Giulia Ghizzoni, Luigi Di Serafino, Giulia Botti, Domenico Galante, Domenico D'Amario, Stefano Benenati, Filippo Luca Gurgoglione, Renzo Laborante, Graziella Pompei, Italo Porto, Gianluca Calogero Campo, Giampaolo Niccoli, Giovanni Esposito, Antonio Maria Leone, Alaide Chieffo
{"title":"[Ischemia with non-obstructive coronary artery disease: state-of-the-art review].","authors":"Giulia Ghizzoni, Luigi Di Serafino, Giulia Botti, Domenico Galante, Domenico D'Amario, Stefano Benenati, Filippo Luca Gurgoglione, Renzo Laborante, Graziella Pompei, Italo Porto, Gianluca Calogero Campo, Giampaolo Niccoli, Giovanni Esposito, Antonio Maria Leone, Alaide Chieffo","doi":"10.1714/4101.40990","DOIUrl":null,"url":null,"abstract":"<p><p>Chest pain affects more than 100 million people globally, however up to 70% of patients undergoing invasive angiography do not have obstructive coronary artery disease and ischemia with non-obstructive coronary artery disease (INOCA) is often a cause of the clinical picture. The symptoms reported by INOCA patients are very heterogeneous and often misdiagnosed as non-cardiac leading to under-diagnosis/investigation and under-treatment. The underlying pathophysiological mechanisms of INOCA are multiple and include coronary vasospasm and microvascular dysfunction. Most importantly, this condition must not be considered benign: compared to asymptomatic individuals, INOCA patients present an increased incidence of cardiovascular events, rehospitalizations, as well as impaired quality of life, with increasing costs for healthcare systems. The aims of this review are to describe the pathophysiological and clinical characteristics of INOCA and to provide guidance to the medical community on the diagnostic approaches and management of INOCA, also via a series of clinical case reports.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.7000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Giornale italiano di cardiologia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1714/4101.40990","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Chest pain affects more than 100 million people globally, however up to 70% of patients undergoing invasive angiography do not have obstructive coronary artery disease and ischemia with non-obstructive coronary artery disease (INOCA) is often a cause of the clinical picture. The symptoms reported by INOCA patients are very heterogeneous and often misdiagnosed as non-cardiac leading to under-diagnosis/investigation and under-treatment. The underlying pathophysiological mechanisms of INOCA are multiple and include coronary vasospasm and microvascular dysfunction. Most importantly, this condition must not be considered benign: compared to asymptomatic individuals, INOCA patients present an increased incidence of cardiovascular events, rehospitalizations, as well as impaired quality of life, with increasing costs for healthcare systems. The aims of this review are to describe the pathophysiological and clinical characteristics of INOCA and to provide guidance to the medical community on the diagnostic approaches and management of INOCA, also via a series of clinical case reports.