Edit concept Question Editor Create issue ticket

Microvascular Angina


Presentation

  • This review briefly addresses the clinical presentation, mechanisms and management of patients with chronic primary stable MVA.[ncbi.nlm.nih.gov]
  • From the group of patients in the present study who complained of chest pain and did not present with epicardial stenosis, MVA was diagnosed in 23.4% of the patients, which was consistent with the rate reported by previous studies ( 22, 25 ).[physiology.org]
  • There is at present no known cure however a change in lifestyle is important. Patients should start following healthier diets which are low in saturated fats, and should participate in regular physical activities.[en.wikipedia.org]
Abdominal Obesity
  • The risk factors include abdominal obesity, meaning excessive fat tissue in and around the abdomen, atherogenic dyslipidemia which is a blood fat disorder, and elevated blood pressure. [2] Other risk factors are insulin resistance or intolerance to glucose[en.wikipedia.org]
Raynaud Phenomenon
  • Some studies have found increased risk of other vasospastic disorders in cardiac microvascular angina parients, such as migraine and Raynaud's phenomenon.[en.wikipedia.org]
Italian
  • Cattolica del Sacro Cuore, Rome, Italy Correspondence to Filippo Crea, MD, Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma E-mail: filippo.crea@unicatt.it Received 11 July, 2017 Revised 30 January, 2018 Accepted 1 February, 2018 2018 Italian[journals.lww.com]
Atrial Septal Defect
  • Left main coronary trunk compression by dilated main pulmonary artery in atrial septal defect. Report of three cases. J Thorac Cardiovasc Surg 104 : 449–452, 1992. PubMed ISI Google Scholar 11.[physiology.org]
Rigor
  • Based on these results, we rigorously diagnosed the condition of the patients and obtained accurate results with no contradictions.[physiology.org]
Heart Disease
  • More: Ongoing Trials Canadian Cardiovascular Society Guidelines for the diagnosis and management of stable ischemic heart disease 28 May 2014 - Publisher: Canadian Cardiovascular Society The main focus of this guideline is on adult patients with suspected[evidence.nhs.uk]
  • ATP-CFR, adenosine triphosphate-induced coronary flow reserve; VSA, vasospastic angina; IHD, ischemic heart disease. Intracoronary ACh-provocation test.[physiology.org]
Hypertension
  • An orally active epoxide hydrolase inhibitor lowers blood pressure and provides renal protection in salt-sensitive hypertension. Hypertension 46 : 975–981, 2005. Crossref PubMed ISI Google Scholar 14.[physiology.org]
  • CMVD can be found in many cardiac or systemic diseases, e.g. cardiomyopathies, coronary atherosclerosis, immunological conditions, systemic hypertension.[ncbi.nlm.nih.gov]
Heart Failure
  • Microvascular angina is an chronic long term condition which increases the risk of heart attack and other cardiac events such as heart failure and frequent hospital admissions.The treatment consists of drugs, mainly to relieve chest pain, but a very important[en.wikipedia.org]
  • We excluded patients with possible heart failure (left ventricular ejection fraction 12-mm left ventricular wall thickness in echocardiography), severe hypertension (HT; 160/110 mmHg), valvular heart disease, and malignant diseases.[physiology.org]
Vascular Disease
  • This study was supported in part by Grants-in-Aid for the Japan Heart Foundation, Tokyo, and the Japan Vascular Disease Research Foundation, Kyoto, Japan. No conflicts of interest, financial or otherwise, are declared by the author(s).[physiology.org]
Suggestibility
  • In some MVA patients, both the early appearance of ECG abnormalities and/or angina during the stress test and the lack of response to sublingual nitrate administration often suggests a microvascular origin of symptoms.[ncbi.nlm.nih.gov]
  • However, the low rate of increase in the MVA PM group suggests dysfunctional EET upregulation.[physiology.org]
  • Reviews Determinants of long-term clinical outcomes in patients with angina but without obstructive coronary artery disease: a systematic review and meta-analysis 24 April 2018 - Publisher: European Heart Journal Review of data from 54 studies (n 35,039) suggests[evidence.nhs.uk]
  • Older people are more at risk to develop this condition, and there is some evidence that suggests that there are genetic mutations that predispose to the syndrome. [3] Women are more prone to this condition than men, as well as those who have a history[en.wikipedia.org]
Withdrawn
  • Vasoactive drugs, including calcium-antagonists, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and nitrates were withdrawn at least 5 days before patients entered this study; sublingual nitroglycerin was withdrawn within 24[physiology.org]

Workup

Dyslipidemia
  • Dyslipidemia (DLP) was defined as low-density lipoprotein 140 mg/dl, high-density lipoprotein 150 mg/dl.[physiology.org]
  • The risk factors include abdominal obesity, meaning excessive fat tissue in and around the abdomen, atherogenic dyslipidemia which is a blood fat disorder, and elevated blood pressure. [2] Other risk factors are insulin resistance or intolerance to glucose[en.wikipedia.org]

Treatment

  • […] part of the treatment is regularly visiting the doctor and repeating the tests to make sure the condition was taken care of in full.[en.wikipedia.org]
  • Read Summary - More: Systematic Reviews The Effect of IV Cangrelor and Oral Ticagrelor Study Source: UK Clinical Trials Gateway - UKCTG - 05 April 2016 Coronary Syndrome (ACS), High On-treatment Platelet Reactivity (HTPR), Microvascular Obstruction (MVO[evidence.nhs.uk]
  • Treatment Treatment of MVA includes full control of cardiovascular risk factors and all other conditions that might impair clinical outcomes (i.e. inflammatory status, oestrogen deficiency, high adrenergic activity).[ncbi.nlm.nih.gov]
  • Coronary microvascular dysfunction, microvascular angina, and treatment strategies. JACC Cardiovasc Imaging 8 : 210–220, 2015. Crossref PubMed ISI Google Scholar 23.[physiology.org]

Prognosis

  • Prognosis has been reported to be good in patients with MVA in the absence of conditions known to be associated with increased risk.[ncbi.nlm.nih.gov]
  • […] and management of stable ischemic heart disease 28 May 2014 - Publisher: Canadian Cardiovascular Society The main focus of this guideline is on adult patients with suspected or known SIHD, covering 4 fundamental processes: establishing diagnosis and prognosis[evidence.nhs.uk]
  • Acetylcholine-provoked coronary spasm at site of significant organic stenosis predicts poor prognosis in patients with coronary vasospastic angina. J Am Coll Cardiol 66 : 1105–1115, 2015. Crossref PubMed ISI Google Scholar 15.[physiology.org]

Pathophysiology

  • […] develop this condition, and there is some evidence that suggests that there are genetic mutations that predispose to the syndrome. [3] Women are more prone to this condition than men, as well as those who have a history of heart disease in the family. [4] Pathophysiology[en.wikipedia.org]
  • A pathophysiologically based approach should be preferred over a ‘first line’ and ‘second line’ recommendation.[ncbi.nlm.nih.gov]
  • Microvascular coronary dysfunction in women-pathophysiology, diagnosis, and management. Curr Prob Cardiol 36 : 291–318, 2011. Crossref PubMed ISI Google Scholar 20. Kubota T, Chiba K, Ishizaki T.[physiology.org]

Prevention

  • Node et al. ( 25 ) reported that EETs prevented leukocyte adhesion to the vascular wall by a mechanism involving inhibition of transcription factor, nuclear factor-κB, and IκB kinase.[physiology.org]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!