AI Insight
Coronary microvascular dysfunction (CMD) and vasomotor disorders are increasingly recognized as significant non-obstructive causes of myocardial ischaemia and anginal symptoms. Since 2023, both American and European clinical practice guidelines have formally incorporated recommendations to evaluate CMD in patients with chronic coronary syndromes. Functional coronary testing is now endorsed as a diagnostic tool to identify and characterize the specific mechanism of vascular dysfunction in affected patients.
Why it matters
This shift in clinical guidelines has direct implications for the diagnosis and management of millions of patients experiencing angina without obstructive coronary artery disease, a population historically underdiagnosed and undertreated. Broader adoption of functional coronary testing could improve targeted treatment strategies and patient outcomes.
Over the past two decades, recognition that non-obstructive causes of myocardial ischaemia account for anginal symptoms in millions of people has grown substantially. Since 2023, American and European clinical practice guidelines have recommended considering coronary microvascular dysfunction (CMD) or vasomotor disorders in patients with chronic coronary syndromes,1,2 as well as using functional coronary testing to reach a diagnosis and to characterise the dominant mechanism or endotype of vascular dysfunction.
Source: [Comment] Microvascular dysfunction in atherosclerotic coronary disease