Sidik, N., McDermott, M., McEntegart, M. B. and Berry, C. (2020) Chest pain without obstructive coronary artery disease: a case series report. European Heart Journal: Case Reports, 4(3), pp. 1-6. (doi: 10.1093/ehjcr/ytaa060) (PMID:32617474) (PMCID:PMC7319819)
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Abstract
Background: Ischaemic heart disease is a leading cause of mortality in women. Even in those without obstructive coronary artery disease (CAD), women with angina continue to have increased mortality. There are gender differences in prevalence of different pathophysiologies, including functional disorders such as microvascular and vasospastic angina. Case summary: We describe four cases of angina in women with no obstructive CAD, in whom coronary function testing was performed. These four patients were diagnosed with disorders of coronary vasomotion, including vasospastic angina and different endotypes of microvascular angina. Discussion: This case series highlights the different mechanisms of ischaemia in the absence of obstructive CAD. Patients with angina and no obstructive CAD classified by computed tomography coronary angiography may have myocardial ischaemia due to microvascular angina, vasospastic angina, or both. Conventional investigations risk under-diagnosing, and as a consequence under-treating, patients with these conditions. Coronary function testing, in the form of diagnostic guidewire-based tests and adjunctive acetylcholine provocation, has proven to be critical in the accurate diagnoses and appropriate management of these patients.
| Item Type: | Articles |
|---|---|
| Additional Information: | This research was also supported by a BHF Centre of Research Excellence award (RE/18/6134217). |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | McEntegart, Dr Margaret and Berry, Professor Colin and Sidik, Ms Novalia |
| Authors: | Sidik, N., McDermott, M., McEntegart, M. B., and Berry, C. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
| Journal Name: | European Heart Journal: Case Reports |
| Publisher: | Oxford University Press |
| ISSN: | 2514-2119 |
| ISSN (Online): | 2514-2119 |
| Published Online: | 24 April 2020 |
| Copyright Holders: | Copyright © 2020 The Authors |
| First Published: | First published in European Heart Journal: Case Reports 4(3): 1-6 |
| Publisher Policy: | Reproduced under a Creative Commons license |
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