Tag: myocardial ischemia and infarction

Research

Phenotype-based management of coronary microvascular dysfunction

40-70% of patients undergoing invasive coronary angiography with signs and symptoms of ischemia are found to have no obstructive coronary artery disease (INOCA). When this heterogeneous group undergo coronary function testing, approximately two-thirds have demonstrable coronary microvascular dysfunction (CMD), which is independently associated with adverse prognosis.

There are four distinct phenotypes, or subgroups, each with unique pathophysiological mechanisms and responses to therapies. The clinical phenotypes are microvascular angina, vasospastic angina, mixed (microvascular and vasospastic), and non-cardiac symptoms (reclassification as non-INOCA). The Coronary Vasomotor Disorders International Study Group (COVADIS) have proposed standardized criteria for diagnosis.

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Around The World

Real Patient Stories

Mary’s story

First came the headaches – worse than migraines – then the shortness of breath and having to lay down after crossing the room.

Five months after my symptoms began, I was diagnosed with a 99% blockage in my LAD and 99% blockage in an artery branch off that.

I was stented and, in doing so, they jailed an artery. I was given Metoprolol and I got worse.

I underwent another Angiogram, and all was fine, so they changed my medication and I began to use my Nitro more.

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Barbara’s story

I am a 62-year-old retired physician. My story began at age 47.

I was a very busy practicing OB/Gyn physician who was otherwise healthy.

I was on call at the hospital, and it was turning out to be one of the busiest days I had ever experienced as a physician. I was in a medical group that took call for 24 hours straight, most of the time working the entire 24 hours.

Halfway through that 24-hour call, I was in the operating room doing a C/Section on a patient. Halfway through the surgery I began to feel crushing chest pain.

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Lynn’s story

I had my first spasm when I was just a young child and continued for almost 50 years with no diagnosis. I always assumed everybody had flushing feelings throughout their body, and hot flashes accompanied by chest pain.

It wasn’t until I was walking my dogs with my sister, one day, and we were going up a steep incline and I couldn’t keep up. I asked her if she felt chest pains when she walked up hills. She looked at me like I was crazy and told me: No!

I then realized something might be wrong with me.

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