• Eur. J. Intern. Med. · Sep 2024

    Review

    Ischemia with non-obstructive coronary artery (INOCA): Non-invasive versus invasive techniques for diagnosis and the role of #FullPhysiology.

    • Stefano Benenati, Gianluca Campo, Sara Seitun, Serena Caglioni, Antonio Maria Leone, and Italo Porto.
    • Department of Internal Medicine (Di.M.I.), University of Genoa, Genoa, Italy.
    • Eur. J. Intern. Med. 2024 Sep 1; 127: 152415-24.

    AbstractIschemia with non-obstructive coronary arteries (INOCA) is an increasingly recognized entity. It encompasses different pathophysiological subtypes (i.e., endotypes), including coronary microvascular dysfunction (CMD), vasospastic angina (VSA) and mixed entities resulting from the variable combination of both. Diagnosing INOCA and precisely characterizing the endotype allows for accurate medical treatment and has proven prognostic implications. A breadth of diagnostic technique is available, ranging from non-invasive approaches to invasive coronary angiography adjuvated by functional assessment and provocative tests. This review summarizes the strength and limitations of these methodologies and provides the rationale for the routine referral for invasive angiography and functional assessment in this subset of patients.Copyright © 2024 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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