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Myocardial Infarction with Non-Obstructive Coronary Arteries: Causes, Work-up and Management

…ACS and troponin elevation. The clinical and electrocardiographic manifestations of STEMI may otherwise resemble those of STEMI associated with obstructive atherosclerotic disease. Patients with MINOCA…

Pre-test Probability and Selection of Non-invasive Testing in Stable Angina

…clinical presentation, including the character and stability of chest discomfort, associated dyspnoea, and the presence of risk factors or previously identified coronary calcification. Age and…

Microvascular Angina and INOCA: Diagnosis with CFR and IMR

…ischaemia. The absence of obstructive disease therefore does not establish a benign diagnosis. ANOCA/INOCA is associated with recurrent symptoms, impaired quality of life, repeated…

Coronary CT Angiography and CAD-RADS Reporting

…earlier techniques. Radiation exposure depends on the protocol and scanner; CAC scanning is associated with a particularly low dose, approximately 1–2 mSv, while contemporary…

Physiological Assessment of Coronary Stenoses and Revascularization Decisions

…Only indices that detect microvascular disease as an independent cause of ischemia, including with non obstructive epicardial arteries (ANOCA/INOCA); CFR has independent prognostic value…

Chronic Coronary Syndrome: Diagnosis and Initial Evaluation

…state. Patients may remain stable for prolonged periods, but chronic coronary disease can progress or destabilize abruptly, leading to an acute coronary syndrome (ACS). Clinical…

Myocardial Perfusion Imaging With SPECT and PET

…Non obstructive coronary atherosclerosis not associated with demonstrable ischaemia may therefore remain undetected unless CT based coronary calcium assessment or another anatomical technique is added…

Refractory Angina: Options When Standard Therapy Fails

…intervention (PCI), including attempted recanalization of a chronic total coronary occlusion. Angina or ischaemia with non obstructive coronary arteries (ANOCA/INOCA), after appropriate investigation has…

Vasospastic (Prinzmetal) Angina: Provocation Testing and Treatment

…this combination is associated with a worse prognosis. VA may occur in the presence of obstructive coronary artery disease (CAD), in non obstructive coronary arteries…

Coronary Anatomy and Segmental Classification for the Clinician

…absence or hypoplasia. Anomalous aortic origin of a coronary artery from the opposite sinus of Valsalva is associated with increased sudden death risk, particularly in…

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