Coronary microvascular disease: Current concepts of pathophysiology, diagnosis and management

Aish Sinha, Haseeb Rahman, Divaka Perera*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

17 Citations (Scopus)


Coronary microvascular disease (CMD) is present in 30% of patients with angina and is associated with increased morbidity and mortality. We now have an improved understanding of the pathophysiology of CMD and the invasive and noninvasive tests that can be used to make the diagnosis. Recent studies have shown that management of CMD guided by physiological testing yields better results than empirical treatment. Despite major advances in diagnosing and stratifying this condition, therapeutic strategies remain limited and poorly defined. This review article discusses recent advances in understanding the pathophysiology of CMD, the modalities that are available to diagnose it clinically, current management options and a look at what is in store for the future.

Original languageEnglish
Pages (from-to)22-30
Number of pages9
JournalCardiovascular Endocrinology and Metabolism
Publication statusAccepted/In press - 2021


  • coronary blood flow
  • coronary flow reserve
  • coronary microvascular disease
  • microvascular resistance
  • nitric oxide
  • physiology-stratified disease endotypes


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