OUP user menu

Coronary microvascular dysfunction: an update

Filippo Crea , Paolo G. Camici , Cathleen Noel Bairey Merz
DOI: http://dx.doi.org/10.1093/eurheartj/eht513 1101-1111 First published online: 23 December 2013


Many patients undergoing coronary angiography because of chest pain syndromes, believed to be indicative of obstructive atherosclerosis of the epicardial coronary arteries, are found to have normal angiograms. In the past two decades, a number of studies have reported that abnormalities in the function and structure of the coronary microcirculation may occur in patients without obstructive atherosclerosis, but with risk factors or with myocardial diseases as well as in patients with obstructive atherosclerosis; furthermore, coronary microvascular dysfunction (CMD) can be iatrogenic. In some instances, CMD represents an epiphenomenon, whereas in others it is an important marker of risk or may even contribute to the pathogenesis of cardiovascular and myocardial diseases, thus becoming a therapeutic target. This review article provides an update on the clinical relevance of CMD in different clinical settings and also the implications for therapy.

  • Acute coronary syndromes
  • Coronary microvascular dysfunction
  • Myocardial diseases
  • Coronary microvascular obstruction
  • Stable angina
View Full Text

Sign In

ESC members Follow the 'ESC Member and Congress Delegate Sign In' link below for free online access if your subscription to this journal is via the European Society of Cardiology, either as a member or an ESC Congress delegate. Discover if you are an ESC member here.

Otherwise, if your subscription is via OUP, enter your OUP username and password, or select an alternative sign in option below.

Log in through your institution