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Angina, “Normal” Coronary Angiography, and Vascular Dysfunction: Risk Assessment Strategies

2007; Public Library of Science; Volume: 4; Issue: 2 Linguagem: Inglês

10.1371/journal.pmed.0040012

1549-1676

Raffaele Bugiardini, Lina Badimón, Peter Collins, Raimund Erbel, Kim Fox, Christian Hamm, Fausto J. Pinto, Annika Rosengren, Christodoulos Stefanadis, Lars Wallentin, Frans Van de Werf,

Coronary Interventions and Diagnostics

Chest pain may be associated with coronary arteries that appear “normal.” Normal is defined here as no visible disease or luminal irregularities (less than 50%) as judged visually at coronary angiography. Normal angiography in patients with chest pain is five times more common in women than in men [1]. Among patients with chest pain and normal angiography, an unknown number are suffering from cardiac pain of ischemic origin. Uncertainty is often difficult to allay, for medical attendants as well as for patients, resulting in perpetuation of symptoms, difficulties in management, and establishment of risk of subsequent coronary events [2]. In this article, we discuss how to stratify risk in patients with chest pain and a normal coronary angiogram. We based our article on a literature review, using the key words “angina with normal angiography,” “angina with normal coronary arteries,” “non-obstructive coronary disease,” or “chest pain of non-cardiac origin,” plus “[a]etiology,” “pathophysiology,” “diagnosis,” “classification,” “prognosis,” or “therapy.” A longer, more detailed version of this paper is found in the supplementary file S1.