microvascular must be assessed functionally. Treatment of MVA initially includes standard anti-ischemic drugs (beta-blockers, calcium antagonists, and nitrates), although control of symptoms is often insufficient. In this review, we discuss the pathophysiology, diagnosis, and treatment of MVA.

Keyword

Microvascular angina; Review

MeSH Terms

Cardiovascular Agents/therapeutic use
Coronary Circulation
Coronary Vessels/physiopathology
Female
Heart Function Tests
Humans
Male
Microcirculation
Microvascular Angina/diagnosis/drug therapy/*epidemiology/physiopathology
Predictive Value of Tests
Risk Factors
Sex Distribution
Sex Factors
Treatment Outcome
Cardiovascular Agents