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Microvascular Angina

An ischemic heart disease in which the epicardial coronary arteries appear normal but microcirculation is impaired.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kardiyoloji department. Book Appointment →

What is Microvascular Angina?

Microvascular angina results from functional and/or structural abnormalities of the coronary arterioles smaller than 500 microns. Conventional coronary angiography shows no obstructive epicardial disease, yet myocardial perfusion is impaired.

It is more common in women and typically presents as chest pain triggered by exertion or stress. Endothelial dysfunction, microvascular remodeling and altered pain sensitivity contribute to the pathophysiology.

Diagnosis can be supported by coronary flow reserve measurement, acetylcholine provocation testing and stress cardiac MRI. Although treatment can be challenging, several options can improve quality of life.

Symptoms

Chest pain triggered by exertion or stress
Pain resolving 10–15 minutes after rest
Variable response to nitroglycerin
Prolonged exercise intolerance
Palpitations and fatigue
Sensation of dyspnea
Coexisting depression and anxiety

Risk Factors

Female sex (especially post-menopausal)
Diabetes mellitus
Hypertension
Hypercholesterolemia
Smoking
Chronic inflammatory disease
Estrogen deficiency

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent angina despite normal angiography
  • Ischemia on stress testing
  • Exertional dyspnea limiting daily life
  • Frequent recurrent chest pain episodes

Treatment Methods

01
Calcium channel blockers and beta-blockers
02
ACE inhibitors and statins
03
Ranolazine and nicorandil
04
Metabolic agents such as trimetazidine
05
Cardiac rehabilitation and regular exercise
06
Cognitive-behavioral therapy and pain management

Which Department to Visit?

You can visit our Kardiyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.