Invasive Endotyping of Angina Pectoris with Nonobstructive Coronary Arteries

Abstract

Patients with chest pain are frequently diagnosed with angina pectoris with nonobstructive coronary arteries (ANOCA). The pathophysiology mainly involves the following mechanisms: structural or functional impairment of the microcirculation, functional impairment of the epicardial arteries, or a combination of both. This review describes the diagnosis of ANOCA, focusing on comprehensive coronary functional testing, resulting in more accurate endotyping and subsequent targeted treatment. It also determines the theoretical basis and practical aspects with graphic examples of the examination.

Keywords

angina with nonobstructive coronary artery disease - comprehensive coronary functional testing - coronary microcirculation - microvascular angina - vasospastic angina - coronary thermodilution - acetylcholine testing

Publication History

Article published online:
08 August 2025

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